Post-stroke individual preferences for lower limb rehabilitation exoskeletons

A Discrete Choice Experiment assessed the preferences of 58 adults post-stroke recruited from two rehabilitation centers in Brittany, France. The sample comprised mostly men, aged 25–80, with ~ 50% over 65. Descriptive analyses used all 58 participants; five failed an internal validity check and were excluded from modeling, leaving 53 for preference estimation. Each respondent completed eight choice tasks comparing two device configurations. Conditional and mixed logit models estimated preference weights and willingness-to-pay (WTP). More than 90% of participants self-reported fair or good health status, and 78% expressed willingness to pay a monthly fee for a rehabilitation device. The conditional logit model fit was acceptable (Likelihood Ratio χ²=93.97, p < 0.001; pseudo-R²=0.17). Cost was a significant deterrent (β = −0.027; p < 0.001). Participants highly valued greater movement freedom (β = 0.702; p = 0.007) and strongly preferred active or semi-passive control over passive modes (β = −0.626; p = 0.046). Feedback and comfort had limited effects. The mixed logit model revealed significant preference heterogeneity, specifically for passive control. The estimated WTP was approximately €26 per month for an additional degree of freedom. In conclusion, post-stroke preferences prioritize autonomy and mobility and are highly sensitive to cost. Integrating these findings into device design and reimbursement strategies could improve the adoption of rehabilitation exoskeletons.