Abstract
A consequence of a complete spinal cord injury (SCI) is the loss of gait capacity. Wearable exoskeletons for the lower extremity enable household and community ambulation in people with SCI. This study assessed the amount, purpose, and location of exoskeleton use in the home and community environment, without any restrictions. The number of steps taken was read from the exoskeleton software. Participants kept a daily logbook, and completed two user experience questionnaires (Quebec User Evaluation of Satisfaction with assistive Technology (D-QUEST) and System Usability Scale (SUS)). Fourteen people with a complete SCI used the ReWalk exoskeleton a median of 9 (range [1–15]) out of 16 ([12–21]) days, in which participants took a median of 3,226 ([330–28,882]) steps. The exoskeleton was mostly used for exercise purposes (74%) and social interaction (20%). The main location of use was outdoors (48%). Overall, participants were satisfied with the exoskeleton (D-QUEST 3.7 ± 0.4) and its usability (SUS 72.5 [52.5–95.0]). Participants with complete SCI report satisfaction with the exoskeleton for exercise and social interaction in the home and community, but report limitations as an assistive device during daily life.
Highlights
IntroductionIntensity of exoskeleton use are critical. The intensity of walking with an exoskeleton is similar to regular physical activities performed at a moderate intensity[14,15], which is known to yield health b enefits[12]
From participant 7 onwards, osteoporosis was tested with a dual energy X-ray absorptiometry (DEXA)-scan at the hip
The subject-reported primary purpose of exoskeleton use was for individual exercise (90 out of 121 sessions, 74% of all sessions) (Fig. 2)
Summary
Intensity of exoskeleton use are critical. The intensity of walking with an exoskeleton is similar to regular physical activities performed at a moderate intensity[14,15], which is known to yield health b enefits[12]. One study described a gym-based setting for exoskeleton use[19]. Instead of in the actual home and community environment, exoskeleton use was investigated in a gym-based setting. According to Fritz et al.[20], home and community use entails engaging in age normative and meaningful activities such as meeting friends at a pub, attending a graduation ceremony, performing one’s job, or going on holiday[20]. In addition to these social activities, home and community use entails household chores such as cooking or doing the laundry. When users had an exoskeleton at their disposal in the community, the full range of problematic scenarios and safety concerns become apparent[20]. Users’ experiences and health related effects during this period were studied as well
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