Users’ experiences of intensive robotic-assisted gait training post-stroke – “a push forward or feeling pushed around?”

Abstract

Purpose

Robotic-assisted gait training (RAGT) is suggested to improve walking ability after stroke. The purpose of this study was to describe experiences of robotic-assisted gait training as part of a gait training intervention among persons in the chronic phase after stroke.

Materials and methods

Semi-structured interviews were performed with 13 participants after a 6-week intervention including treadmill gait training with the Hybrid Assistive Limb^® (HAL) exoskeleton. Data were analysed using qualitative content analysis.

Results

Four categories emerged: (1) A rare opportunity for potential improvements describes the mindset before the start of the intervention; (2) Being pushed to the limit represents the experience of engaging in intensive gait training; (3) Walking with both resistance and constraints reveals barriers and facilitators during HAL training; (4) Reaching the end and taking the next step alone illustrates feelings of confidence or concern as the intervention ended.

Conclusions

The gait training intervention including RAGT was considered demanding but appreciated. Support and concrete, individual feedback was crucial for motivation, whilst the lack of variation was a barrier. Results encourage further development of exoskeletons that are comfortable to wear and stimulate active participation by enabling smoothly synchronised movements performed during task-specific activities in different environments.

IMPLICATIONS FOR REHABILITATION

• When provided in a suitable context, the mental and physical challenges of intensive robotic-assisted gait training can be both inspiring and motivating.

• Support and engagement along with informative feedback from therapists are suggested crucial for motivation.

• Intensive task-specific gait training may preferably be performed in an enriched environment and combined with other physiotherapy treatments to stimulate engagement.

Keywords:

• Hybrid Assistive Limb
• exoskeleton
• electromechanical assistance
• walking
• user perspectives
• qualitative research

Disclosure statement

The research was conducted in absence of any commercial or financial relationships that could be considered a potential conflict of interest.

Additional information

Funding

This work was supported by The Swedish Research Council; The Swedish Brain Foundation; The Umeå University Foundation for Medical Research; The Region Vasterbotten; The Foundation for Stroke Research in Norrland and King Gustaf V and Queen Victoria’s Foundation of Freemasons.