Satisfaction analysis of overground gait exoskeletons in people with neurological pathology. a systematic review

Journal of NeuroEngineering and Rehabilitation, 2023 · DOI: https://doi.org/10.1186/s12984-023-01161-4 · Published: March 30, 2023

Patient Experience Assistive Technology Neurorehabilitation

Simple Explanation

This study reviews how satisfied people with neurological conditions are with using overground exoskeletons to help them walk. It looks at various studies where patients and therapists rated their experiences with these devices. The review found that while users generally feel positive about the safety, effectiveness, and comfort of exoskeletons, there are common issues. These include difficulty in adjusting the devices, their size and weight, and how easy they are to use. The research suggests that future exoskeleton designs should focus on addressing these issues to improve user satisfaction and make the devices more practical for everyday use.

Study Duration

Not specified

Participants

Stroke (n = 165), spinal cord injury (SCI) (n = 102) and multiple sclerosis (MS) (n = 68)

Evidence Level

IV; Case series

Key Findings

1
Users generally reported positive satisfaction with overground exoskeletons in terms of safety, efficacy, and comfort.
2
The most commonly used questionnaires to assess participant satisfaction were the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0.) and the Participant Satisfaction Questionnaire (PSQ).
3
The worst-rated aspects of the exoskeletons were ease of adjustment, size and weight, and ease of use.

Research Summary

This systematic review assessed user satisfaction with overground gait exoskeletons in individuals with neurological pathologies such as stroke, spinal cord injury (SCI), and multiple sclerosis (MS). The review analyzed 23 articles, including 19 clinical trials, covering 14 different overground exoskeleton models and various methods for assessing patient and therapist satisfaction. The study concludes that while users generally perceive exoskeletons positively in terms of safety, efficacy, and comfort, improvements are needed in ease of adjustment, size, weight, and ease of use to enhance user satisfaction and device practicality.

Practical Implications

Design Improvements

Exoskeleton manufacturers should prioritize design improvements focusing on ease of adjustment, reduced size and weight, and enhanced usability to increase user satisfaction.

Personalized Exoskeleton Configuration

Consider modular designs that allow for customized configurations based on individual patient needs and functional capacity, potentially reducing weight and energy consumption.

Expanded Research

Further research is needed with higher methodological quality and larger sample sizes to validate the efficacy of walking exoskeleton therapy and to standardize satisfaction outcome measures.

Study Limitations

1
Most included studies were Non-Randomized Studies on Intervention (NRSI), limiting the strength of the evidence.
2
Heterogeneity in satisfaction assessment procedures across studies makes it difficult to draw definitive conclusions.
3
Many of the questionnaires used have not undergone validation, potentially affecting the reliability of results.

Your Feedback

Was this summary helpful?

Back to Patient Experience