Patient-Centered Selection Criteria for Robot-Assisted Gait Training in Subacute Stroke: A Focus of User Satisfaction

Abstract

Purpose

To identify patient-centered selection criteria for exoskeletal wearable robot-assisted gait training (RAGT) by investigating predictors of satisfaction in subacute stroke survivors.

Materials and Methods

In this subgroup analysis of an international, multicenter, randomized controlled trial, 58 inpatients completed a 4-week RAGT program (20 sessions). Satisfaction was assessed using a modified 15-item QUEST 2.0 questionnaire across five domains (appropriateness, effectiveness, convenience, conformance, reliability). Predictors of the mean satisfaction score were analyzed using multiple linear regression.

Results

The overall satisfaction questionnaire score was 3.9 ± 0.6 (out of 5). The effectiveness domain was rated significantly higher than other domains (p < 0.05). Age was the only significant independent predictor of satisfaction (β = -0.269; 95% CI −0.315 to −0.007; p < 0.05). Participants aged <65 years reported significantly higher overall satisfaction than those aged ≥65 years (p < 0.05). This difference was driven by the appropriateness domain, where older adults reported lower comfort scores (p < 0.05).

Conclusion

RAGT received high user ratings, particularly for effectiveness. However, younger age predicted greater satisfaction, primarily due to discomfort in older adults. Selection criteria should consider age, and strategies to mitigate discomfort in older adults are needed to maximize adherence.

Trial details: ClinicalTrial.gov Identifier NCT05157347 (first registration (10/12/2021)).