Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton
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(2019) 16:94
RESEARCH
Open Access
Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton Patricia J. Manns* , Caitlin Hurd and Jaynie F. Yang
Abstract Background: Powered 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. Methods: A 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. Results: The 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). Conclusions: Incorporating 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 registration: www.clinicaltrials.gov (NCT02322125). Registered Dec 22, 2014 – Retrospectively registered after the first 4 participants had enrolled in the study. Keywords: ReWalk, Qualitative
Background 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]). Reports of exoskeleton safety and performance over a number of training sessions are emerging for a few devices including the ReWalk [2–6], the Ekso [7–11], and the Indego [12, 13]. Recent reviews [14–16] provide information * Correspondence: [email protected] Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, AB T6G 2G4, Canada
about performance-based measures such as walking speed and endurance with exoskeleton walking. Walking speed is reported to be greater using an exoskeleton as compared to a reciprocating gait orthosis, but remains well below that required for community ambulation [14]. Walking
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