Table 1 Summary table of included studies

Awad

2020 [46]

ReStore

Stroke

8

QUEST 2.0

Physical Therapist Questionnaire

Overall participant satisfaction: 33.8 ± 6.1 out of 40.

Parameters consider by participants more relevant: effectiveness (69.4%), comfort (52.8%) and ease of use (50.0%).

Overall physiotherapist’s satisfaction: 33.7 (maximum score: 45).

Less valued parameters by therapists: donning/doffing time (3.1 ± 0.95), usefulness in clinical practice (3.4 ± 0.9) and recommendation to other professionals (3.4 ± 0.9). Most valued by physiotherapists: ease of use (4.3 ± 0.9) and user interface (4.3 ± 0.8).

P 84.5

T 74.9

Birch

2017 [39]

REX

SCI

1

Device Acceptability Questionnaire (REX)

95% of participants felt very confident and stable, 89% very safe. 78% strongly agreed that they enjoyed their experience and would use it weekly and would recommend.

Sound and size of REX influenced 8 participants negatively.

98% of participants would like the device to be more affordable.

P 83.4

Bortole

2015 [48]

H2

Stroke

12

Likert ease of use

Overall rating: 7.2 out of 10, were 0 indicates “extremely hard to use” and 10 indicates “extremely ease of use”.

P 72.0

Chihara

2016 [47]

HAL

Stroke

6

Satisfaction interviews family and patients

No satisfaction results.

-

Corbianco

2021 [38]

Ekso GT

SCI

17

Subjective Experience Participant Impact

Ekso overall satisfaction and emotion: 6.6 ± 2.2 and 5.0 ± 3.3 out of 10.

Low scores of fatigue, mental effort and fear or discomfort were observed in the Lokomat. Lokomat was perceived to be less demanding when compared to the Ekso training.

P 52.7

Del-Ama

2015 [41]

Kinesis

SCI

3

QUEST 2.0

The overall satisfaction was 32.0 (4.0 ± 0.9) out of 40.

The overall lowest scores: weight (3.3 ± 0.4), fitting (3.2 ± 0.5) and comfort (3.0 ± 0.0) whereas safety (4.25 ± 0.9), durability (4.5 ± 0.5) and efficacy (5.0 ± 0.0) were top rated.

P 80.0

Dijsseldonk

2020 [13]

ReWalk

SCI

1 to 15

QUEST

SUS

Overall participant satisfaction: 3.7 ± 0.4 per item out of 5.

Subscale assistive device 3.5 ± 0.4 and 4.2 ± 0.5 in subscale service. Weight, Effectiveness, Ease of use and Safety were the most frequently scored as dissatisfied (mean < 3.0), and at the same time indicated as important.

The mean SUS score was rate with a median of 72.5% [52.5–95.0].

Low usability (< 3.0) in: ease of use and device function integration.

P 74.0*

Esquenazi

2012 [37]

ReWalk

SCI

24

Participant Satisfaction Questionnaire

27.7% of participants reported improved spasticity. No participant felt any pain. 9% of subjects fatigue. 45.5% of subjects reported improved bowel regulation.

-

Fernández-Vázquez 2021 [50]

Ekso GT

MS

13

QUEST 2.0

Client Satisfaction Questionnaire (CSQ-8)

Physical Therapist Questionnaire

Overall QUEST satisfaction: 31.3 ± 5.7 out of 40.

Parameters considered more relevant: effectiveness (32%), safety (26%) and ease of use (22%).

Overall CSQ-8 satisfaction: 26.3 ± 4.7 out of 32 points. Correlation between number of sessions and patients’ satisfaction (rho = 0.5; p < 0.001).

Overall physiotherapist’s satisfaction: 38.5 ± 3.7 out of 45 points. Correlations: age and satisfaction device adjustment (rho = 0.7; p = 0.007); and between experience and satisfaction combining with other gait trainings (rho = 0.7; p = 0.003).

P 78.2

T 85.5

Gómez-Vargas

2021 [45]

T-FLEX

Stroke

1

QUEST 2.0

Parameters more relevant: comfortable (70%); safety (60%); weight (60%).

Satisfaction level between satisfied (60%) and very satisfied (40%).

P 33.3

Høyer

2020 [44]

Ekso GT

Stroke

9

Likert satisfaction, usefulness, disadvantages, and willingness to repeat.

Overall satisfaction and usefulness of the training sessions 5.0 out of 5. 1.0 out of 4 no inconveniences as a result of the training and willingness to repeat exercises with Ekso GT.

P 100*

Jyräkoski

2021 [49]

Indego

Stroke

16

Participant Satisfaction Questionnaire + 2 additional questions

Overall satisfaction: 35.6 out of 50 (3.5 ± 0.6).

The lowest scores: improvements in bowel movement (2.4 ± 1.1), and ease of adjusting the device (3.8 ± 0.7). The best rated: comfort during and after the session (4.2 ± 0.8 and 4.2 ± 0.5).

