Therapists' experience of training and implementing an exoskeleton in a rehabilitation centre

Background Lower limb exoskeletons are a recent intervention promoted to improve gait disorders. Available research has focused on clinical outcomes; however, little is known about therapists' experiences using the device in practice. Purpose We explored the implementation of an exoskeleton at a tertiary rehabilitation center. Method In this longitudinal qualitative study we conducted semi-structured interviews with 10 therapists. One group of therapists was formally trained using the device, whereas the other group only had clinical exposure to the device. The interviews were transcribed, coded, and analyzed for themes. Results Three main themes emerged: (1)A steep learning curvedescribed challenges in learning to use the exoskeleton. (2)One step at a timeillustrated the complex process of incorporating the exoskeleton in daily work. (3)Not a magic bulletrevealed the tensions using this emergent technology in practice. Conclusion The exoskeleton represents one of the most complicated and labor-intensive interventions provided by therapists. Implementation requires substantial resources, raising questions regarding its efficacy and cost-effectiveness relative to other approaches. Until more evidence becomes available around the use and effectiveness of this rapidly evolving technology, therapists must contend with a high degree of uncertainty.