A qualitative study to elicit user requirements for lower limb wearable exoskeletons for gait rehabilitation in spinal cord injury.
Diana Herrera-Valenzuela, Laura Díaz-Peña, Carolina Redondo-Galán and 5 others
PMID 37848992WHAT IT FOUND
People with spinal cord injury and clinicians have different priorities for exoskeletons.
Patients want home use and psychological benefits, while clinicians worry about workload and cost. Both groups agree devices must be adjustable and easy to put on. This study reports their preferences, not clinical outcomes.
Key findings
01Patients without prior experience expected the devices to enable sports and independent home use, whereas experienced patients noted current devices were not ready for home use.
02Clinicians identified high purchase cost, increased physical workload, and the need for extensive training as major barriers to implementing exoskeletons in rehabilitation settings.
03Both patients and clinicians agreed that devices must be adjustable to fit different bodies and adapt to changing needs during rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted in Spain within a public health system, so findings on cost and accessibility may not apply to private healthcare systems. The sample was recruited from specific rehabilitation centers, which may limit the transferability of findings to other settings. Qualitative data cannot be generalized statistically to the broader population of people with spinal cord injury. There was a significant difference in time since injury between the subgroups (subacute vs. chronic), which may have influenced expectations.
Declared interests
The study was part of a larger project called TAILOR, funded by the Spanish Ministry of Science and Innovation and the European Regional Development Fund. The authors declared no competing interests.
The easy way to misread this
Do not interpret the patients' expectations of independent home use or sports capability as evidence that current exoskeletons can achieve these outcomes. Experienced patients and clinicians explicitly noted that current devices are not ready for independent home use and face significant accessibility and practical barriers.