STUDY PROTOCOL article
Front. Digit. Health
Sec. Health Technology Implementation
Volume 7 - 2025 | doi: 10.3389/fdgth.2025.1591866
This article is part of the Research TopicExoskeleton Gait TrainingView all 12 articles
Evaluation of the HAL® Lumbar Type Exoskeleton in Long-Term Care: Protocol for a Mixed-Methods Feasibility Study
Provisionally accepted
Sebastian Hofstetter1*
Pascal Müller Müller1
Dominik Behr1Suenje Thal2Motoaki Komiya2Stefan Dowiasch3
Patrick Jahn1- 1Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Halle/Saale, Germany
- 2Cyberdyne Care Robotics GmbH, Bochum, Germany
- 3Bochum University of Applied Sciences, Bochum, North Rhine-Westphalia, Germany
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Lower back pain (LBP) is one of the most common occupational health issues among healthcare professionals, particularly in long-term care settings. The HAL® Lumbar Type Exoskeleton is a wearable assistive technology designed to reduce strain on the lower back during physically demanding care activities. However, evidence regarding its feasibility, usability, and acceptance in real-world long-term care settings remains limited.This study aims to evaluate the feasibility, usability, and user acceptance of the HAL® Lumbar Type Exoskeleton in long-term care facilities. Specifically, the study assesses whether the exoskeleton can reduce self-reported lower back pain and improve the ergonomic conditions for caregivers.This is a non-randomized, exploratory interventional feasibility study using a mixed-methods design. A total of 30 caregivers from two long-term care facilities will participate in a 90-day intervention. The exoskeleton will be integrated into daily care routines, and caregivers will undergo training on its proper use.• Visual Analog Scale (VAS) for pain assessment before and after using the exoskeleton.• Oswestry Disability Index (ODI) and Short-Form Health Survey (SF-8) at baseline (T1), mid-study (T2), and post-intervention (T3).Qualitative methods include semi-structured interviews with eight caregivers, exploring usability, perceived benefits, and barriers to adoption.Data will be analyzed using descriptive statistics, repeated measures ANOVA, and thematic content analysis for qualitative data. Findings will inform future studies on integrating wearable assistive technologies into caregiving workflows.This study will provide essential insights into the feasibility and usability of exoskeletons in long-term care, potentially contributing to improved ergonomic conditions and caregiver wellbeing.Trial Registration: [Deutsches Register Klinischer Studien DRKS00036285; https://drks.de/search/en/trial/DRKS00036285/entails]
Keywords: exoskeleton, Long-Term Care, Caregivers, usability, Occupational Health, Assistive Technology
Received: 11 Mar 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Hofstetter, Müller, Behr, Thal, Komiya, Dowiasch and Jahn. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sebastian Hofstetter, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Halle/Saale, Germany
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.