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Hammerton J.1, Wong S.L.2, Moki S.3, Iftikhar S.3, Ismail Kaduji A.3
1Sheffield Hallam University, Allied Health Professions, Sheffield, United Kingdom, 2Sheffield Teaching Hospitals Foundation Trust, Physiotherapy, Sheffield, United Kingdom, 3Sheffield Hallam University, Physiotherapy, Sheffield, United Kingdom
Background: Evidence is increasingly showing that technology can enhance neurological rehabilitation, though few devices have transferred into clinical use, except the exo-skeleton in spinal cord injury. At a cost of around £50,000 per suit purchasers need to be sure this investment is worthwhile. Research on robotics in spinal cord injury rehabilitation has previously focused on non-acute injuries and the physical effects, this study was a unique opportunity to investigate users and clinicians perspectives on using robotics in acute rehabilitation.
Purpose: The aim of this qualitative study was to explore patient and clinician perspectives of an exo-skeleton programme as part of acute spinal cord injury rehabilitation.
Methods: Patients who had completed an exo-skeleton rehabilitation programme during their in patient admission following acute spinal injury were invited to participate in a semi structured interview. Clinicians who worked on the rehabilitation wards were recruited through posters. Ethical approval was given by the UK National Research Ethics service. Interviews were recorded and transcribed verbatim. Member checking was used to ensure accuracy. Thematic analysis was then systematically undertaken through thorough familiarisation with the data, generating initial codes, discussing emerging themes with the principal researcher and refining the codes and themes across the data sets.
Results: 4 patients (n=10) and 5 clinicians were recruited to the study. Patients were aged 27 - 45 , all male and 3 had a complete spinal injury. The clinicians were all graduate therapists.
9 themes were identified: education, usability, physical effects, psychological effects, finance, engagement, pre-conceptions, workload, impact. Two were prioritised for this presentation as they were shared across both participant groups:
Education: Participants felt positive about seeing others use the device but requested better access to information prior to participating in the programme.
Usability : Reliability and comfort were identified with reference made the weight of the device and the fatigue experienced. Participants expressed frustrations with mechanical failure and the high costs both of which limited access.
Conclusion(s): The study has shown that using an Ekso GT® in acute Spinal Injury rehabilitation can be a positive experience for patients and clinicians. The use of a qualitative approach allowed participants to express clinical utility issues which need to be addressed for technology to successfully integrate into acute rehabilitation. Research into the perceived physical and psychological effects for acutely injured patients is required.
Implications: Results from this study will support other services considering robotic devices as part of acute rehabilitation and inform designers for future development needs.
Manufacturers should consider the physical constraints, costs and reliability of future devices.
Service planners should consider early engagement of clinicians and patients in service design and a variety of information tools for prospective users and all clinicians involved in rehabilitation.
Funding acknowledgements: No external funding was provided
Topic: Neurology: spinal cord injury
Ethics approval: Fulham NRES Committee, London, England
All authors, affiliations and abstracts have been published as submitted.
