Saskia Baltrusch

240 Chapter 9 exoskeleton in the rehabilitation setting for patients with low-back pain. Considering that health care professionals bear the responsibility of implementing an exoskeleton when used in rehabilitation, but see greater potential of using an exoskeleton in the working environment, I decided to put the focus of the study on industry as my main potential field of application. That is why the iterative testing and the final focus groups were conducted with employees with and without low-back pain, rather than low-back pain patients recruited from clinical settings. Low-back pain patients might still be a promising target group for using a passive trunk exoskeleton. Still, as they need the healthcare professionals for implementing the device in the rehabilitation setting it is currently less likely that a passive trunk exoskeleton will be introduced in the clinical environment. Potential concerns mentioned by the focus group participants in the first part of my thesis influenced my decision on what to take into account when evaluating the SPEXOR exoskeleton. Healthcare professionals, for instance, were concerned about confirming the patient’s disability, increasing vulnerability and decreasing confidence in their low-back. Regarding this concern, I decided to conduct a study that assessed the change in self-efficacy when using the exoskeleton (Chapter 8). I aimed to investigate whether the SPEXOR exoskeleton indeed decreases confidence or whether it helps employees with a history of low-back pain to be more confident about performing certain tasks in regard to their low-back pain. As described in Chapter 8, the SPEXOR exoskeleton increased self-efficacy in employees with low-back pain, especially for those being more restricted by their low-back pain. This is in line with Chapter 1, in which low- back pain patients believed that an exoskeleton would help them to overcome their daily limitations. It, however, stands in contrast to the concern mentioned by the healthcare professionals and thus indicates the importance of including multiple potential end-users in order to see the bigger picture. It should be noted here, though, that self-efficacy was measured in employees, suffering from low-back pain, whereas healthcare professionals talked about low-back pain patients that are treated in a multi-disciplinary rehabilitation setting. The different target groups might show different changes in self-efficacy when using an exoskeleton and the healthcare professionals’ concerns cannot be refuted, but should be studied in future research.