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  4. Living With Assistive Robotics: Exploring the Everyday Use of Exoskeleton for Persons With Spinal Cord Injury

Living With Assistive Robotics: Exploring the Everyday Use of Exoskeleton for Persons With Spinal Cord Injury

Frontiers in Medical Technology, 2021 · DOI: 10.3389/fmedt.2021.747632 · Published: October 8, 2021

Spinal Cord InjuryAssistive Technology

Simple Explanation

Recent advancements in technology have led to increased research into exoskeletons for people with mobility problems. This study explores the everyday experience of using the ReWalk exoskeleton for individuals with spinal cord injuries. The study found that integrating the exoskeleton into daily life requires social support and is influenced by various factors like physical ability, social context, and psychological well-being. The decision to use the technology is influenced by physical, social, cultural, environmental, and psychological factors. The research emphasizes that successful development and implementation of such technology depend on understanding the users' daily lives and experiences. The development and implementation of the technology need to be grounded in a deep understanding of the day-to-day lives and experiences of the people that use them.

Study Duration
Not specified
Participants
Two outpatients with paralysis below the waist
Evidence Level
Case Study

Key Findings

  • 1
    The meaning of mobility extends beyond functional ability; standing and walking with the exoskeleton held socio-cultural significance linked to self-identity and life priorities. Physical mobility represents more than functional capacity.
  • 2
    Effective use of the exoskeleton involves a process of re-embodiment, where patients develop a new relationship with their body and learn to coordinate movement with the device. Patients are not relearning to walk but instead are developing a completely new relationship with one’s corporeality and self-image.
  • 3
    Successful integration of the exoskeleton requires ongoing adjustments and adaptations to meet the individual's needs, highlighting the importance of user feedback in the design cycle. Effective integration of robotic exoskeletons demands ongoing adjustments and adaptations

Research Summary

This study explores the lived experience of individuals with spinal cord injuries using the ReWalk exoskeleton, revealing that successful integration depends on social and organizational processes, not just technical advancements. However, our data has shown that technical progress alone will not address the challenges to the everyday use of robotic exoskeletons. Key themes include the socio-cultural meaning of mobility, the process of re-embodiment required to coordinate with the device, and the need for continuous adaptation and adjustment. Firstly, we have found that patients’ mobility needs and wishes are unique (meaning of mobility). The study emphasizes the importance of a collaborative approach involving healthcare professionals, family, and the user, highlighting the need to consider the social support network in the technology's implementation. Finally, we must understand how the introduction and use of the technology align with the patient’s formal and informal social support network (human element)

Practical Implications

Personalized Design

Exoskeleton design and provision should focus on what matters most to the individual, rather than solely on functional walking ability.

Re-Embodiment Support

Technology developers must be aware of the cognitive load and new body techniques required by the device, providing support for patients in achieving this transition.

Collaborative Ecosystem

Acknowledge and embrace the roles that others could play in enhancing the technology's potential, fostering a collaborative environment for sustained use.

Study Limitations

  • 1
    Small sample size of two participants
  • 2
    Limited generalizability due to the case study approach
  • 3
    Study setting was limited to a rehabilitation clinic in northern Italy

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