Consumer perspectives on mobility: implications for neuroprosthesis design

The purpose of this study was to systematically assess mobility issues from the point of view of persons with spinal cord injuries (SCIs), so as to guide clinicians, researchers, and developers of assistive technologies. A telephone survey was developed through focus groups and discussions with individuals with SCI and rehabilitation experts. Telephone interviews were conducted with 94 individuals with paraplegia (51.4% response rate) from a Midwestern regional rehabilitation hospital's SCI database. Respondents were asked to prioritize desired mobility functions, to identify the acceptable quality of the activities, and to assess their willingness to experience related risks. Respondents ranked walking and then standing as top priorities (64% and 25%, respectively), regardless of injury level. For most, the acceptable quality of new mobility maneuvers did not have to approach premorbid function. Invasive procedures such as surgery were often as acceptable as less-invasive therapy and exercise. Qualities and costs of standing and walking were related to what respondents had to gain or lose relative to their current level of function. Contrary to opinions based on anecdotal evidence, persons with paraplegia were willing to accept high costs for limited function in certain mobility activities. These findings should encourage clinicians to consider the needs of persons with disabilities during the development of treatment interventions.