a Priori and Short-, Medium-, and Long-Term Social Acceptability of Innovative Robot-Assisted Gait Training by Users

Abstract Background An innovative mobile and modular robot for gait rehabilitation was tested according to a psychosocial intervention framework, involving users, neuroscientists, engineers, and a social psychology laboratory. The study included a pre-design phase allowing the definition of the robot specifications. Our main objective was to study the social acceptability of the robot prototype among users and determine the relevance of the technological options chosen and the possible obstacles to the dissemination of the robot in light of the users' perceptions and experience with the robot. Methods The a priori acceptability of the robot by patients with a neurological impairment that altered their gait capacity and physical therapist (PT), both naïve to the robot, was evaluated just before its implementation in 2 rehabilitation departments and then that after 7 days (D7), and 28 days (D28), and 5 months (M5, only for the PT). The evaluation was conducted using questionnaires with Likert scale (maximum 7), according to the UTAUT (unified theory of acceptance and usage of technology) model, developed by the social psychology laboratory. Each patient participated in three 45-minute rehabilitation sessions with the robot per week for four weeks, for a total of 12 sessions, conducted by the 4 PT included. The change in the responses to the questionnaires as a function of time and the influence of the degree of gait recovery of the patients were analyzed, as well as the evolution of balance and gait parameters. Results 36 patients, mean age 58 years (SD10) and 4 PT were included. The robot was well accepted. It appeared to be useful, usable, and socially acceptable by both patients and PT and the intention to use was rated repeatedly ≥ 5. The rehabilitation activities met the functional expectations defined during the pre-design phase. In addition, a significant improvement in balance and gait was observed. Conclusion The acceptability of the robot was good for both patients and PT. Inclusion of a pre-design phase probably reduced the resistance to change often observed in healthcare organizations. The results concerning balance and gait are encouraging. They must be confirmed by a randomized controlled trial.