Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists
Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists
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DOI：
10.1186/s12984-020-00750-x
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发表时间：
2020-09-10
影响因子：
5.1
通讯作者：
Patterson, Kara
中科院分区：
文献类型：
--
作者：
Vaughan-Graham, Julie;Brooks, Dina;Patterson, Kara
可穿戴动力外骨骼是一种新兴的技术，其被开发用于提供感觉引导的机动化下肢辅助，使得能够利用具有步态障碍的人的典型下肢运动模式进行密集的任务特定运动训练。为确保器械满足最终用户需求，重要的是要了解并纳入最终用户的观点，但该领域的研究在卒中后人群中极为有限。本研究的目的是探索深入的，最终用户的观点，中风患者和物理治疗师，与H2外骨骼的一次性使用会议后。方法我们使用了定性的解释性描述方法，利用半结构化的面对面访谈，与中风后的人和物理治疗师，1.5小时的会议后，H2外骨骼。结果5名脑卒中患者和6名物理治疗师自愿参加研究。两个参与者小组都对他们使用外骨骼的经验提供了有见地的评论。从中风参与者数据中开发了四个主题：（1）采用技术;（2）设备问题;（3）发展行走能力;以及（4）整合外骨骼使用。根据物理治疗师参与者数据开发了5个主题：（1）操作员-用户协作;（2）器械特定问题;（3）器械程控;（4）需要考虑的患者特征;以及（5）适应症。结论本研究提供了一个解释性的理解最终用户的观点，中风和神经物理治疗师的人，与H2外骨骼的单次使用经验。两个利益相关者群体的调查结果重叠，因此确定了四个过度关注的概念，包括：（i）利益相关者参与;（ii）增强与自主机器人;（iii）外骨骼可用性;以及（iv）器械特定问题。最终用户对H2外骨骼的使用和设计提供了有价值的观点，确定了中风后步态康复的特定需求，需要一个强大的证据基础，同时还强调了在整个中风康复过程中对这项技术的重大兴趣。
Background Wearable powered exoskeletons are a new and emerging technology developed to provide sensory-guided motorized lower limb assistance enabling intensive task specific locomotor training utilizing typical lower limb movement patterns for persons with gait impairments. To ensure that devices meet end-user needs it is important to understand and incorporate end-users perspectives, however research in this area is extremely limited in the post-stroke population. The purpose of this study was to explore in-depth, end-users perspectives, persons with stroke and physiotherapists, following a single-use session with a H2 exoskeleton. Methods We used a qualitative interpretive description approach utilizing semi-structured face to face interviews, with persons post-stroke and physiotherapists, following a 1.5 h session with a H2 exoskeleton. Results Five persons post-stroke and 6 physiotherapists volunteered to participate in the study. Both participant groups provided insightful comments on their experience with the exoskeleton. Four themes were developed from the persons with stroke participant data: (1) Adopting technology; (2) Device concerns; (3) Developing walking ability; and, (4) Integrating exoskeleton use. Five themes were developed from the physiotherapist participant data: (1) Developer-user collaboration; (2) Device specific concerns; (3) Device programming; (4) Patient characteristics requiring consideration; and, (5) Indications for use. Conclusions This study provides an interpretive understanding of end-users perspectives, persons with stroke and neurological physiotherapists, following a single-use experience with a H2 exoskeleton. The findings from both stakeholder groups overlap such that four over-arching concepts were identified including: (i) Stakeholder participation; (ii) Augmentation vs. autonomous robot; (iii) Exoskeleton usability; and (iv) Device specific concerns. The end users provided valuable perspectives on the use and design of the H2 exoskeleton, identifying needs specific to post-stroke gait rehabilitation, the need for a robust evidence base, whilst also highlighting that there is significant interest in this technology throughout the continuum of stroke rehabilitation.