Perspectives of wheelchair users with chronic spinal cord injury following a walking program using a wearable robotic exoskeleton

Claude Vincent; Frédéric S Dumont; Manon Rogers; Tiffany Hu; Alec Bass; Mylène Aubertin-Leheudre; Antony D Karelis; Suzanne N Morin; Michelle McKerral; Cyril Duclos; Dany H Gagnon

doi:10.1080/09638288.2024.2317994

Perspectives of wheelchair users with chronic spinal cord injury following a walking program using a wearable robotic exoskeleton

Disabil Rehabil. 2024 Feb 15:1-9. doi: 10.1080/09638288.2024.2317994. Online ahead of print.

Authors

Claude Vincent^{1

2}, Frédéric S Dumont², Manon Rogers², Tiffany Hu², Alec Bass^{3

4}, Mylène Aubertin-Leheudre⁵, Antony D Karelis⁵, Suzanne N Morin⁶, Michelle McKerral^{4

7}, Cyril Duclos^{3

4}, Dany H Gagnon^{3

4}

Affiliations

¹ School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Québec, Canada.
² Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec, Canada.
³ School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada.
⁴ Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada.
⁵ Department of Exercise Science, Université du Québec à Montréal, Montréal, Canada.
⁶ Department of Medicine, McGill University, Montréal, Canada.
⁷ Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montréal, Canada.

PMID: 38357879
DOI: 10.1080/09638288.2024.2317994

Abstract

Purpose: To examine the perspectives of wheelchair users with spinal cord injury (WU_SCI) regarding their participation in a 16-week walking program using a wearable robotic exoskeleton (WRE); and explore concerns and expectations regarding potential use of this device and intervention in the context of a home or community-based adapted physical activity program.

Method: Semi-structured interviews were conducted using a narrative research, 3 weeks post-intervention. Thematic analysis resulted in 6 themes and 21 subthemes.

Results: Seven men and 4 women aged between 32 and 72 years were interviewed; 8 of them had a complete SCI. After the walking program, WU_SCI reported positive psychological aspects (having fun and motivation) and experiencing improvements in physical aspects (strength, endurance, balance and flexibility, blood circulation and intestinal transit). The structural aspects of the WRE device were acceptable in a lab with research personnel (appearance, size, weight, and comfort). Participants had concerns about safety on uneven surfaces, and possibility of falling. They expressed the desire to use the WRE for more life habits than just walking.

Conclusion: This is the first study in which WU_SCI report that the WRE should be implemented in initial rehabilitation. Lack of availability for community use after rehabilitation remains a concern.

Keywords: Mobility device; paraplegia; physical activity; rehabilitation; robotic exoskeleton; spinal cord injury.

Plain language summary

Participation in a walking training program using a wearable robotic exoskeleton, 1-3 times weekly over several weeks, may be well tolerated and provide physical and psychological benefits for wheelchair users with spinal cord injuries.Using a robotic exoskeleton during initial rehabilitation may be well received and help with regaining strength, endurance, balance, and flexibility as well as promoting blood circulation and intestinal transit.The use of the wearable robotic exoskeleton always needs supervision of a clinician for walking and can’t be used independently by wheelchair users; there is no possibility for hands free for household tasks (e.g., washing floors, accessing cupboards or reaching shelves, using stairs), and for recreation (e.g., exercising, taking walks, cultural activities, concerts).