Factors Influencing Physiotherapist’s Intention to Use a Novel
Physical Exercise Communication System in Neurorehabilitation
Elise Klæbo Vonstad, Marit N. Olsen, Linda Rennie and Arve Opheim
Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
1 OBJECTIVES
Due to increasing pressure on health care system,
technology will play an important role in
maintaining high quality care for patients. In
rehabilitation after illness or injury, physiotherapist-
guided exercises and subsequent home exercises is
an imperative part of patients’ program for regaining
motor function. The home based exercises
prescribed to the patient are often written down or
printed out on a piece of paper. Consequently, the
patient might feel insecure with regards to knowing
if the exercises are performed correctly. Also, the
therapist does not know if the patient is performing
the exercises with sufficient quality and quantity.
A web-based communication platform for
physical rehabilitation (Mobile Movement Monito-
ring, Sunnaas Rehabilitation Hospital, Norway) has
been developed in a concept, combining mobile
telephone technology and sensor technology. This
platform allows patients to get real-time feedback of
their exercise performance. Furthermore, the
physiotherapist can get an overview of the quality
and quantity of the exercises performed by the
patient. The platform is intended to help address the
upcoming challenges in providing more focused
quality health care as the population ages. The
intention is that this interactive feedback system can
be a valuable tool in motivating patients, and
providing effective physical exercises without the
presence of a physiotherapist, both at the hospital
and at home or in the gym. This gives the
physiotherapist the opportunity to follow up the
patients’ exercise quality and adherence and adjust
the exercises accordingly. There’s a need for
exploring the users’ acceptance of, and attitudes
towards, such a platform as its actual use is
dependent on it being perceived as useful and easy
to implement in the clinical setting by the intended
users (Broens et al 2007, Sharma et al 2010, Vincent
et al 2007). The most common way to explore this is
through the Technology Acceptance Model (TAM,
Davis 1989), a robust questionnaire that inquires the
acceptance of information systems (Chen et al
2011). Various versions of this questionnaire exist,
adjusted to be specific to the technology being
evaluated. For the current subject, the Modified
Technology Acceptance Model (mTAM, Gagnon et
al 2012) was deemed appropriate, as it expands the
original TAM to include key domains related to the
use of such a system in an organizational context,
which have been shown to influence user acceptance
(Gagnon et al 2012). The domains are Perceived
Usefulness (PU), Perceived Ease of Use (PEU),
Attitude (Att), Intention to use (Int), Compatibility
(Comp), Social Norm (SN), Facilitators (Fac) and
Habits (Hab). Intention to Use, or user behavior, is
seen as the main determinant in adoption of
telemonitoring systems (Al-Adwan et al 2013).
Therefore, the aim of this pilot study was to
investigate the level of acceptance of the Mobile
Movement Monitoring platform in specialized
therapists in neurorehabilitation.
2 METHOD
Health professionals from three different specialized
rehabilitation institutions in the county of Akershus,
Norway participated. Prior to answering the
questionnaire, participants were, in a plenary
session, given a standardized oral presentation of
how the system works and its different
functionalities both for the patient and the health
care professional. They were also shown a
demonstration video of a work flow using the
system. To ensure a common base of knowledge the
Questions & Answers-session about the platform
was held after the questionnaires were filled out. The
questionnaire consists of 33 statements: 6 each
regarding Percieved Usefullness and Percieved Ease
of Use, 4 each regarding Attitude, Compatibility and
Social Norm, and 3 each regarding Facilitators,
Habit and Intention. Answers were given on a 1-7
Likert scale, where 1=strongly disagree
and7=strongly agree. The items with reverse scoring
Vonstad, E., Olsen, M., Rennie, L. and Opheim, A.
Factors Influencing Physiotherapist’s Intention to Use a Novel Physical Exercise Communication System in NeuroRehabilitation.
In Extended Abstracts (NEUROTECHNIX 2016), pages 3-5
Copyright
c
2016 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
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Table 1. Relationships between domains.
Variable PEU Att Comp Int
r p r p r p r p
PU
0.55 0.001 0.82 0.000 0.57 0.000 0.66 0.000
PEU
0.59 0.000
Att
0.53 0.001
Fac
0.44 0.007 0.60 0.000
SN
0.46 0.005
Hab
0.49 0.002
7=strongly agree. The items with reverse scoring
were coded so all answers given could be interpreted
in the manner higher score = more positive response
to the statement. Relationships between domains
were analyzed in accordance with the theoretical
model in Gagnon et al (2012), and thus not all
relationships are examined. Descriptive statistics
were extracted, and the relationships between the
different domains were analyzed using the
Spearman’s Rho Correlation Coefficient reported
with p-value (α <0.01) for statistical significance.
