Exoskeleton home and community use in people with complete spinal cord injury

Abstract

A consequence of a complete spinal cord injury (SCI) is the loss of gait capacity. Wearable exoskeletons for the lower extremity enable household and community ambulation in people with SCI. This study assessed the amount, purpose, and location of exoskeleton use in the home and community environment, without any restrictions. The number of steps taken was read from the exoskeleton software. Participants kept a daily logbook, and completed two user experience questionnaires (Quebec User Evaluation of Satisfaction with assistive Technology (D-QUEST) and System Usability Scale (SUS)). Fourteen people with a complete SCI used the ReWalk exoskeleton a median of 9 (range [1-15]) out of 16 ([12-21]) days, in which participants took a median of 3,226 ([330-28,882]) steps. The exoskeleton was mostly used for exercise purposes (74%) and social interaction (20%). The main location of use was outdoors (48%). Overall, participants were satisfied with the exoskeleton (D-QUEST 3.7 ± 0.4) and its usability (SUS 72.5 [52.5-95.0]). Participants with complete SCI report satisfaction with the exoskeleton for exercise and social interaction in the home and community, but report limitations as an assistive device during daily life.

Figure 1

Example of the logbook during the period of home and community use.

Figure 2

Purpose of exoskeleton use during the period of home and community use.

Figure 3

Location of exoskeleton use during the period of home and community use.

Figure 4

Distribution of the satisfaction scores on the items of the Quebec User Evaluation of Satisfaction with Assistive Technology (D-QUEST). A satisfaction score of ‘more or less satisfied’ or less (D-QUEST ≤ 3) was considered dissatisfied. The numbers in brackets represent how frequent an item was indicated within the top 3 most important items of the D-QUEST by the participants.