4.4 Article

Patients' and therapists' experience and perception of exoskeleton-based physiotherapy during subacute stroke rehabilitation: a qualitative analysis

Journal

DISABILITY AND REHABILITATION
Volume 44, Issue 24, Pages 7390-7398

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2021.1989503

Keywords

Physical therapy modalities; stroke; walking; lower limb; exoskeleton device; qualitative research

Categories

Funding

  1. Heart and Stroke Foundation of Canada [G-15-0009030]
  2. Canadian Institutes of Health Research Foundation [FDN 143340]
  3. Heart and Stroke Canadian Partnership for Stroke Recovery Trainee Award
  4. Vanier Canada Graduate Scholarship Program
  5. Canadian Institutes of Health Research
  6. Canada Research Chair Program

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The study found that patients with stroke had a positive attitude towards exoskeleton-based physiotherapy program, believing it to be a beneficial and positive experience for their rehabilitation. They also provided recommendations for future integration of exoskeleton training into stroke rehabilitation.
Purpose To explore the experience and acceptability of an exoskeleton-based physiotherapy program for non-ambulatory patients during subacute stroke rehabilitation from the perspective of patients and therapists. Materials and methods This was a qualitative descriptive study using semi-structured interviews and thematic analysis. Fourteen patients with stroke who participated in the experimental arm of a randomized controlled trial investigating the efficacy of exoskeleton-based physiotherapy were recruited. Six physiotherapists who provided the intervention were also recruited. Results Three themes were identified relating to the experience and acceptability of an exoskeleton-based physiotherapy program: (1) A matter of getting into the swing of things depicted the initial and ongoing learning process of using an exoskeleton; (2) More of a positive experience than anything else described the participants' mostly favorable attitude toward exoskeleton-based gait training; and (3) The best step forward captured participant-identified recommendations and considerations for the future integration of exoskeleton training into stroke rehabilitation. Conclusions Patients with stroke were even more optimistic than therapists toward the experience and benefits of exoskeleton-based gait training during subacute stroke rehabilitation. Future clinical practice should consider the balance between actual and perceived benefits, as well as the potential barriers to integrating an exoskeleton into stroke rehabilitation.

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