Wearable robotic exoskeletons: A socio-philosophical perspective on Duchenne muscular dystrophy research

Abstract

Recently, several research projects in the Netherlands have focused on the development of wearable robotic exoskeletons (WREs) for individuals with Duchenne muscular dystrophy (DMD). Such research on WREs is often treated solely within the disciplines of biomedical and mechanical engineering, overlooking insights from disability studies and philosophy of technology. We argue that mainly two such insights should receive attention: the problematization of the ableism connected to the individual model of disability and the stigmatization by assistive technology. While disability studies have largely rejected the individual model of disability, the engineering sciences seem to still locate disability in an individual’s body, not questioning their own problematization of disability. Additionally, philosophy of technology has argued that technologies are not neutral instruments but shape users’ actions and perceptions. The design of WREs may convey a message about the understanding of disability, which can be comprehended as a challenge and an opportunity: stigmatization needs to be avoided and positive views on disability can be evoked. This article aims to highlight the benefits of considering these socio-philosophical perspectives by examining the case of WREs for people with DMD and proposing design principles for WREs. These principles may enhance acceptability of WREs, not only by individuals with DMD but also by other users, and help engineers to better place their work in the social context.

Robotic devices for paediatric rehabilitation: a review of design features

“…This advantage will help to provide free movement to enhance the subject’s motivation and autonomously practise their movement training for longer periods [ 17 , 154 ]. Furthermore, as technology advance, this freedom in mobility will help to increase the participation of children with physical disabilities in different social activities [ 155 ]. However, as the technology moves from clinical facilities to open spaces and robots interact more closely with the children, designers will face notable challenges (e.g.…”

“…Thus, the designs have been focused on design devices capable of assisting with exercise and helping with the ADLs to maintain specific abilities (e.g. walking) for a longer period of time [ 122 , 155 ].…”

Accounting for Diversity in Robot Design, Testbeds, and Safety Standardization

“…We conducted a literature review and identified regulatory gaps and legal inconsistencies to realize this objective. We built upon the recent work from the H2020 Cost Action 16,116 on Wearable Robots that mapped some of the central ethical, legal, and societal issues arising from the deployment of exoskeletons in society [60,61,62]. We completed this work with other literature in this realm [5,34,92,103] and complemented these findings through a practical exploration of (some of) the identified limitations in the standard through two weeks of experimentation in the testbeds created by the H2020 EUROBENCH project in Hospital Los Madronos in Madrid.…”

“…In comparison, four subjects indicated to be uncertain in this regard. What we found out over the two weeks of experiments is that the particular health condition of a subject, age, and psychological aspects play a significant role in how they experience their interaction with an exoskeleton [60,62,91]. A review of the literature on social robots has shown that people with disabilities are portrayed as having defective abilities that the robot is called on to fix [107].…”

Implementing Ethical, Legal, and Societal Considerations in Wearable Robot Design

“…Such acceptance is paramount because it leads to faster adoption of WRs in daily practice [7][8][9], making WRs more commercially successful. Considering ELSI also helps researchers think through their projects with a broader lens, which may also facilitate faster ethical approvals for testing and consecutive prototyping [10]).…”