Physiological And Perceptual Burden Of Overground Robotic Exoskeleton Training Among Inpatient Physical Therapy Staff

High physical and cognitive burden is associated with increased risk for work-related injuries and burnout among physical therapists (PTs). Provision of gait training interventions for patients with neurological injuries [e.g., spinal cord injury (SCI) and stroke (CVA)] places a high demand on PTs in the inpatient rehabilitation setting. Utilizing overground robotic exoskeletons (ORE) for gait training may reduce the burden on PTs compared to delivery of usual care (UC) gait training modalities. PURPOSE: Describe the physiological and perceptual burden experienced by PTs when providing ORE and UC for patients with SCI and CVA during inpatient rehabilitation. METHODS: In this observational cohort study, PTs conducted two gait training interventions (once with ORE; once with UC), on a patient with SCI or CVA, while physiological and perceptual burden were assessed. Physiological burden was assessed using metabolic [metabolic equivalents (METs) and energy expenditure (EE)] and cardiovascular [percent of age-predicted max heart rate (HR)] outcomes measured via a portable metabolic cart and wearable HR monitor. Perceptual burden (mental, physical, and temporal demand, performance, effort, and frustration) was assessed using domain scores from the NASA Task Load Index. Outcomes were compared using Wilcoxon Signed Rank Tests and effect sizes were calculated. RESULTS: 4 PTs [female (100%), white (50%), median (Q1, Q3) age = 34.5 (34, 37.25) years] completed both assessments. Detailed in Table 1, observations included large effect sizes between ORE and UC in all perceptual outcomes, average METs, % time in MET zones corresponding to moderate and vigorous intensity, EE, peak HR, recovery HR, and % time spent in HR zones corresponding with moderate and near maximal intensities. CONCLUSION: Physiological and perceptual burden of our PTs was lower during ORE than UC gait training for patients with SCI and CVA during inpatient rehabilitation.