Usability of an exosuit in domestic and community environments

Abstract

Background Exosuits have been shown to reduce metabolic cost of walking and to increase gait performance when used in clinical environment. Currently, these devices are transitioning to private use to facilitate independent training at home and in the community. However, their acceptance in unsupervised settings remains unclear. Therefore, the aim of this study was to investigate end-user perspectives and the adoption of an exosuit in domestic and community settings. Methods We conducted a mixed-method study to investigate the usability and user experience of an exosuit, the Myosuit. We leveraged on a cohort of seven expert users, who had the device available at home for at least 28 days. Each participant completed two standardized questionnaires (SUS and QUEST) and one personalized, custom questionnaire. Furthermore, a semi-structured interview with each participant was recorded, verbatim transcribed and analyzed using descriptive thematic analysis. Data collected from device sensors quantified the frequency of use. Results A mean SUS score of 75.4 out of 100 was reported. Five participants scored above the threshold for above-average usability. Participants also expressed high satisfaction with most of the technical features in the QUEST with an average score of 4.1 (3.86–4.71) out of 5. Participants used the Myosuit mainly for walking outside and exercising at home. However, the frequency of use did not meet the recommendations for physical activity established by the World Health Organization. Five participants used the Myosuit approximately once per week. The two other participants integrated the device in their daily life and used the Myosuit to a greater extent (approx. five times per week). Major factors that prevented an extensive use of the technology were: (i) difficulties in donning that led to (ii) lack of independence and (iii) lack of motivation in exercising. Conclusions Although usable for various activities and well perceived, the adoption of the exosuit in domestic and community settings is yet limited. Use outside the clinic poses further challenges that should be considered when developing new wearable robots. Primarily, design should meet the users' claim for independence and increased adjustability of the device.

Enhancing walking efficiency of adolescents with neurological impairments using an exosuit for ambulatory activities of daily living

“…Although she could perceive the benefits of the Myosuit’s support, she would never use the device in public. Interestingly, in a previously conducted study, adult users of the Myosuit mentioned only the difficulty in donning and did not perceive the weight and appearance as obstacles to a higher rate of adoption ( Basla et al, 2022 ). These findings highlight the differences in requirements to be considered when developing technologies for the pediatric population.…”

“…The Myosuit (Myoswiss AG, Switzerland) is a lightweight exosuit that provides mechanical support to the hip and the knee joints simultaneously. Its practicality for in-home and community-based training and engagement in ADLs was previously shown for the adult population ( Basla et al, 2022 ). Leveraging this knowledge, we designed the current study to assess the effectiveness of biarticular mechanical support provided by the exosuit while walking in- and outdoors in children with diverse ambulatory limitations.…”

“…To resolve this concern, mobile, wearable robots providing active support in daily life, such as exoskeletons and exosuits, have been recently developed for patients with walking impairments. Although they have been intensively investigated for the adult population ( Asbeck et al, 2015 ; Awad et al, 2017 ; Kim et al, 2019 ; Awad et al, 2020 ; Basla et al, 2022 ), few mobile wearable robots have been developed for and evaluated in the pediatric population. The Hybrid Assistive Limb (HAL) exoskeleton was downsized and tested with approximately 20 children with CP showing improvements in self-selected walking speed, cadence, and hip joint angles ( Matsuda et al, 2018 ; Mataki et al, 2020 ).…”

Evidence-based rehabilitation medicine: definition, foundation, practice and development

“…The International Classification of Functioning, Disability, and Health (ICF) is a framework that views health as a comprehensive concept beyond the mere focus on disease or bodily impairment. From the perspective of the ICF, the development of EBRM and its future direction can be seen through the following four trends: personalized rehabilitation [ 23 ], multidisciplinary cooperation and comprehensive rehabilitation [ 24 , 25 ], community rehabilitation and environmental optimization [ 26 , 27 ]. These trends align with the principles and framework of the ICF, which emphasizes a holistic perspective on health and functioning.…”

Soft robotic shorts improve outdoor walking efficiency in older adults

“…They have proven efficacy in various settings, by alleviating muscle strain in upper body joints 14,15,16 , and reducing the metabolic expenditure associated with walking or running 17,18,19 . Exosuits have showcased comparable usability to rigid exoskeletons, but with superior user satisfaction in terms of weight, effectiveness, and safety 20 . Social acceptance is also higher with respect to their rigid counterpart, increasing the likelihood that individuals would incorporate them into daily life applications 20 .…”