Integrating Stakeholder Input to Develop a Robotic Gait Training Intervention for People with SCI during Inpatient Rehabilitation

Research Objectives No clinical guidelines exist for the delivery of robotic exoskeleton gait training (RGT) during inpatient rehabilitation. Our purpose was to modify a RGT intervention with input from an Advisory Board (AB) of stakeholders to meet the unique needs of individuals with spinal cord injury (SCI) during inpatient rehabilitation. Design Community-Based Participatory Research. Setting Virtual meeting. Participants AB comprised 12 invitees (5 individuals with SCI lived experience, 2 physicians, 1 rehabilitation psychologist, 3 robotic exoskeleton-certified physical therapists and 1 robotic exoskeleton industry representative) and 9 research team members. Interventions AB members engaged in small break-out and large group discussions over a 3-hour virtual meeting. Participants were given structured prompts and open-ended questions to review prior to meeting. Research team members recorded the meeting and documented feedback on suggested RGT modifications. Stakeholders were contacted as needed following the meeting for clarification and iterative decision-making. Main Outcome Measures Qualitative responses about 1) Inclusion/exclusion criteria, 2) Clinical application and dosage of RGT, 3) Outcome measures, and 4) Engagement and Recruitment. Results Feedback from AB included: 1) expand inclusion criteria for those aged 16 to 70 years, 2) include co-existing mild/uncomplicated traumatic brain injury, 3) afford opportunities for patients to engage with clinical team regarding pros/cons to participating in RGT, 4) aim for 90 minutes/week of RGT, but allow for individual flexibility determined by patient tolerance and therapeutic priorities, and 5) assess affective outcomes in addition to gait and mobility performance. Conclusions AB feedback provided keen insight for developing an RGT intervention for inpatients with SCI. Future research efforts should examine the efficacy and effectiveness of the adapted intervention amidst ongoing stakeholder engagement. Author(s) Disclosures The authors have nothing to disclose.