JMIR Publications

ABSTRACT

Background:

Spinal cord injury (SCI) may, and often does, profoundly reshape daily life, altering physical abilities, social roles and personal identities. While assistive technologies, including assistive robotics such as supernumerary robotic limbs (SRLs), are often framed as solutions to re-establish independence, their adoption is shaped by more than just functional qualities. Individuals with SCI, their relatives and healthcare professionals navigate a complex interplay of practical, emotional and social considerations when encountering assistive robotics. Understanding these dynamics, how assistive technologies are perceived, imagined and potentially integrated into everyday life, may help developers and designers create assistive robotics that are meaningful and useful for intended users.

Objective:

This study explores how individuals with SCI, relatives and healthcare professionals working with SCI patients conceptualise, engage with and negotiate the possibilities and limitations of assistive robotics. The study seeks to understand the factors that influence the intention to use assistive robotics among individuals with spinal cord injuries.

Methods:

We used a qualitative approach, conducting semi-structured interviews and participatory workshops in Sweden and Spain. In total, the study involved 18 interview participants with SCI, 21 workshop participants with SCI, 12 relatives and 26 healthcare professionals. The interviews and workshops elicited reflections on participants’ experiences, expectations and concerns regarding assistive robotics in general and SRLs in particular. Thematic analysis was applied to identify patterns in the data, with a focus on interpreting the meanings embedded in participants’ narratives.

Results:

The analysis revealed that engagement with assistive robotics was shaped by interwoven imaginaries of technological promise and practical constraints. The main barriers identified were: practical constraints, including the subthemes “lived experiences during transition periods,” “difficulties with awareness and access,” and “concerns about costs”; and interaction with robots, including “doubts about meaningfulness,” “uncertainty regarding reliability and safety,” “uneasiness about competence,” and “apprehension of social norms.” Participants’ visions of enhanced self-efficacy through assistive robotics were interpreted as enabler of the intention to use and motivation to try assistive robotics. Technological imaginaries significantly influenced the participants’ perceptions and intentions regarding assistive robotics.

Conclusions:

Rather than presenting assistive robotics as an inevitable progression towards greater autonomy, this study highlights the complexities and contingencies that shape how individuals relate to assistive robotics in general and SRLs in particular. Participants’ responses illustrate that robotic assistance is not merely a question of technological feasibility but is deeply entangled with embodied experiences, shifting identities and evolving social relations. While visions of independence through assistive robotics remain compelling among participants, sociotechnical imaginaries coexist with concerns about meaningful engagement, reliability, safety, competence and social norms, as well as challenges related to transition periods, costs and limited awareness and access to assistive robotics.