3 RESULTS
36 participants completed the mTAM questionnaire.
Mean age=39.9 years (SD 11.4), 27 (75 %) were
women. 29 (81 %) were physiotherapists, 4 (11 %)
were sports educators, 2 (6 %) were human
movement scientists and 1 (3 %) was a general
physician. Mean number of years in current
occupation was 11.9 (SD 8.8), indicating that all
participants were experienced healthcare worker.
The median score (Q1, Q3) was 5.29 (4.7, 6.0) for
Percieved Usefullness, 5.17 (4.5, 5.8) for Percieved
Ease of Use, 5.75 (5.0,6.0) for Attitude, 4.50 (3.8,
4.8) for Compatibility, 4.75 (4.3, 5.6) for Social
Norm, 5.33 (4.3, 6.0) for Facilitators, 3.83 (3.3, 5.7)
for Habit and 5.00 (4.5, 5.3) for Intention.
Results show a generally positive attitude to the
developed platform: Lowest median score was Habit
(3.83), while the highest was Attitude (5.75), and all
other domains had a median score close to or over
5.0, which also was the exact median score of Int.
Domains were significantly correlated (Table 1), and
the highest correlation was between Percieved
Usefullness and Attitude with r=.82 (p=.000).
Attitude was also moderately correlated to Pervieved
Ease of Use, with r=.59 (p=.000). Percieved
Usefullness, Attitude and Facilitators showed the
highest correlations to Intention, with r=.66
(p=.000), r=.53 (p=.001) and r=.60 (p=.000),
respectively.
4 DISCUSSION
The current study explored the level of acceptance
of the Mobile Movement Monitoring system among
physiotherapists in neurorehabilitation. Therapists
were generally positive to the concept. The system
was seen as useful (PU) and easy to use (PEU), and
the attitude (Att) towards the system was good.
Intention has been shown to be most influenced
by Attitude and Facilitators (Gagnon et al 2012).
Results in the current study support these findings.
These two domains represent different contexts of
user acceptance, organizational and personal, and
therefore show that it is imperative to take into
account both these contexts when planning on
implementing a new system such as the current one.
Furthermore, the results from these domains are
moderate to high, which indicates that the therapists
have a positive impression of using the system, and
of the institutions being able to facilitate use of the
system. The lowest median score was Habit, with
3.83, which might show that there are not a lot of
similar systems in use today in these institutions. It
also indicates that healthcare workers in physical
rehabilitation might need systematic training to be
comfortable in using a system like the one proposed.
This is also reflected in the median score of the
domain Compatibility, which show a compatibility
with daily routines that is moderate to low, which
again is correlated to Perceived Usefulness.
5 CONCLUSION
The acceptance of Mobile Movement Monitoring
was moderate to high in the current study. The
system is seen as a useful tool in ensuring the quality
NEUROTECHNIX 2016 - 4th International Congress on Neurotechnology, Electronics and Informatics
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of home-based physical rehabilitation exercises in
neurological patients. The study also shows that
facilitators and habits should be taken into
consideration when planning on implementing such
a platform into the clinical setting in
neurorehabilitation.
REFERENCES
Al- Adwan, Amer; Al- Adwan, Ahmad; Smedley, Jo.
Exploring students acceptance of e-learning using
Technology Acceptance Model in Jordanian
universities. International Journal of Education &
Development using Information. 2013;9 2
Broens TH, Huis in’t Veld RM, Vollenbroek-Hutten MM,
et al. Determinants of successful telemedicine
implementations: A literature study. J Telemed
Telecare 2007;13:303–309.
Chen S, Li S & Li C. Recent Related Research in
Technology Acceptance Model: A literature Review.
Austr J Bus Manag Res 2011; 1(9), 124-127.
Davis FD. Perceived usefulness, perceived ease of use,
and user acceptance of information technology. MIS Q
1989;13, 319–340.
Gagnon M P, Orruño E, Asua J A, Abdeljelil A B,
Emparanza J. Using a Modified Technology
Acceptance Model to Evaluate Healthcare
Professionals’ Adoption of a New Telemonitoring
System. Telem eHealth 2012; 18(1), 54-59.
Sharma U, Barnett J, Clarke M. Clinical users’ perspective
on telemonitoring of patients with long term
conditions: Understood through concepts of Giddens’s
structuration theory & consequence of modernity. Stud
Health Technol Inform 2010;160, 545–549.
Vincent C, Reinharz D, Deaudelin I, et al. Understanding
personal determinants in the adoption of
telesurveillance in elder home care by community
health workers. J Commun Pract 2007;15,99–118.
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