title: Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.
abstract: OBJECTIVE
  Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use.
  
  
  METHODS
  A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Self-report and observer-rated outcome measures evaluated therapists' confidence, clinical reasoning and behaviour with respect to MLS use. A focus group captured therapists' perspectives on MLS use during VR-based therapy provision.
  
  
  RESULTS
  The intervention improved self-reported confidence about MLS use as measured by confidence ratings (p <0.001). Chart-Stimulated Recall indicated a moderate level of competency in therapists' clinical reasoning about MLSs following the intervention, with no changes following additional opportunities to use VR (p = .944). On the Motor Learning Strategy Rating Instrument, no behaviour change with respect to MLS use was noted (p = 0.092). Therapists favoured the strategy of transferring skills from VR to real-life tasks over employing a more comprehensive MLS approach.
  
  
  CONCLUSIONS
  The KT intervention improved therapists' confidence but did not have an effect on clinical reasoning or behaviour with regard to MLS use during VR-based therapy.
authors.affiliation: Department of Physical Therapy, Movement Sciences and Rehabilitation, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America.
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Levac
authors.affiliation: Therapy Department, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada.
authors.forename: Stephanie M N
authors.initials: SM
authors.lastname: Glegg
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sveistrup
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Colquhoun
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Miller
authors.affiliation: Physiatry, Élisabeth Bruyère Hospital and Bruyère Continuing Care, Ottawa, Ontario, Canada.
authors.forename: Hillel
authors.initials: H
authors.lastname: Finestone
authors.affiliation: School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: DePaul
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jocelyn E
authors.initials: JE
authors.lastname: Harris
authors.affiliation: Regional Rehabilitation Center, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Velikonja
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026761:Physical Therapy Specialty / Q000193:education*; D018794:Problem-Based Learning; D057566:Self Report; D000071939:Stroke Rehabilitation / Q000379:methods*; D057170:Translational Research, Biomedical / Q000193:education; D063367:Virtual Reality Exposure Therapy / Q000379:methods*