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Priorities & Preferences of Adults with Spinal Cord Injury for Exoskeleton Walking

Annika Pfister, Siena Villancio-Wolter, Kimberly A. Ingraham

University of Washington Department of Electrical & Computer Engineering

Exoskeletons for walking rehabilitation after a spinal cord injury (SCI)

Conceptual Framework

Methodology

Semi-structured interviews (n=12)

Learn: general perspectives on exoskeletons, how lived experiences affect user priorities

Plan for Analysis

Template coding from interview and focus group transcripts

  • Deductive content analysis: compare themes with previous published research4-8
  • Inductive themes: relationships between lived experience and technology facets

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  • Understand how exoskeleton features shape user priorities
  • Identify control and interface designs for use with exoskeletons

Acknowledgements: We thank our participants for sharing their time, personal experiences, and thoughts with us to make this research possible. We also thank the NWRSCIS, Fatma Inanici, Marsalis Smith, Soshi Samejima, and Zijie Jin for assistance with recruitment. The hip exoskeleton design featured in this work was generously shared by Fatima Tourk (Shepherd Lab, Northeastern University, Boston). This project is funded by the UW CREATE Student Mini-Grant Program.

Walking is a top first-ranked priority for many adults with an incomplete SCI1

Exoskeletons are wearable robots that can help adults with SCI walk faster, longer, or with less mental/physical effort

Use in daily life is limited by barriers such as:

  • Higher cognitive load while walking2
  • Frustration from difficulty controlling the exoskeleton3

What are the perceptions and experiences of adults with SCI regarding exoskeletons for walking?

  • Does form factor influence priorities for walking?
  • How do adults with SCI want to interact with exoskeletons?
  • What are the feedback priorities of adults with SCI?

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Background

Need for improved control and interfaces4

Figure: van Dijsseldonk et al. 2023

User priorities

Exoskeleton control strategies

Technology Facets

Lived Experience

Perceptual dimensions of adults with SCI for exoskeleton walking

Social factors

Non-exoskeleton mobility devices/experiences

Desired use cases (every day, in clinic, outside, etc.)

Expectations for exoskeleton technology

Exoskeleton hardware

Feedback interfaces

Exoskeleton actions/settings

Focus groups (2 sessions total, n=3 per session)

Learn: impressions of different exoskeleton hardware, potential feedback interfaces

Feedback Interfaces

Exoskeletons

References:

  1. Thorogood NP et al. (2023). Topics in Spinal Cord Injury Rehabilitation, 29(2), 1–15.
  2. Lusardi R et al. (2021). Frontiers in Medical Technology, 3, 747632.
  3. Pinelli E et al. (2023). Disability and Rehabilitation: Assistive Technology, 19(6), 2355–2363.
  4. van Dijsseldonk RB et al. (2023). Disability and Rehabilitation, 45(7), 1139–1146.

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  • Hampshire L et al. (2022). Journal of Medical Engineering & Technology, 46(6), 527–535.
  • Manns PJ et al. (2019). Journal of NeuroEngineering and Rehabilitation, 16, 94.
  • Thomassen G-KK et al. (2019). Spinal Cord Series and Cases, 5, 103.
  • Lajeunesse V et al. (2018). Technology and Disability, 30(3), 99–114.

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