Adapted physical activity as a tool to optimize exoskeleton use in daily life for individuals with spinal cord injury

Spinal cord injuries significantly affect mobility, autonomy, and quality of life, impacting approximately 85,000 individuals in Italy. Advances in robotic exoskeletons show promise for improving mobility; however, challenges persist in adapting these devices for daily use, particularly in maneuverability and functionality in home settings. Additionally, structured physical activity programs are essential for enhancing the strength, endurance, and coordination required for exoskeleton use. This project aims to develop a physical activity program to prepare individuals with spinal cord injuries for exoskeleton use. Specific objectives include: (1) identifying barriers and facilitators to exoskeleton use; (2) examining attitudes toward physical activity in this population; and (3) designing and evaluating a home-based, adapted physical activity program. A systematic review revealed key barriers, including financial costs, environmental adaptability, and psychological acceptance. A survey highlighted motivational and environmental factors influencing physical activity participation, emphasizing personalized support. Lastly, a study protocol was developed for the SCI-HOME-ACTIVE program, featuring supervised exercises to enhance physical conditioning over three months. The findings highlight the need for an integrated approach combining physical training, exoskeleton technology, and healthcare support to improve mobility and independence in individuals with spinal cord injuries. The study also underscores the importance of interdisciplinary collaboration, professional training, and policy measures to promote accessible and adapted physical activity programs.