Physiotherapists' User Acceptance of a Lower Limb Robotic Exoskeleton in Specialized Rehabilitation: Qualitative Exploratory Study.
Anstein Olimb Hillkirk, Kirsti Skavberg Roaldsen, Hege Mari Johnsen
PMID 40238235WHAT IT FOUND
Seven physiotherapists described the exoskeleton as useful for specific patients but too time-consuming for routine use.
They felt the setup and staffing demands outweighed the benefits, leading them to use it sparingly despite acknowledging its potential for neuroplasticity and safety.
Key findings
01Participants perceived the disadvantages of using the exoskeleton, particularly time consumption and staffing needs, as outweighing the benefits.
02Use was driven by specific patient benefits like enabling standing in spinal cord injury, but hindered by the need for two therapists and lengthy setup.
03Therapists expressed uncertainty about treatment effectiveness and called for more evidence before justifying the resource investment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only seven participants from a single specialized hospital in Norway, limiting transferability to other settings or disciplines. The sample was restricted to physiotherapists certified to use the device, excluding perspectives of those who chose not to use it or other healthcare professionals. The qualitative nature means findings reflect perceptions and intentions rather than measured clinical outcomes or actual usage frequency data. Two eligible participants withdrew before interviews, potentially introducing selection bias if they held differing views.
Declared interests
The authors declared no conflicts of interest. The study was funded by the University of Agder and the Oslo University Hospital, with no mention of commercial sponsorship from the device manufacturer (Ekso Bionics).
The easy way to misread this
Do not interpret this as evidence that exoskeletons are ineffective. The study reports therapist perceptions of usability and resource burden, not patient outcomes. The negative findings relate to the implementation challenges and cost-benefit analysis for therapists, not necessarily the clinical efficacy of the intervention for patients.