How occupational therapists integrate robotic therapy into routine practice: a qualitative study

PURPOSE: To explore how occupational therapists integrate robotic hand exoskeleton therapy into routine occupational therapy practice for stroke rehabilitation. MATERIALS AND METHODS: This interpretive descriptive study was conducted in two occupational therapy services in Bangkok, Thailand. Participants included seven occupational therapists providing robotic hand exoskeleton therapy and nine people with stroke receiving the intervention as part of routine occupational therapy. Data were collected through semi-structured interviews and structured observations of therapy sessions. Reflexive thematic analysis was used to explore therapists' clinical reasoning, clients' occupational experiences, and therapeutic practices. RESULTS: Five themes were constructed: (1) client readiness and motivation for robotic therapy; (2) time-limited integration within routine service constraints; (3) robotic task selection and adaptation; (4) therapist-supported engagement; and (5) occupational relevance and transfer. Robotic therapy was selectively introduced based on client readiness and motivation, adapted within time and service constraints, actively mediated by therapists during sessions, and variably connected to functional daily activities. CONCLUSIONS: These findings suggest that integration of robotic therapy into occupational therapy practice is shaped by therapists' clinical reasoning, organizational conditions, and client experiences rather than standardized protocols. Understanding these practice-based processes may help inform the implementation of rehabilitation technologies within similar routine stroke rehabilitation services.