TWIICE One powered exoskeleton: effect of design improvements on usability in daily life as measured by the performance in the CYBATHLON race.
Tristan Vouga, Jemina Fasola, Romain Baud and 3 others
PMID 35761399WHAT IT FOUND
One experienced pilot with spinal cord injury completed a daily-life obstacle course 40% faster with the updated TWIICE One exoskeleton.
Design changes to the foot and control modes improved performance, but data from a single athlete cannot predict outcomes for typical patients.
Key findings
01The entire race time improved by an average of 40% compared to comparable obstacles in the 2016 race.
02Improvements in the sole design and stepping strategy drastically reduced the time to complete the rough terrain task.
03Usability metrics for the single pilot included a 60-second preparation time, 129-second donning time, and a normal walking speed of 0.32 m/s.
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 reports data from a single pilot who was selected for her athletic condition, meaning the performance metrics represent the maximum achievable rather than typical outcomes for people with paraplegia. Pilot satisfaction and user experience were not evaluated in a systematic way. The comparison is based on a competition format with slightly different obstacles between 2016 and 2020, which may influence the directness of the time improvements. The device requires manual triggering of each step, leading to pauses that limit walking speed, and lacks automatic adaptation to terrain.
Declared interests
The study was funded by Sonceboz SA, which manufactured the custom motors used in the exoskeleton, as well as the Swiss National Center for Competence in Research Robotics, EPFL Innogrant program, Fischer connector, and Bâloise Group.
The easy way to misread this
Do not interpret the 40% race time improvement as evidence that this exoskeleton will increase walking speed or functional independence for typical patients. The pilot was an experienced athlete with four years of training, and the paper explicitly states that her performance is not representative of most people with paraplegia.