Clinical Bottom Line
“How should I apply this information?”
Establishing reliability (intrarater and interrater) is an important step in the development and use of any tool. The Motor Learning Strategy Instrument is a tool to assess the applications of motor learning variables and principles within a therapeutic session. Although excellent intrarater reliability was demonstrated previously, interrater reliability was not found to be sufficient. The researchers sought to compare real-world clinical situations, that is, usual care and virtual reality (VR), but only as a therapist used motor learning strategies in those situations. In this study, the tool was found to be most reliable in coding sessions of usual care as therapists applied motor learning strategies. Clinicians are able to see item examples of strategy categories as they might be applied in sessions with children. Researchers may find use for this tool for comparing usual interventions between settings or between therapists. Academicians might find it useful in providing student feedback on the application of motor learning strategies in usual care in real or simulated patients.
“What should I be mindful about in applying this information?”
Although this study established interrater reliability for the use of this tool in usual care sessions, future development of the tool is necessary to apply it to sessions of VR in practice.
If the instrument is to be used to provide feedback or for research purposes, time-intensive training might be required by the users.
The focus of the interventions was usual care and VR, but this study was not an effectiveness study, that is, comparing the results of usual care and virtual reality. No conclusions are being drawn about the success, failure, or limitations of the interventions.
Karen M Kott, PT, PhD
School of Physical Therapy
Old Dominion University
Sharon Held, PT, DPT, MS, PCS, C/NDT
Department of Physical Therapy
Amherst, New York