Toward better assistive lower-limb exoskeletons
Insights from stroke survivors through co-design
Reinhard Claeys (Vrije Universiteit Brussel)
Elissa Embrechts (Universiteit Utrecht, Vrije Universiteit Brussel, Universiteit Antwerpen)
Ruben Debeuf (Vrije Universiteit Brussel)
Mahyar Firouzi (Vrije Universiteit Brussel)
Aikaterini Bourazeri (University of Essex)
Sylvie De Raedt (Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel)
Charlotte Moeyersons (Vrije Universiteit Brussel)
Benjamin Filtjens (Katholieke Universiteit Leuven, TU Delft - Transport and Logistics, University of Toronto, University Health Network)
Tom Verstraten (Vrije Universiteit Brussel)
David Beckwée (Vrije Universiteit Brussel, Universiteit Antwerpen)
Eva Swinnen (Vrije Universiteit Brussel)
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Abstract
Assistive lower-limb exoskeletons (LLEs) have been recognized as promising tools for enhancing physical capacity in stroke survivors. Involving end-users in the early development stages is essential to ensure these technologies meet user needs. Co-design approaches, which actively engage end-users, support this goal. This study aims to (1) evaluate the impact of fatigue on daily living, (2) identify activities that could benefit from LLE assistance, (3) outline design and usability requirements for home-based LLEs, and (4) define physical parameters LLEs should monitor and assess. Discussions were structured using the PERCEPT co-design methodology and thematically analyzed. Four chronic stroke survivors participated in three focus group sessions, each lasting approximately 2 hours. Fatigue was identified as a significant factor in daily life, underscoring the importance of assistive technologies, such as LLEs, to help mitigate exhaustion. Participants recognized LLEs as valuable tools for enhancing physical performance, with benefits for muscle strength, balance, fatigue management, coordination, and general mobility. Design considerations included system modularity, battery efficiency, ease of donning and doffing, and practical needs for daily use. Our findings offer valuable insights into stroke survivors’ design and usability concerns regarding LLEs and provide a foundation for advancing the development and adoption of new assistive technologies.