Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study

Objective Upper limb movement difficulties in children with acquired brain injury (ABI) result in longer recovery times compared with lower limb. Intensive neurorehabilitation promotes a good long-term functional outcome. Virtual reality (VR) and video game technologies are invaluable adjuncts to tr...

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Main Authors: Rajat Gupta, William Farr, Daniel Ray, Chandrasekar Rathinam
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e083120.full
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author Rajat Gupta
William Farr
Daniel Ray
Chandrasekar Rathinam
author_facet Rajat Gupta
William Farr
Daniel Ray
Chandrasekar Rathinam
author_sort Rajat Gupta
collection DOAJ
description Objective Upper limb movement difficulties in children with acquired brain injury (ABI) result in longer recovery times compared with lower limb. Intensive neurorehabilitation promotes a good long-term functional outcome. Virtual reality (VR) and video game technologies are invaluable adjuncts to traditional neurological rehabilitation as they help to motivate, engage and gain children’s compliance in goal-directed therapy. However, this technology is not routinely used in the National Health Service, UK; it requires embedding to benefit children and their families. VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aimed to understand the factors influencing the use of VR in upper limb rehabilitation in children.VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aims to understand the factors influencing the use of VR in upper limb rehabilitation in children.Design An interpretative qualitative study used focus groups and 1:1 semi-structured interviews conducted in person and online to explore participants’ experiences. These were analysed for inductive overarching themes, particularly focusing on the views of professionals and young people regarding the use of VR in upper limb rehabilitation.Setting Two neurorehabilitation services located in two children’s hospitals in England, UK.Participants Three physiotherapists, five occupational therapists, a play worker and four members from the Young Persons’ Advisory Group took part. Four focus groups with 2–4 participants in each group and two 1:1 semi-structured interviews were conducted. Thematic analysis was used to create the model participants described as the factors that influenced the use of VR in neurorehabilitation.Results Five closely related major themes and thirty associated subthemes were developed: training, knowledge, promotion, consideration of barriers and family factors. There is a lack of knowledge and understanding about the use of VR, its limitations, and the clinicians’ motivation to use it. Training packages with available VR equipment, clinical indicators and scientific evidence are required. Staff need frequent training, logistics (uninterrupted Wi-Fi, software, hardware) and simple instruction manuals.Conclusion To introduce VR into the routine rehabilitation of children with ABI, investment in improving knowledge, frequent training and positive behaviour change among health professionals is needed.
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spelling doaj-art-b20ae685cb1449e48788c07a279039e62025-01-17T23:45:08ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2023-083120Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative studyRajat Gupta0William Farr1Daniel Ray2Chandrasekar Rathinam31 College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK3 Faculty of Education, St. Edmund`s College,University of Cambridge, Cambridge, UK4 Birmingham Women`s and Children`s NHS Foundation Trust, Birmingham, Birmingham, UK1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKObjective Upper limb movement difficulties in children with acquired brain injury (ABI) result in longer recovery times compared with lower limb. Intensive neurorehabilitation promotes a good long-term functional outcome. Virtual reality (VR) and video game technologies are invaluable adjuncts to traditional neurological rehabilitation as they help to motivate, engage and gain children’s compliance in goal-directed therapy. However, this technology is not routinely used in the National Health Service, UK; it requires embedding to benefit children and their families. VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aimed to understand the factors influencing the use of VR in upper limb rehabilitation in children.VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aims to understand the factors influencing the use of VR in upper limb rehabilitation in children.Design An interpretative qualitative study used focus groups and 1:1 semi-structured interviews conducted in person and online to explore participants’ experiences. These were analysed for inductive overarching themes, particularly focusing on the views of professionals and young people regarding the use of VR in upper limb rehabilitation.Setting Two neurorehabilitation services located in two children’s hospitals in England, UK.Participants Three physiotherapists, five occupational therapists, a play worker and four members from the Young Persons’ Advisory Group took part. Four focus groups with 2–4 participants in each group and two 1:1 semi-structured interviews were conducted. Thematic analysis was used to create the model participants described as the factors that influenced the use of VR in neurorehabilitation.Results Five closely related major themes and thirty associated subthemes were developed: training, knowledge, promotion, consideration of barriers and family factors. There is a lack of knowledge and understanding about the use of VR, its limitations, and the clinicians’ motivation to use it. Training packages with available VR equipment, clinical indicators and scientific evidence are required. Staff need frequent training, logistics (uninterrupted Wi-Fi, software, hardware) and simple instruction manuals.Conclusion To introduce VR into the routine rehabilitation of children with ABI, investment in improving knowledge, frequent training and positive behaviour change among health professionals is needed.https://bmjopen.bmj.com/content/15/1/e083120.full
spellingShingle Rajat Gupta
William Farr
Daniel Ray
Chandrasekar Rathinam
Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
BMJ Open
title Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
title_full Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
title_fullStr Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
title_full_unstemmed Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
title_short Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study
title_sort factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation a qualitative study
url https://bmjopen.bmj.com/content/15/1/e083120.full
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AT chandrasekarrathinam factorsinfluencingvirtualrealityuseinpaediatricacquiredbraininjuryupperlimbrehabilitationaqualitativestudy