Abstract

BackgroundPowered exoskeletons for over ground walking were designed to help people with neurological impairments to walk again. Extended training in powered exoskeletons has led to changes in walking and physiological functions. Few studies have considered the perspective of the participants. The users’ perspective is vital for adoption of assistive devices. We explored the expectations and experiences of persons with spinal cord injury, training with the ReWalk exoskeleton.MethodsA qualitative research design with individual interviews was used. Eleven participants with spinal cord injury, taking part in 12 weeks of 4 times weekly training using the ReWalk, were interviewed before, immediately after, and 2 months after training. Interviews were audio recorded and transcribed verbatim. A six stage approach to thematic analysis was used.ResultsThe theme consistently expressed was the exoskeleton allowed participants to do everyday activities, like everyone else, such as looking people in the eye or walking outside. Their experiences were captured in three categories: 1) learning, a description of both expectations for learning and perspectives on how learning occurred; 2) changing, perspectives on perceived changes with training; and 3) contributing, which captured participant perspectives on contributing to research, including the giving of direct feedback regarding the exoskeleton (i.e., what worked and what could be changed).ConclusionsIncorporating the view of the user in the design and refinement of exoskeletons will help ensure that the devices are appropriate for future users. Availability and support for the use of exoskeleton devices in community settings is an interim step to home use as the devices continue to improve.Trial registrationwww.clinicaltrials.gov (NCT02322125). Registered Dec 22, 2014 – Retrospectively registered after the first 4 participants had enrolled in the study.

Highlights

  • Powered exoskeletons for over ground walking were designed to help people with neurological impairments to walk again

  • The number of powered exoskeletons for training and restoring over ground walking in persons with neurological impairments has grown rapidly in the last decade

  • Given that adoption of an assistive device is highly dependent on the user’s perspective [19, 20], it is surprising that little research has focused on participant impressions of these powered exoskeletons and the learning process

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Summary

Introduction

Powered exoskeletons for over ground walking were designed to help people with neurological impairments to walk again. The number of powered exoskeletons for training and restoring over ground walking in persons with neurological impairments has grown rapidly in the last decade (reviewed in Esquenazi et al, see reference [1]). Given that adoption of an assistive device is highly dependent on the user’s perspective [19, 20], it is surprising that little research has focused on participant impressions of these powered exoskeletons and the learning process. A recent literature review [21] reported only 3 of 51 exoskeleton studies gathered user perspectives, and only 2 of the 3 were based on participant experience using the exoskeleton [3, 22], with the third study [23] based on impressions of the idea and potential of powered exoskeletons. Research that seeks and incorporates feedback from people who will potentially use technological advances such as exoskeletons is critically important

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