Abstract:

Background:
The UK is increasingly embracing rehabilitation technologies, from mobility aids to smart home systems, to boost independence and ease healthcare demands. Yet adoption remains uneven due to challenges like limited stakeholder training, lack of professional confidence, and low integration into practice. Collaboration among professionals, educators, developers, and those with lived experience is key to sharing insights and identifying training needs. Patient and public involvement (PPI) is the essential first step.

Methods:
Members of the NIHR HealthTech Research Centre in Rehabilitation carried out patient and public involvement (PPI) activities with 15 key stakeholders from the UK. Our goal was to co-design a stakeholder engagement plan, that would support a deeper understanding of their perspectives on rehabilitation technologies and help identify their top priorities for education and training.

The group included:
- 6 rehabilitation professionals: an occupational therapist, physiotherapist, orthotist, speech and language therapist, rehabilitation nurse, and medical registrar.
- 5 individuals with lived experience of life-changing illness or injury, including amputation, stroke, brain injury, hearing loss, and multiple sclerosis.
- 2 healthcare educators with expertise in nursing, physiotherapy, and sports rehabilitation.
- 2 technology innovators.

Approach to PPI:
We prioritised accessibility by using inclusive communication, flexible engagement options, and building trust through co-production. Contributors shared views via asynchronous (email, text, survey, video) and synchronous (meetings, calls) formats. Support was available for accessibility needs and scheduling, including evenings and weekends. To reach under-represented groups, we partnered with local organisations and community leaders. All input was anonymised. Our PPI partner was an equal member of the research team, supported by the project lead. We evaluated the process via a contributor survey and the GRIPP2-SF framework.

Results:
The 15 PPI contributors (aged 28–72) included 8 women, 6 men, and 1 non-binary person. Ethnicities were White (9), Asian (3), Black (2), and Arab (1). Contributions were summarised in collaboration with our PPI partner to ensure accuracy and confidentiality. Evaluation ratings reflected the perceived ease of contribution (listened to, valued, flexible approaches), high accessibility for sharing views (at participant preference, support provided), and the creation of a safe and supportive environment (non-judgmental, inclusive, respectful).

Key insights:
- Technology innovators faced challenges with clinical adoption, patient and professional engagement, and evidencing long-term effectiveness.
- Rehabilitation professionals reported limited training (albeit this varied by profession and technology type), low confidence in using technologies, and barriers like trust in effectiveness, integration into care, and cost.
- Patients highlighted low awareness, lack of training, and the emotional and motivational challenges affecting technology use.

Conclusions:
To bridge the gap between invention and real-world use, innovators must embrace co-design by involving rehabilitation professionals and patients. Understanding their needs is crucial for meaningful engagement with technology. This work informed the co-development of a stakeholder engagement strategy to explore all perspectives and identify key education and training priorities.

Keywords:

Technology, rehabilitation, education, training, healthcare professionals, patients, innovators, industry, healthcare, public involvement.