BackgroundExoskeleton technology has potential benefits for wheelchair users’ health and mobility. However, there are practical barriers to their everyday use as a mobility device. To further understand potential exoskeleton use, and facilitate the development of new technologies, a study was undertaken to explore perspectives of wheelchair users and healthcare professionals on reasons for use of exoskeleton technology, and the importance of a variety of device characteristics.MethodsAn online survey with quantitative and qualitative components was conducted with wheelchair users and healthcare professionals working directly with individuals with mobility impairments. Respondents rated whether they would use or recommend an exoskeleton for four potential reasons. Seventeen design features were rated and compared in terms of their importance. An exploratory factor analysis was conducted to categorize the 17 design features into meaningful groupings. Content analysis was used to identify themes for the open ended questions regarding reasons for use of an exoskeleton.Results481 survey responses were analyzed, 354 from wheelchair users and 127 from healthcare professionals. The most highly rated reason for potential use or recommendation of an exoskeleton was health benefits. Of the design features, 4 had a median rating of very important: minimization of falls risk, comfort, putting on/taking off the device, and purchase cost. Factor analysis identified two main categories of design features: Functional Activities and Technology Characteristics. Qualitative findings indicated that health and physical benefits, use for activity and access reasons, and psychosocial benefits were important considerations in whether to use or recommend an exoskeleton.ConclusionsThis study emphasizes the importance of developing future exoskeletons that are comfortable, affordable, minimize fall risk, and enable functional activities. Findings from this study can be utilized to inform the priorities for future development of this technology.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-169) contains supplementary material, which is available to authorized users.

Objective-To systematically review evidence on the prevention and treatment of pressure ulcers in those with a spinal cord injury.Data Sources-For this evidence-based review, the following data sources were used: MEDLINE ® /PubMed, CINAHL ® , EMBASE ® and PsycINFO ® Study Selection-To be selected for inclusion in the current review, there had to have been an intervention, studies had to have 3 or more subjects, and 50% or more of the participating group had to have a spinal cord injury.Data Extraction-Data extracted included study design, subject demographics, inclusion and exclusion criteria, study type, sample size, outcome measures used, and study results.Data Synthesis-Articles selected for this review were organized into one of two categories: prevention or treatment. Within each broad category, several smaller ones were created and articles were grouped together according to the prevention (direct or indirect) or treatment intervention discussed.Conclusions-Of the 26 articles selected for inclusion in the systematic review, 7 were randomized control trials that dealt with treatment for pressure ulcers, and there was one RCT on prevention. Despite the cost effectiveness of prevention, little research exists on preventative interventions, and what does exist mostly is Level 4 evidence. More research is needed for both prevention and treatment, but especially the former.

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