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Virtual Reality Implantation in Paediatric Rehabilitation (IMPLANT-VR4 CHILD)

Recruiting
Conditions
Children with Undergoing Rehabilitation
Interventions
Other: Focus group
Other: Interviews
Other: Implementing facilitating strategies
Registration Number
NCT06627049
Lead Sponsor
Fondation Ildys
Brief Summary

Virtual Reality Implementation in Paediatric Rehabilitation (IMPLANT-VR 4 CHILD) Virtual Reality (VR) and Active Video Games (AVG) are promising devices for children in need of rehabilitation. VR and AVG have been widely studied in research, with promising results in a number of areas, including motor function, cognitive function, pain management and attention disorders.

However, despite these promising results and the enthusiasm they generate in research, VR and AVG are rarely used in clinical practice, particularly in the paediatric services of Ty Yann and Perharidy of the ILDYS Foundation. There is a strong demand from professionals for these tools to be better integrate these devices into their clinical practice.

The project is to conduct an action research with rehabilitation professionals, health managers and children in need of rehabilitation in order to facilitate the implementation of VR and AVG in the paediatric rehabilitation services of Ty Yann and Perharidy. Firstly, the facilitators and barriers present in these services will be identified. Then, specific strategies to facilitate the implementation of VR will be used. Finally, the impact of these strategies on the use of VR will be evaluated.

Detailed Description

Children with chronic conditions and rehabilitation needs may require long periods of care. Some rehabilitation interventions can cause stress, anxiety or pain and may be unmotivating for children. However, in the context of motor learning, for example, current scientific research supports the intensification of training.

Motivation is a fundamental part of rehabilitation treatment. Sometimes the length of treatment can lead to a lack of motivation. If motivation decreases in children, this may lead to a reduction in the intensity required to be effective in rehabilitation. Finding efficient solutions to facilitate the rehabilitation process is therefore a major challenge. Virtual reality (VR) may be interesting to increase the duration of motor rehabilitation while maintaining motivation.

VR is a promising tool to address these challenges. VR can be defined as the digital simulation of a virtual environment with which the user can interact using our own movements. Immersive VR devices use a head-mounted display that allows full visual immersion in the virtual environment. Non-immersive VR devices involve two-dimensional virtual environment in flat-screen displays, and include the category of AVG. It has been studied in many areas of paediatric rehabilitation (motor function, pain management, attention disorders, cognitive function). For example, in motor rehabilitation, the playful aspect of VR helps to maintain children\'s motivation, while facilitating motor learning. VR games can be played at high intensity. Rehabilitation goals can also be set by the child when using VR, increasing the effectiveness of rehabilitation management.

The aim of implementation science is to facilitate the integration and use of evidence in clinical practice. There are often differences between research findings and the methods used in clinical practice. It often takes several years for research findings to be implemented in clinical practice. It is estimated that it takes about 17 years in some fields for a scientific discovery to be used in clinical practice. There are a number of factors that may explain this long delay. First of all, there are several stages in the research process to develop practice guidelines. These stages are relatively long. In addition, clinicians often have little time to read newly published data, and these data are not always easily accessible.

VR is still rarely used into routine clinical practice, despite promising results and the enthusiasm it generates in research. There are barriers, such as the time required to prepare sessions and a lack of knowledge about the devices. Some barriers to the implementation of VR are common to several rehabilitation centres, and are frequently found in the literature, while others are specific to one rehabilitation centre. In order to address the specific barriers, it is necessary to identify them within the rehabilitation centre itself.

Several studies have identified the facilitators and barriers present among rehabilitation professionals. To our knowledge, this work has not been carried out among decision makers (managers and directors of rehabilitation centres), nor among children undergoing rehabilitation. However, the facilitators and barriers to the implementation of VR may come from different levels within the rehabilitation centre. For example, national care policies, funding for VR, the organisation of services, and the beliefs of professionals and children are all factors that can influence the way care is provided and whether or not VR devices are used. Therefore, in order to be as effective and comprehensive as possible when implementing VR in paediatric rehabilitation, it is recommended to consider the facilitators and barriers related to rehabilitation professionals, decision makers and children.

The ILDYS Foundation is a rehabilitation centre. Every week, this institution welcomes around 200 children with disabilities in its different services, located in two sites, Perharidy and Ty Yann. Both sites provide rehabilitation for children and adolescents with chronic conditions that limit their activities and participation and therefore require rehabilitation treatment.

There is a demand from rehabilitation professionals and the decision makers to facilitate the integration of VR, which is currently little used in the services. However, during informal discussions, many barriers were mentioned that could explain the lack of use of VR during rehabilitation sessions.

Action research can be defined as work carried out in collaboration between researchers and participants. This collaboration makes it possible to involve clinicians, decision makers and patients in the study, which can facilitate the implementation of new care strategies.

The main objective of this project is to improve the use of VR in the Ty Yann and Perharidy paediatric rehabilitation centre. In order to carry out this implementation project, the study is divided into three stages:

* First, the facilitators and barriers that exist in the services at Ty Yann and Perharidy will be identified. Several focus groups with rehabilitation professionals, and children in rehabilitation in Ty Yann and Perharidy will be conducted. The investigator will conduct some interviews with decision makers at the ILDYS Foundation. The investigator will collect socio-demographic data from the participants in order to characterise the population involved in this research project. The investigator will also collect data on the use of VR and the ease of use of VR by rehabilitation professionals. Tne investigator will collect socio-demographic data from the participants in order to characterise the population taking part in this research project. Data will also be collected on the use of VR and the ease of use of VR by rehabilitation professionals.

* Secondly, specific strategies to improve the use of VR according to the focus group and interview responses will be implemented.

* Thirdly, the strategies in terms of the number of uses of the VR devices will be evaluated. On the other hand, focus groups and interviews will be used to collect the views of rehabilitation professionals, decision makers and children on the implemented strategies.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
39
Inclusion Criteria

Not provided

Exclusion Criteria
  • Not being able to understand focus group or interview questions.
  • Not being able to communicate during focus groups or interviews.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Rehabilitation professionalsFocus groupPediatric rehabilitation professionals
Rehabilitation professionalsImplementing facilitating strategiesPediatric rehabilitation professionals
Decision makersInterviewshealthcare managers or directors
ChildrenFocus groupChildren in paediatric rehabilitation services
ChildrenImplementing facilitating strategiesChildren in paediatric rehabilitation services
Primary Outcome Measures
NameTimeMethod
Form of the number of uses per weekOctober 2024 - november 2025

This form will be used to record the use of VR tools in paediatric rehabilitation, in order to extract the number of times VR devices are used per week. Thanks to this form, we will be able to know if the use of VR devices has increased after the implementation of the strategies. This form will be introduced before, during and after the implementation of the strategies in order to quantify changes in the use of VR. The professionals will complete this form at each session.

Focus group and interviews based on the Consolidated Framework for Implementation Research (CFIR)October 2024 - november 2025

The CFIR is a conceptual framework used to guide the implementation process. We will use focus groups and interviews to assess facilitators and barriers to the use and the implementation of VR. These results will help us to implement specific strategies. Focus group and interviews will be used to evaluate the strategies. Qualitative methods will be used in Stage 1 to select the strategies to be implemented to improve the use of VR. In Stage 3, the focus group and interviews will be used to gather the views of professionals, decision makers and children on the strategies.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Fondation ILDYS, Site de Ty Yann

🇫🇷

Brest, France

Fondation ILDYS, Site de Perharidy

🇫🇷

Roscoff, France

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