Saskia Baltrusch

39 Chapter 2 are indeed limitations of most assistive devices [9,38] , leading to decreased user-friendliness and limited usability in daily life. When discussing the usability of the exoskeleton and it’s field of application, healthcare professionals believed that exoskeletons are mainly useful as preventive measures at work site, supporting tasks like forward bending, lifting and strenuous physical work. This type of usage is supported by several studies that have shown that forward bending, lifting and static holding are supported by assistive devices [8-11]. Users, however, should be aware of potential negative consequences, such as misuse of the assistive device at work or increased work expectations by the employer. Furthermore, healthcare professionals considered using the device in the late stage of rehabilitation, namely vocational reintegration, provided a clear target group and an explicit implementation strategy is defined. Furthermore, long-term supervision would be crucial to ensure the correct use of the assistive device. Patients considered using the device to be supported in their daily activities and to overcome their participation limitations, such as dependency on others and social exclusion, provided the suggested features could be incorporated. The different opinions on application underlines the importance of adequate communication between healthcare professional and patient, when aiming to introduce an exoskeleton in rehabilitation. Still, further research is needed to identify the optimal application for an exoskeleton. Limitations and Futures research As the majority of participants in this study were recruited at the same rehabilitation centre in the Netherlands, transferability and applicability of the focus group findings are somewhat restricted. Results may be different in other healthcare centres and other countries. We, however, believe that our findings give a good insight into context-dependent views of potential end-users on this currently important topic in research regarding the use of wearable assistive devices in the prevention and management of low-back pain. Another limitation of this study is the small sample size of the focus group with patients. As a result, the moderator had to actively facilitate the interaction. However, as an advantage of the small group, patients intensively shared their personal experience with low-back pain. 2