Supporting virtual reality and active video game use in pediatric rehabilitation: Protocol for a mixed-methods feasibility study

Abstract

Background Virtual reality (VR) and active video game (AVG) systems that offer repetitive practice and multimodal feedback in engaging environments are attractive pediatric rehabilitation intervention options. Evidence supports their effectiveness to improve functional outcomes in multiple pediatric populations. However, VR/AVG integration into clinical practice faces multiple barriers, including limited access to these often-expensive technologies, a rapid development sector resulting in frequent obsolescence, and insufficient educational resources to help clinicians select appropriate games that match children’s therapeutic objectives. Knowledge translation initiatives that primarily target clinician knowledge and attitudes about VR/AVG use have shown limited success in facilitating adoption. To address these challenges, we used the Consolidated Framework of Implementation Research (CFIR) to structure development of the Technotheque, a multi-faceted VR/AVG support initiative at our large pediatric rehabilitation centre. The Technotheque addresses both access- and knowledge-based barriers to VR/AVG use via a dedicated gameplay space staffed by knowledge brokers who directly support clinicians in VR/AVG implementation in therapy sessions and provide education towards independent VR/AVG use.

Objective To evaluate the feasibility of the Technotheque as a knowledge translation initiative to enhance VR/AVG use at our pediatric rehabilitation centre, as measured by demand, acceptability, adaptation, and implementation criteria.

Methods Convergent mixed-methods design. We will use convenience and snowball sampling strategies to recruit clinicians (physiotherapists, occupational therapists, speech therapists, special educators, and neuropsychologists) to participate in this 4-month study. Following informed consent, participants will complete a modified ‘Assessing the Determinants of Prospective Take-up of Virtual Reality’ (ADOPT-VR2) instrument. Participants can then request individualized training and/or clinical implementation support with our knowledge brokers at a self-determined frequency and duration, and with their choice of clientele. Participants will be free to begin and end their study participation at any point during the four months. Data collection will include study-specific Technotheque pre-session objective and post-session feedback forms, a post-study ADOPT-VR reassessment, a CFIR-based satisfaction questionnaire, and individual semi-structured interviews. Quantitative analyses will examine demand (participant demographics, usage patterns, correlations between usage and ADOPT-VR2 scores), acceptability (satisfaction scores in relation to usage patterns and ADOPT-VR2 changes), adaptation (variety of professions, client populations, and clinical objectives), and implementation (pre-post ADOPT-VR2 changes and patterns of support needs over time). Qualitative data will be deductively analysed using the four feasibility criteria as a coding framework. Quantitative and qualitative results will be integrated to identify areas of alignment and/or divergence.

Results Research Ethics Board approval has been obtained.

Conclusions The Technotheque initiative is designed to address both access and knowledge barriers to VR/AVG use in pediatric rehabilitation. Study results will inform subsequent research efforts to evaluate the effectiveness of VR/AVG as a rehabilitation intervention and to examine the impact of this initiative on sustained VR/AVG use.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study is funded by a Master's scholarship from the Fonds de Recherche du Quebec - Sante to A. Ferron.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Research Ethics Committee of the CHU Sainte Justine gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

There is no data related to this manuscript.

Comments (0)

No login
gif