Saskia Baltrusch

34 Chapter 2 Muscle Weakness and Overloading An issue that both groups noted was the fear of losing muscle strength when wearing the device for a longer period of time. Patients were concerned about not using their back muscles anymore, resulting in overloading and probably more pain once the device has been taken off. Healthcare professionals talked about a transformation in muscle tissue in the long-term, leading to an even more vulnerable patient, and a potential overloading of the knees, since the exoskeleton transfers the load from the back to the legs. 3.4 Positive Aspects and Design Improvements Individual fit and task specific Patients reached consensus that an assistive device should provide individual fit, being case-specific to their personal needs and maintaining independence when using the device. Consequently, using the device should not require any help for putting it on or taking it off, or for making adjustments. Another important issue raised by both groups was having a versatile device that can provide different modes of support, depending on the task performed. Comfort and Visibility In both focus groups, improved comfort was considered as an important design requirement. Patients focused on changing the location of the chest pad to prevent pressure on the chest and to reduce the weight of the device. One patient explained she would like to have a device that is: “[…] less present. Not because someone might see it, but I just don’t wanna feel that I have something around me.” (Paula, P) They all agreed that being seen with the device would be acceptable, if it was of light material and not too bulky. Healthcare professionals considered using a back-pack like structure, instead of the chest pad, to distribute the pressure over the upper body. When discussing the visibility of the device, healthcare professionals raised positive and negative