Acceptability of Overground Wearable Powered Exoskeletons for People with Spinal Cord Injury: a Multicenter Qualitative Study

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Abstract
Background: Exoskeletons are used in rehabilitation centers for people with spinal cord injury (SCI) due to the potential benefits they offer for locomotor rehabilitation. The acceptability of exoskeletons is crucial to promote rehabilitation and to ensure a successful implementation of this technology. The objective was to explore the acceptability of overground wearable powered exoskeleton used in rehabilitation among people with SCI. Methods: Fourteen individuals with SCI (9 men, mean age 47 years [14,8], majority with traumatic and thoracic lesion (T6-T12)) who had utilized an exoskeleton in Canada or in France during their rehabilitation participated in a semi-structured interview. A thematic analysis using the Theoretical Framework of Acceptability was carried out. Results: Participants were motivated to use an exoskeleton during their rehabilitation. They reported several perceived benefits to its use, including better walking pattern, increased endurance and greater muscle mass. They also experienced mild pain, notable concentration demands and fatigue. Most participants reported that using exoskeletons in their rehabilitation process was appropriate and relevant to them. Conclusions: Exoskeletons are generally well accepted by participants in this study. Adjustments in their use, such as conducting training sessions in obstacle-free environment and technological improvements to address the device’s restrictive characteristics, heaviness, and massiveness are however still needed.
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