National Rehabilitation Hospital

Assessing the Impact of Previous Experience and Attitudes Towards Technology, On Levels of Engagement in a Virtual Reality Based Occupational Therapy Intervention for Spinal Cord Injury Rehabilitation

Paul O’Raw

The aim of the current research project was to determine if there were significant differences between patients with higher or lower levels of experience with technology in terms of their level of engagement with virtual reality (VR) in occupational therapy, their future uptake of VR technology in therapy, and their attitudes towards technology. Patients’ experience of technology was also examined in relation to demographic characteristics such as age and education level.

Participants were 10 acute SCI patients with complete and incomplete SCI (C5 – L2), and ages ranging from 21 – 73 years (mean = 38.8 years; SD = 21.04). Time post-injury was 6 – 23 weeks (mean = 13.7 weeks; SD = 5.85).

On recruitment patients were asked to rate their level of experience with technology, and were assigned to either a higher or lower experience group based on the median level of experience. There were 5 participants in each group, and they took part in five occupational therapy sessions using the Sony Playstation II EyeToy while their level of participation was recorded by the attending therapist. On completion of the research trials participants were asked to complete a feedback questionnaire aimed at assessing their overall opinion of the experience. The attending therapist was also asked to provide a qualitative assessment of patients’ performance.

Results show that participants with higher levels of experience with technology engaged at higher levels with the EyeToy during therapy. This finding was supported by the qualitative assessment from the attending therapist, who judged those from the higher experience group to be more proactive in their approach to therapy. All participants reported that they would use the EyeToy again if it was introduced as a regular part of therapy, although only 7 out of the 10 patients reported they would use the EyeToy for gentle exercise after discharge from hospital. Participants in the higher experience group were also found to hold a more positive attitude towards technology, and used a wider range of more complex technologies in everyday life than those in the lower experience group, who held a neutral attitude to technology. Analysis of participant demographic information revealed that those in the higher experience group were from a significantly younger age group, and had higher levels of formal education than those in the lower experience group.

These findings indicate that prior experience of technology is a significant influence on patient participation in VR-based occupational therapy, and suggests that not all patients will equally engage with, nor derive the same benefits from, this novel approach to rehabilitation. Rather, the EyeToy should be regarded as one option among many available to therapists to facilitate SCI patients’ rehabilitation, and can be applied with best therapeutic effect only after each patient’s needs and preferences are taken into account.

Final Report presented to the NRH Ethics Committee –  October 2007