“Within Their Spaces, Within Their Context”: Māori Therapists’ Perspectives of Robotic Technology in Upper Limb Stroke Rehabilitation

Abstract

Upper limb impairment following stroke is common, contributing to restrictions in functional capacity and reduced quality of life. Robotic devices are being developed to augment rehabilitation and support upper limb recovery. However, a lack of end-user input has resulted in devices that fail to fully meet therapist and patient needs. In Aotearoa New Zealand, involving Māori (Indigenous) rehabilitation therapists is essential for developing culturally responsive devices and interventions. This qualitative study utilised a Māori-centred approach underpinned by Kaupapa Māori (Indigenous research) principles to explore the requirements for effective upper limb robotic rehabilitation with Māori following stroke. Semi-structured interviews were conducted with six Māori stroke rehabilitation therapists to explore their perspectives. Five interconnected themes were interpreted through thematic analysis. Inequities imposed by The system (Theme 1) and burden from The stroke (Theme 2) profoundly impact Māori people’s experiences of rehabilitation and recovery, requiring devices that avoid perpetuating or exacerbating these challenges. Hononga (Joining and connection) (Theme 3) highlights how robotic devices could support connections to Te Ao Māori (Māori worldview), whānau (family and communities), and meaningful activities. Whanaungatanga (Relationships) (Theme 4), emphasised the importance of building trusting relationships between therapists, patients, and whānau. Therapists can uphold Tino rangatiratanga (Self-determination) (Theme 5) by supporting Māori patients and whānau to have control over their rehabilitation. The participants’ clinical and cultural expertise provided valuable insights for advancing robotic device design and implementation, emphasising the importance of inclusive approaches that address the diverse needs of Māori and promote culturally responsive rehabilitation technology.