Clinicians’ Experiences of Instrumented Gait Analysis in Management of Patients with Cerebral Palsy: A Qualitative Study
Anna Hebda-Boon, Bairu Zhang, Augustine Amankwah, Adam Shortland, Dylan Morrissey
Abstract
AIM: To identify the interaction of instrumented gait analysis (IGA) training, expertise, and application in gait-related management of cerebral palsy. METHODS: Semi-structured interviews with 20 purposively sampled clinicians with varying professional backgrounds, expertise, and training, analyzed using the framework method. RESULTS: Fifteen sub-themes were identified within three domains: training, equipment/outputs, and roles/reasons under the core theme IGA practice. Findings were illustrated using the Experience/Equipment/Roles/Training (Exp-ERT) Framework which identifies four user categories - based on influencing factors, beset by barriers, with experience reported as a common enabling factor. Clinicians who encountered barriers in one of the domains were categorized as either "frustrated" or "hesitant" users. Those who were no longer using IGA for clinical decisions were designated "confident non-users". Finally, the 'confident experts' reported the required level of training and access to interpret IGA outputs for clinical decision-making. Expertise gained at any level of clinical practice was shown to initiate advancement within domains. CONCLUSIONS: Clinicians encounter a multitude of barriers to IGA practice that can result in failure to progress or impact on clinical decision-making. The Exp-ERT Framework emerges strongly from the data and could serve as an evaluation tool to diagnose barriers to confident expertise and support IGA-related professional development planning.