JMIR Publications

ABSTRACT

Background:

Demand for rehabilitation services and associated technologies is increasing globally due to population ageing and rising chronic disease burden. Despite their potential to enhance access, efficiency, and outcomes, adoption of rehabilitation technologies in clinical practice remains uneven. Barriers include limited workforce capability and confidence, resource constraints, fragmented governance, and challenges integrating technologies into existing systems. Collaboration among health and care professionals, educators, technology professionals (including developers, innovators, and suppliers of rehabilitation technologies) and individuals with lived experience is essential to identify training needs and strengthen capability for technology enabled rehabilitation.

Objective:

This study aimed to develop an in-depth understanding of education and training needs relating to rehabilitation technologies across 3 stakeholder groups—rehabilitation professionals, technology professionals, and individuals with lived experience to inform future cross stakeholder training initiatives.

Methods:

A qualitative study was conducted, primarily across England, using purposive sampling to recruit rehabilitation professionals, technology professionals, individuals with lived experience of injury, illness, or disability. Data were collected through online focus groups and individual interviews and analyzed using reflexive thematic analysis. Although reflexive thematic analysis is inherently interpretive, the initial analysis focused primarily on the descriptive content of participants' accounts. Subsequently, deeper theoretical interpretation was undertaken through application of the COM-B model, selected TDF domains, and CFIR. Themes were subsequently mapped to the Capability, Opportunity, Motivation–Behavior (COM-B) model to identify behavioral determinants with selected domains from the Theoretical Domains Framework (TDF) used to clarify behavioral influences. The Consolidated Framework for Implementation Research (CFIR) was then applied to situate behavioral determinants within organizational and system-level contexts.

Results:

A total of 50 participants contributed to 7 focus groups and 11 individual interviews. Three overarching themes were identified: (1) perceived capability and confidence in technology engagement; (2) system-level resource constraints; and (3) fragmented governance structures and organizational decision making. COM-B mapping indicated that capability-related influences were most prominent among individuals with lived experience, whereas opportunity related and structural constraints were more influential in accounts from rehabilitation and technology professionals. CFIR analysis highlighted that these behavioral determinants were embedded within, and often constrained by, infrastructure, procurement processes, and wider NHS policy environments.

Conclusions:

Individuals with lived experience require accessible, ongoing support to build confidence and skills in using rehabilitation technologies. Rehabilitation professionals and technology professionals emphasized the need for structured education on available technologies and practical training on integrating them into clinical workflows, particularly for telerehabilitation and emerging digital and AI enabled tools. Findings indicate that training initiatives must extend beyond individual skill development to address organizational resources, infrastructure, and governance processes. Coordinated, cross-stakeholder education and training strategies are essential to support equitable and sustainable adoption of rehabilitation technologies within the NHS. Training programs should be co designed across stakeholder groups, embed behavioral and implementation considerations, and align with NHS infrastructure and procurement pathways. Addressing both capability and system level constraints will be critical for achieving widespread, confident, and sustained use of rehabilitation technologies.