Physiotherapy students’ perspectives on the use and implementation of exoskeletons as a rehabilitative technology in clinical settings

Abstract

Purpose

Wearable lower body robotic exoskeletons are an emerging technology used in gait rehabilitation to facilitate task-specific overground walking. Despite their proposed utility as a rehabilitation intervention, exoskeletons have not been widely implemented into clinical practice by physiotherapists. This study aims to inform future development of exoskeleton technology through the exploration of physiotherapy student perspectives on the use of the H2 robotic exoskeleton and the implementation of exoskeletons as a therapeutic technology in neurological gait rehabilitation.

Methods

A qualitative descriptive study, including fifteen physiotherapy students, was conducted using three equally sized focus groups. A collaborative data analysis process was employed using the DEPICT model.

Results

Five themes were identified during data analysis: developing evidence-informed practice, clinical considerations for exoskeleton use, resource demands, device-specific challenges for implementation, and future development. The results suggest there are several barriers limiting novel clinicians’ future use of exoskeletons.

Conclusion

This study highlights current challenges surrounding exoskeleton implementation into clinical practice and provides direction for future exoskeleton development.

Implications for rehabilitation

• Physiotherapy students view exoskeletons as a potentially valuable rehabilitation tool once perceived limitations are addressed.

• This study encourages collaboration between physiotherapists and biomedical engineers for future exoskeleton development.

• More research is needed to inform treatment parameters and appropriate client criteria to guide exoskeleton use for gait rehabilitation.

Keywords:

• Exoskeleton
• H2
• gait
• neurological
• rehabilitation
• physiotherapy

Acknowledgments

This research was completed in partial fulfilment of the requirements for an MScPT degree at the University of Toronto. The authors wish to express a special thanks to Lowell Rose and the Unit 6-10-12 coordinators for their support.

Disclosure statement

The authors report no conflict of interest. The authors received no financial support for the research, authorship or publication of this article.