Saskia Baltrusch

242 Chapter 9 Certainly, this approach is only possible, if healthcare professionals believe in the advantages of the exoskeleton themselves, which was not the case in the focus group study presented in Chapter 2. Only the psychologist mentioned: “I see it a bit like somebody keeps on moving. Can in principle be helpful” (Psychologist, Rehabilitation Center Heliomare) Considering that physical activity is a promising treatment strategy for low-back pain [8], an exoskeleton might indeed improve a patient’s health by increasing physical activity in daily life. This potential important effect does deserve attention in future research. With regard to introducing an exoskeleton in industry, an adequate implementation strategy is of importance as well, to deal with employees who do not see the need of wearing an exoskeleton. To increase the acceptability of an exoskeleton at work sites, managers need to take into account factors that potentially affect the employees’ openness to use the exoskeleton. As described in Chapter 8, one factor might be being seen with the exoskeleton in a working environment, especially if this is dominated by a male culture. By wearing the exoskeleton, the user is seen to show vulnerability to colleagues, which could inhibit the use of the device. A contractual obligation was discussed to solve that problem. In that way, the exoskeleton could also be prescribed to people without low-back pain, who are less open to use it. In contrast to the rehabilitation setting, in which the patients were positive about using an exoskeleton, but the healthcare professionals had many concerns, in industry, the employees might resist the use of an exoskeleton, while managers are supportive of using it. Knowledge of factors that can improve the acceptability of the device to employees, helps the management to select an adequate implementation strategy that deals with the employees’ and the management’s concerns. Obviously, exoskeleton design may also play a role in dealing with this kind of barriers. In sum, user-centered research starts with users and ends with the answers that are tailored to their individual needs. Understanding the people one is trying to reach, and designing from their perspective, will yield answers that help to design an exoskeleton that truly meets their requirements. The user-centered approach applied here shows the importance of listening to the thoughts of