Wearable Robotic Gait Training in Persons with Multiple Sclerosis: A Satisfaction Study

Abstract

Wearable exoskeletons have showed improvements in levels of disability and quality of life in people with neurological disorders. However, it is important to understand users’ perspectives. The aim of this study was to explore the patients’ and physiotherapists’ satisfaction from gait training with the EKSO GT® exoskeleton in people with multiple sclerosis (MS). A cross-sectional study with 54 participants was conducted. Clinical data and self-administered scales data were registered from all patients who performed sessions with EKSO GT®. To evaluate patients’ satisfaction the Quebec User Evaluation with Assistive Technology and Client Satisfaction Questionnaire were used. A high level of satisfaction was reported for patients and for physiotherapists. A moderate correlation was found between the number of sessions and the patients’ satisfaction score (rho = 0.532; p < 0.001), and an excellent correlation between the physiotherapists’ time of experience in neurology rehabilitation and the satisfaction with the possibility of combining the device with other gait trainings approaches (rho = 0.723; p = 0.003). This study demonstrates a good degree of satisfaction for people with MS (31.3 ± 5.70 out of 40) and physiotherapists (38.50 ± 3.67 out of 45 points) with the EKSO GT®. Effectiveness, safety and impact on the patients’ gait were the most highly rated characteristics of EKSO GT®. Features such as comfort or weight of the device should be improved from the patients’ perspectives.

Multicentric investigation on the safety, feasibility and usability of the ABLE lower-limb robotic exoskeleton for individuals with spinal cord injury: a framework towards the standardisation of clinical evaluations

“…The average satisfaction score obtained for the ABLE Exoskeleton (31.6 ± 5.7) in study participants was comparable to the EksoGT™ exoskeleton (31.3 ± 5.70) [ 26 ] and the ReWalk device (29.4 ± 2.5) [ 32 ] when tested in individuals with multiple sclerosis, and considerably better than the Marsi Active Knee device (22.4 ± 3.2) when used by individuals with stroke and multiple sclerosis [ 27 ]. In respect to weight (Median: 4.0/Mean: 4.0 ± 1.0), easiness to use (Median: 4.0/Mean: 3.8 ± 0.9) and safety (Median: 4.5, Mean 4.4 ± 0.8) the ABLE Exoskeleton was also better in comparison to the Marsi Active Knee device (Weight: Median 2.8; Easiness to use: Median 2.6; Safety: Median 3.6) and comparable to the EksoGT™ device (Weight: Mean 3.8 ± 1.0; Easiness to use: Mean 3.7 ± 0.9; Safety: Mean 4.3 ± 0.9) [ 26 , 27 ]. These results show that participants are satisfied with the ABLE Exoskeleton and its usability.…”

“…Two additional questionnaires were therefore included, the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) and the Psychosocial Impact of Assistive Devices Scale (PIADS). The QUEST 2.0 measures the satisfaction with an assistive device and has been used in previous studies with exoskeletons [ 13 , 26 , 27 ]. The PIADS assesses the psychosocial impact of a device on a sum scale from -78 (negative impact) to + 78 (positive impact) [ 28 ].…”

Exoskeletons in MS rehabilitation are ready for widespread use in clinical practice: No

“…The effectiveness, safety and impact on the patient's gait were highly rated, while comfort, weight, and ease of use of the device were reported as elements that should be improved. 9,10 It is known that for a first training with an exoskeleton donning times of 20 min are needed, and for the subsequent trainings 10 to 15 min. Bearing in mind that a normal physiotherapy session is between 30 min and 1 hr, this means that a significant amount of time is lost on the patient setup only.…”

Safety, performance and user satisfaction study of the new ABLE lower-limb exoskeleton for individuals with SCI: the result of a co-creation process with clinicians and patients

“…No other study reports user satisfaction for SCI participants or therapists for a comparable robotic exoskeleton with a standard questionnaire such as QUEST 2.0, though studies with multiple sclerosis participants reported lower scores for the EksoGT (31.3 ± 5.70) [25] and the ReWalk (29.4 ± 2.5) [26]. User satisfaction is an extremely important factor for device adoption into standard of care, so future work should focus on more standardized reporting of these metrics.…”