RT Journal Article SR Electronic T1 Factors influencing virtual reality use in paediatric acquired brain injury upper limb rehabilitation: a qualitative study JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e083120 DO 10.1136/bmjopen-2023-083120 VO 15 IS 1 A1 Rathinam, Chandrasekar A1 Farr, William A1 Ray, Daniel A1 Gupta, Rajat YR 2025 UL http://bmjopen.bmj.com/content/15/1/e083120.abstract AB Objective Upper limb movement difficulties in children with acquired brain injury (ABI) result in longer recovery times compared with lower limb. Intensive neurorehabilitation promotes a good long-term functional outcome. Virtual reality (VR) and video game technologies are invaluable adjuncts to traditional neurological rehabilitation as they help to motivate, engage and gain children’s compliance in goal-directed therapy. However, this technology is not routinely used in the National Health Service, UK; it requires embedding to benefit children and their families. VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aimed to understand the factors influencing the use of VR in upper limb rehabilitation in children.VR implementation in rehabilitation practice requires development. The associated influencing factors require further exploration before routine use can be established. This project aims to understand the factors influencing the use of VR in upper limb rehabilitation in children.Design An interpretative qualitative study used focus groups and 1:1 semi-structured interviews conducted in person and online to explore participants’ experiences. These were analysed for inductive overarching themes, particularly focusing on the views of professionals and young people regarding the use of VR in upper limb rehabilitation.Setting Two neurorehabilitation services located in two children’s hospitals in England, UK.Participants Three physiotherapists, five occupational therapists, a play worker and four members from the Young Persons’ Advisory Group took part. Four focus groups with 2–4 participants in each group and two 1:1 semi-structured interviews were conducted. Thematic analysis was used to create the model participants described as the factors that influenced the use of VR in neurorehabilitation.Results Five closely related major themes and thirty associated subthemes were developed: training, knowledge, promotion, consideration of barriers and family factors. There is a lack of knowledge and understanding about the use of VR, its limitations, and the clinicians’ motivation to use it. Training packages with available VR equipment, clinical indicators and scientific evidence are required. Staff need frequent training, logistics (uninterrupted Wi-Fi, software, hardware) and simple instruction manuals.Conclusion To introduce VR into the routine rehabilitation of children with ABI, investment in improving knowledge, frequent training and positive behaviour change among health professionals is needed.Data sharing not applicable as no datasets generated and/or analysed for this study. The participants of this work did not give consent for their data to be shared publicly. Therefore, the research supporting data is not available.