Implementation of dynamic Lycra® orthoses for arm rehabilitation in the context of a randomized controlled feasibility trial in stroke: A qualitative study using normalisation process theory

 So you measured NOTHING about recovery? Useless.

 Implementation of dynamic Lycra® orthoses for arm rehabilitation in the context of a randomized controlled feasibility trial in stroke: A qualitative study using normalisation process theory

Rehabilitation Process and Outcome , Volume 9

NARIC Accession Number: J85746.  What's this?
ISSN: 1179-5727.
Author(s): Delvaux, Joke ; John, Alexandra ; Wedderburn, Lucy ; Morris, Jacqui.
Publication Year: 2020.
Number of Pages: 10.

Abstract: 

Study explored how rehabilitation practitioners implemented dynamic Lycra® orthoses for arm recovery after stroke into rehabilitation practice as part of a feasibility randomized controlled trial. Semi-structured interviews were conducted at the end of the trial with 15 healthcare practitioners involved in delivery of dynamic Lycra® orthoses at 2 inpatient stroke units and their associated rehabilitation hospitals in Scotland. The interviews examined their experiences of orthosis implementation. Normalization Process Theory structured the interview guide and informed data analysis. NVivo software supported data analysis. Practitioners intuitively made sense of the intervention in the face of uncertainty about its precise mechanisms of action (Normalization Process Theory construct: coherence) and espoused commitment to the research, despite uncertainty about orthosis effectiveness (cognitive participation). They did however adapt the intervention based on perceived therapeutic need, their own skillsets and stroke survivor preference (collective action). They were uncertain about benefits (reflexive monitoring). Across the 4 theoretical constructs, ambivalence about the intervention was detected. Ambivalence interfered with implementation – but only to an extent. ‘Good-enough’ coherence, cognitive participation, collective action and reflexive monitoring were sufficient to initiate normalization – as long as implementation did not undermine the relationship between practitioner and stroke survivor. Ambivalence stemmed from practitioners’ uncertainty about the intervention theory and mechanisms of action. Making intervention mechanisms of action more explicit to practitioners may influence how they implement and adapt a research intervention and may determine whether those processes undermine or enhance outcomes.
Descriptor Terms: ASSISTIVE TECHNOLOGY, CLINICAL MANAGEMENT, HEALTH PERSONNEL, INTERNATIONAL REHABILITATION, LIMBS, MOTOR SKILLS, NURSING, OCCUPATIONAL THERAPY, ORTHOTICS, PHYSICAL THERAPY, STROKE.


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Citation: Delvaux, Joke , John, Alexandra , Wedderburn, Lucy , Morris, Jacqui. (2020). Implementation of dynamic Lycra® orthoses for arm rehabilitation in the context of a randomized controlled feasibility trial in stroke: A qualitative study using normalisation process theory.  Rehabilitation Process and Outcome , 9 Retrieved 4/23/2021, from REHABDATA database.