Multidisciplinary collaboration on exoskeleton development adopting user-centered design: a systematic integrative review

Abstract

Purpose: The world population is ageing, along with an increasing possibility of functional limitations that affect independent living. Assistive technologies such as exoskeletons for rehabilitative purposes and daily activities assistance maintaining the independence of people with disabilities, especially older adults who wish to ageing-in-place. The purpose of this systematic integrative review was threefold: to explore the development team compositions and involvement, to understand the recruitment and engagement of stakeholders, and to synthesise reported or anticipated consequences of multidisciplinary collaboration. Methods: Databases searched included PubMed, CINAHL Plus, PsycINFO, Web of Science, Scopus, and IEEE Xplore. A total of 34 studies that reported the development of exoskeleton adopting user-centered design (UCD) method in healthcare or community settings that were published in English from 2000 to July 2022 were included. Results: Three major trends emerged from the analysis of included studies. First, there is a need to redefine multidisciplinary collaboration, from within-discipline collaboration to cross-discipline collaboration. Second, the level of engagement of stakeholders during the exoskeleton development remained low. Third, there was no standardised measurement to quantify knowledge production currently. Conclusion: As suggested by the synthesised results in this review, exoskeleton development has been increasing to improve the functioning of people with disabilities. Exoskeleton development often required expertise from different disciplines and the involvement of stakeholders to increase acceptance, thus we propose the Multidisciplinary Collaboration Appraisal Tool to assess multidisciplinary collaboration using the UCD approach. Future research is required to understand the effectiveness of multidisciplinary collaboration on exoskeleton development using the UCD approach.IMPLICATIONS FOR REHABILITATION Global trend of population ageing causes a higher risk of disability in older adults who require rehabilitation and assistance in daily living. Assistive technologies such as exoskeletons have the potential to contribute to rehabilitation training and daily activity assistance demand closer multidisciplinary collaboration. A Multidisciplinary Collaboration Appraisal Tool using user-centered design approach (MCAT) is proposed to understand the effectiveness as well as limitations and barriers associated with multidisciplinary collaboration in developing exoskeletons.