Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-17T04:21:19.427Z Has data issue: false hasContentIssue false

WHAT ARE USER PERSPECTIVES OF EXOSKELETON TECHNOLOGY? A LITERATURE REVIEW

Published online by Cambridge University Press:  29 August 2017

Deborah Hill
Affiliation:
Neurological Services, Jersey General Hospitald.hill3@health.gov.je
Catherine Sarah Holloway
Affiliation:
UCLIC, University College London
Dafne Zuleima Morgado Ramirez
Affiliation:
UCLIC, University College London
Peter Smitham
Affiliation:
University College London
Yannis Pappas
Affiliation:
Institute for Health Research, University of Bedfordshire

Abstract

Objectives: Exoskeletons are electromechanical devices that are worn by a human operator to increase their physical performance. Several exoskeletons have been developed to restore functional movements, such as walking, for those with paralysis due to neurological impairment. However, existing exoskeletons have limitations with respect to affordability, size, weight, speed, and efficiency, which may reduce their functional application. Therefore, the aim of this scoping review is to collect and narratively synthesize the perspectives of users of exoskeleton technology.

Methods: A systematic literature search was conducted across several healthcare related online databases.

Results: A total of 4,619 articles were identified, of which 51 were selected for full review. Only three studies were identified that met the inclusion criteria. Of these, one showed an incongruence between users’ expectations and experiences of device use; another reported perspectives on potential rather than actual device use, ranking design features in order of perceived importance; and the other reported ratings of ease of device use in training.

Conclusions: The heterogeneity of studies included within this review, leave the authors unable to suggest consensus as to user perspectives of exoskeleton technology. However, it is apparent that users are able to suggest priorities for exoskeleton design and that users’ perspectives of exoskeleton technology might change in response to experience of use. The authors, therefore, suggest that exoskeleton design should be an iterative process, whereby user perspectives are sought, incorporated and refined by tangible experience, to ensure that devices developed are acceptable to and usable by the populations they seek to re-enable.

