Evaluation of the HAL® lumbar type exoskeleton in long-term care : protocol for a mixed-methods feasibility study

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Quantitative measures include: 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.

Results: 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.

Discussion: 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 well-being.