A new combined motor and cognitive strategy training intervention for stroke: Stakeholder perceptions

Introduction: Hemiparesis affects about half of persons with chronic stroke and frequently leads to decreased participation in meaningful daily life activities. The purpose of this investigation was to evaluate the perceived acceptability and practicality feasibility of a complex intervention for addressing motor impairment and activity limitations post stroke. The newly developed intervention, Metacognitive Virtual Reality (MetacogVR), combines virtual reality technology to improve motor impairments with task-based, cognitive strategy training for meaningful transfer of skills. Method: Three separate focus groups were held with stakeholders including persons with stroke (n=5), caregivers (n=5), and occupational therapists (n=5). Focus groups were audio recorded and transcribed. Data were analyzed using inductive content analysis. Results: Themes revealed stakeholder perceptions of the intervention as a cost-efficient and transportable intervention. The time commitment of the intervention was acknowledged as intense, but necessary for optimal improvements. Findings also included perceptions of the intervention as highly motivating and client-centered. Essential elements of guided discovery, cognitive strategies, and high repetitions were seen as facilitators of the intervention. Conclusion: Results indicate MetacogVR has positively perceived acceptability and practicality feasibility. Findings warrant further feasibility testing of MetacogVR prior to efficacy testing.