Perceptions, attitudes, and lived experiences of therapists with lower limb robotic exoskeletons in stroke rehabilitation: a systematic review of qualitative studies.
Ravi Shankar, Ziyu Goh, Qian Xu et al.
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In 30 seconds
This systematic review synthesized qualitative studies of therapists’ perceptions and experiences using lower limb robotic exoskeletons in stroke rehabilitation. Ten studies included 157 therapists across nine countries. Four themes concerned perceived clinical benefits, implementation barriers, professional adaptation, and integration into rehabilitation. Therapists described reduced physical demands and increased treatment capacity, including a reported 40-fold increase in step repetitions. However, setup time, cost, and restrictive patient eligibility were substantial barriers. Across the studies, therapists agreed that exoskeletons should complement, not replace, conventional therapy; confidence was high for 60% of key findings.
Key findings
- Therapists reported reduced physical demands and increased treatment capacity, including a 40-fold increase in step repetitions.
- Exoskeleton setup took 15-40 min, and reported costs ranged from $33,000-$250,000 USD.
- Therapists reached universal consensus that exoskeletons should complement rather than replace conventional therapy.
- Confidence was high for 60% of key findings.
Why it matters
The review highlights a gap between the perceived therapeutic potential of exoskeletons and the practical conditions needed to use them. Setup demands, cost, and patient eligibility may constrain access and routine implementation. Therapists’ accounts also point to the importance of training and organizational support while retaining clinical reasoning in rehabilitation.
What to keep in mind
The review synthesizes qualitative evidence, so findings describe therapists’ perceptions and experiences rather than establishing comparative clinical effectiveness.