Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton.
Patricia J Manns, Caitlin Hurd, Jaynie F Yang
PMID 31324256WHAT IT FOUND
People with spinal cord injury described ReWalk training as helping them stand, walk, and do everyday things like peers.
They reported bowel, spasticity, and pain changes, valued purpose and social contact, and said it was not ready for home use.
Key findings
01Participants described the ReWalk as letting them stand, walk outside, meet people at eye level, and do everyday things like their peers.
02Some participants reported decreased spasticity, decreased neuropathic pain, and faster or more regular bowel movements, and described enhanced mental well-being and social benefit.
03Nine of eleven participants said they would take the ReWalk home if cost was not a factor, but participants generally felt it was not ready for home use and two would not take it because they needed assistance for safety.
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 qualitative analysis included 11 participants, so the themes cannot be treated as representative of all people with spinal cord injury. Not all participants completed the planned interview schedule: eight had all three interviews, one stopped after six weeks, two had no pre-training interview, and one completed baseline testing only. The sample was largely unemployed, with only 2 of 11 having jobs, which may have shaped the emphasis on purpose, contribution, and having a place to go. Participants were volunteers, so perspectives of people who were ineligible or could not commit to the time required were not captured. Physical changes were participant reports from interviews, not controlled outcome measures, and the study cannot separate the effects of the exoskeleton from standing, walking, exercise, social contact, or having a regular training purpose.
Declared interests
The paper states the funder was named as the Craig H. Neilsen Foundation. It does not report an author financial conflict of interest.
The easy way to misread this
Do not read the reported decreases in spasticity, pain, and bowel changes as proven effects of the ReWalk. This was a qualitative interview study of 11 participants, so these are participant reports, not controlled outcomes.