Willing to use it as rehabilitation tool in the future in 80% of participants, and none of them could imagine using it at home.

P 71.2

Kozlowski 2017 [51]

ReWalk

MS

20

QUEST 2.0

The average total of the QUEST 2.0 was 29.3 ± 2.5 (range 2.8 ± 0.4 to 5.0 ± 0.0).

P 73.2

Kwon

2020 [36]

ReWalk

SCI

20

Usability evaluation questionnaire of walking devices (auto developed)

Interview

The usability of a ReWalk + crutches was compared with a KAFO + Walker.

KAFO best rated compared to ReWalk on: safety (3.5 ± 0.6 vs. 3.3 ± 0.8); effectiveness (3.5 ± 0.7 vs. 3.2 ± 0.6); efficiency (3.3 ± 0.7 vs. 3.0 ± 0.5); and overall satisfaction (4.2 ± 0.8 vs. 3.5 ± 0.7).

P 65.2*

López-Larraz

2016 [32]

H2

SCI

3

QUEST 2.0

Overall satisfaction: 30.5 out of 45 (3.3 ± 0.6).

The lowest scores: comfortability (2.5), weight and ease in adjusting (3.0). The highest scores: safety and ease of use (4.2), and effectiveness (3.7).

P 67.8

Nam

2019 [43]

Exowalk

Stroke

20

Questionnaire on satisfaction of electromechanical exoskeleton-assisted gait training

Overall satisfaction was 4.1 ± 0.2 out of 5.0.

High satisfaction rates: improvement of depression (4.5 ± 0.5), confidence in gait (4.2 ± 0.9), and desire to continue gait training (4.7 ± 0.6). The lowest score: motivation (3.8 ± 0.9).

P 82.0*

Platz

2016 [35]

ReWalk

SCI

25

Participant Satisfaction Questionnaire

The lowest score: spasticity (2.1), followed by fatigue (2.5) and ease of use (2.9). The best rated: breathing difficulty (4.9), pain (4.8) and comfort after the end of the session (4.6) out of 5.0.

P 42.0

Puyuelo-Quintana

2020 [53]

MAK

Stroke

MS

1

QUEST 2.0

Overall satisfaction: 22.4 ± 3.2 out of 40 (2.8 ± 0.4).

The best features of the exoskeleton: safety, size and weight (3.6). The lowest scores: effectiveness (2.4); and ease of use (2.6) and durability (2.6). The lowest score was the effectiveness of the device in resolving the participant’s problems.

P 56.0

Sale

2016 [33]

Ekso

SCI

20

Participant Satisfaction Questionnaire

Two satisfaction assessments: at the start of the study (T0) and after 20 sessions of use (T1).

Overall total at T0: 43.6 (4.3 ± 0.6) and at T1: 45 out of 50 (4.5 ± 0.3). The biggest improvements compared to T0: improvement bowel movement and safety (up 0.7 and 1.6 points respectively). The best T1 scores: improvement on spasticity (5.0 ± 0.0) and breathing difficulties (5.0 ± 0.0). The lowest score: fatigue (4.0 ± 1.0).

T0 87.2

T1 90.0

Sale

2018 [34]

Ekso

SCI

20

Participant Satisfaction Questionnaire

Two satisfaction assessments: at the start of the study (T0) and after 20 sessions of use (T1).

The overall total at T0 was 39.9 out of 50 (3.9 ± 0.6) and T1 was 45.1 out of 50 (4.5 ± 0.4) points.

After T1 all items increased in score. All scores greater than 4.0, with the exception of fatigue (3.7 ± 1.2), and 5 points were scored on improvement of spasticity and respiratory distress.

T0 79.8

T1 90.2

Swank

2020 [52]

Ekso GT

Stroke

SCI

8

4

Therapist Interview

Ekso therapist feasibility

Ekso patient feasibility

Feedback from therapists improved after six months except for communication between therapists and the Ekso trainer. All dimensions exceeded 70% scale score (2.9), with best results in overall satisfaction with therapy (3.7). No results were shown by pathology.

P 83.1*

Tamburella

2020 [40]

Achilles

SCI

10

QUEST 2.0

2 participants very satisfied (5.0) for all the aspects, with the exception about Achilles donning/doffing procedures (2.0) and reliability/robustness (2.0). Other 2 participants satisfied (4.0) by dimension, safety and ease of use.

-

Villa-Parra

2019 [42]

ALLOR

Stroke

1

QUEST 2.0

Overall satisfaction per item 4.2 ± 0.4. All categories exceeded 3.9 score, with a score of 5.0 for ease of use. The best feature of the exoskeleton was ease of use (5.0 ± 0.0 and the lowest scores were: dimensions (3.9 ± 0.0); weight (3.9 ± 0.8); and effectiveness (3.9 ± 0.8).

P 84.0*