<p class="first" id="P1">Virtual reality and active video games (VR/AVGs) are promising
rehabilitation tools
because of their potential to facilitate abundant, motivating, and feedback-rich practice.
However, clinical adoption remains low despite a growing evidence base and the recent
development of clinically accessible and rehabilitation-specific VR/AVG systems. Given
clinicians’ eagerness for resources to support VR/AVG use, a critical need exists
for knowledge translation (KT) interventions to facilitate VR/AVG integration into
clinical practice. KT interventions have the potential to support adoption by targeting
known barriers to, and facilitators of, change. This scoping review of the VR/AVG
literature uses the Theoretical Domains Framework (TDF) to (1) structure an overview
of known barriers and facilitators to clinical uptake of VR/AVGs for rehabilitation;
(2) identify KT strategies to target these factors to facilitate adoption; and (3)
report the results of these strategies. Barriers/facilitators and evaluated or proposed
KT interventions spanned all but 1 and 2 TDF domains, respectively. Most frequently
cited barriers/facilitators were found in the TDF domains of Knowledge, Skills, Beliefs
About Capabilities, Beliefs About Consequences, Intentions, Goals, Environmental Context
and Resources, and Social Influences. Few studies empirically evaluated KT interventions
to support adoption; measured change in VR/AVG use did not accompany improvements
in self-reported skills, attitudes, and knowledge. Recommendations to target frequently
identified barriers include technology development to meet end-user needs more effectively,
competency development for end-users, and facilitated VR/AVG implementation in clinical
settings. Subsequent research can address knowledge gaps in both clinical and VR/AVG
implementation research, including on KT intervention effectiveness and unexamined
TDF domain barriers.
</p>