Type
Methods
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Cenciarini, M, Dollar, AM, editors. Biomechanical considerations in the design of lower limb exoskeletons. IEEE Int Conf Rehabil Robot. 2011;2011:5975366.Google Scholar
2. Mertz, L. The next generation of exoskeletons: Lighter, cheaper devices are in the works. IEEE Pulse. 2012;3:5661.Google Scholar
3. Ekso, Bionics. [Internet]. Ekso Bionics - Exoskeleton, wearable robot for people with paralysis from spinal cord injury or stroke. http://intl.eksobionics.com/ekso (accessed June 3, 2015).Google Scholar
4. Rex, Bionics. [Internet]. Rex Bionics: Our products. http://www.rexbionics.com/products/ (accessed June 3, 2015).Google Scholar
5. ReWalk, Robotics. [Internet]. ReWalk: More Than walking 2016. http://rewalk.com/ (accessed April 26, 2016).Google Scholar
6. Parker Hannifin Corp. [Internet]. Indego: Powering people forward 2016. http://indego.com/indego/en/home (accessed April 26, 2016).Google Scholar
7. Gwynne, P. Technology: Mobility machines. Nature. 2013;503: S16-SS7.Google Scholar
8. Woollaston, V. [Internet]. Robotic exoskeleton to help rehabilitate disabled people passes safety tests - paving the way for it to go on sale in the UK. 2013. http://www.dailymail.co.uk/sciencetech/article-2384930/Robotic-exoskeleton-help-rehabilitate-disabled-people-passes-safetytests–paving-way-sale-UK.html (accessed June 3, 2015).Google Scholar
9. Buckland, D, Low, V. [Internet]. Robotic wedding suit lets father of bride make moving speech The Times. 2014. http://www.thetimes.co.uk/tto/technology/article4213717.ece (accessed June 3, 2015).Google Scholar
10. Nicholson, R. [Internet]. Opinion: Why the obsession with walking? 2013. http://attitudelive.com/blog/red-nicholson/opinionwhy-obsession-walking (accessed June 3, 2015).Google Scholar
11. Bohannon, R. Comfortable and maximal walking speeds of adults aged 20–79 years: Reference values and determinants. Age Ageing. 1997;26:1519.Google Scholar
12. Esquenazi, A, Talaty, M, Packel, A, Saulino, M. The ReWalk powered exoskeleton to restore ambulatory function to individuals with thoracic-level motor-complete spinal cord injury. Am J Phys Med Rehabil. 2012;91:911921.Google Scholar
13. Karmarkar, AM, Cooper, RA, Wang, H, Kelleher, A, Cooper, R. Analyzing wheelchair mobility patterns of community-dwelling older adults. J Rehabil Res Dev. 2011;48:10771086.Google Scholar
14. Cowan, RE, Fregly, BJ, Boninger, ML, Chan, L, Rodgers, MM, Reinkensmeyer, DJ. Recent trends in assistive technology for mobility. J Neuroeng Rehabil. 2012;9:20.Google Scholar
15. Tobe, F. [Internet]. 3 Exoskeleton companies go public the robot report. 2014. http://www.therobotreport.com/news/3-exoskeleton-companies-go-public (accessed June 3, 2015).Google Scholar
16. Demain, S, Burridge, J, Ellis-Hill, C, et al. Assistive technologies after stroke: Self-management or fending for yourself? A focus group study. BMC Health Serv Res. 2013;13:334.Google ScholarPubMed
17. McMillen, A-M, Söderberg, S. Disabled persons’ experience of dependence on assistive devices. Scand J Occup Ther. 2002;9: 176183.Google Scholar
18. Brown-Triolo, DL, Roach, MJ, Nelson, K, Triolo, RJ. Consumer perspectives on mobility: Implications for neuroprosthesis design. J Rehabil Res Dev. 2002;39:659670.Google Scholar
19. Miller, LE, Zimmermann, AK, Herbert, WG. Clinical effectiveness and safety of powered exoskeleton-assisted walking in patients with spinal cord injury: Systematic review with meta-analysis. Med Devices (Auckl). 2016;9:455466.Google Scholar
20. Bortole, M, Venkatakrishnan, A, Zhu, F, et al. The H2 robotic exoskeleton for gait rehabilitation after stroke: Early findings from a clinical study. J Neuroeng Rehabil. 2015;12:54.Google Scholar
21. Benson, I, Hart, K, Tussler, D, van Middendorp, JJ. Lower-limb exoskeletons for individuals with chronic spinal cord injury: Findings from a feasibility study. Clin Rehabil. 2016;30: 7384.Google Scholar
22. Wolff, J, Parker, C, Borisoff, J, Mortenson, WB, Mattie, J. A survey of stakeholder perspectives on exoskeleton technology. J Neuroeng Rehabil. 2014;11:169.Google Scholar
23. Rosati, G, Oscari, F, Reinkensmeyer, DJ, et al. Improving robotics for neurorehabilitation: Enhancing engagement, performance, and learning with auditory feedback. IEEE Int Conf Rehabil Robot. 2011;2011:5975373.Google Scholar
24. Zeilig, G, Weingarden, H, Zwecker, M, Dudkiewicz, I, Bloch, A, Esquenazi, A. Safety and tolerance of the ReWalk™ exoskeleton suit for ambulation by people with complete spinal cord injury: A pilot study. J Spinal Cord Med. 2012;35:96101.Google Scholar
25. Giszter, SF. Spinal cord injury: Present and future therapeutic devices and prostheses. Neurotherapeutics. 2008;5:147162.Google Scholar
26. Shah, SGS, Robinson, I. Benefits of and barriers to involving users in medical device technology development and evaluation. Int J Technol Assess Health Care. 2007;23:131137.Google Scholar
27. Lane, JP, Usiak, DJ, Stone, VI, Scherer, MJ. The voice of the customer: Consumers define the ideal battery charger. Assist Technol. 1997;9:130139.Google Scholar
28. ATIA. [Internet]. ASSISTIVE TECHNOLOGY: What is it? What do you need to know? http://www.atia.org/i4a/pages/index.cfm?pageid=3859 (accessed January 14, 2016).Google Scholar
29. Biddiss, E, Chau, T. Upper-limb prosthetics: Critical factors in device abandonment. Am J Phys Med Rehabil. 2007;86: 977987.Google Scholar
30. Kittel, A, Marco, AD, Stewart, H. Factors influencing the decision to abandon manual wheelchairs for three individuals with a spinal cord injury. Disabil Rehabil. 2002;24:106114.Google Scholar
31. Kiesler, S, Hinds, P. Human-robot interaction: Citeseer. Hum-Comput Interact. 2004;19:18.Google Scholar
32. Pape, TL-B, Kim, J, Weiner, B. The shaping of individual meanings assigned to assistive technology: A review of personal factors. Disabil Rehabil. 2002;24:520.Google Scholar
33. Bates, PS, Spencer, JC, Young, ME, Rintala, DH. Assistive technology and the newly disabled adult: Adaptation to wheelchair use. Am J Occup Ther. 1993;47:10141021.Google Scholar
34. Shah, SGS, Robinson, I, Alshawi, S. Developing medical device technologies from users' perspectives: A theoretical framework for involving users in the development process. Int J Technol Assess Health Care. 2009;25:514521.Google Scholar
35. Martin, JL, Murphy, E, Crowe, JA, Norris, BJ. Capturing user requirements in medical device development: The role of ergonomics. Physiol Meas. 2006;27:R49.Google Scholar
36. Kilgore, KL, Scherer, M, Bobblitt, R, et al. Neuroprosthesis consumers' forum: Consumer priorities for research directions. J Rehabil Res Dev. 2001;38:655660.Google Scholar
37. Daily Mail Reporter. [Internet]. Revolutionary exoskeleton that helps wheel-chair bound walk to go on sale in UK. 2011. http://www.dailymail.co.uk/health/article-1374067/Robot-trousers-gives-paraplegics-power-walk-sale-UK.html (accessed April 26, 2016).Google Scholar
38. Pons, JL. Rehabilitation exoskeletal robotics. IEEE Eng Med Biol Mag. 2010;29:5763.Google Scholar