Digital technologies for pediatric rehabilitation: current access and use in the European Rehatech4child survey.

Background: Digital technologies such as robotics and treadmill-systems (RobTS), virtual-reality and active video-gaming (VR-AVG), and telehealth and apps (T&Apps) used within pediatric motor rehabilitation may promote recovery and improve function. However, digital technology uptake may be limited in clinical practice.

Aim: To explore access to and use of digital technologies for pediatric motor rehabilitation (DT4R) in Europe as a function of individual and environmental factors, as well as potential barriers to their use.

Design: This observational study was based on RehaTech4child, a cross-sectional survey (2022), supported by the European Academy of Childhood Disability.

Setting: Online survey available in 20 European languages.

Population: The survey was disseminated through convenience and snowball sampling to pediatric motor rehabilitation professionals in Europe.

Methods: The survey included items on outcomes (access, use, purposes of use and intention to use for the three categories of DT4R, i.e. RobTS, VR-AVG and T&Apps), determinants (socio-demographics, rehabilitation practice) and barriers. The association between access and use, and individual and environmental determinants was assessed using logistic regression adjusted for age, gender and profession.

Results: Of the 1397 responses received, 635 were included. Respectively 67.7% and 74.3% of respondents reported using and having access to at least one of the three categories of DT4R. T&Apps and VR-AVG were used by 50.8% and 45.5% of respondents, respectively, and RobTS by 36.6% (P<0.001). Ease of access was the main determinant of use and frequency of use. Individual (e.g. age) and environmental (e.g. healthcare facility, patients' age) factors were access determinants. At least 70% of professionals intended to use a DT4R if available. Lack of financial resources and training were the most frequently reported severe barriers.

Conclusions: This study found that DT4R were already used in clinical practice by around two-thirds of respondents and that they generally wished to use them even more. Access was the main determinant of use and frequency of use.

Clinical rehabilitation impact: To facilitate access and use of DT4R, infrastructure and financial resources should be outlined, and training opportunities provided for professionals. Practice guidance should be developed and adapted for specific age groups and rehabilitation goals.