{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:25Z","timestamp":1785545005812,"version":"3.56.0"},"reference-count":53,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Assessing usability is important given the increasing use of technology in rehabilitation. While wearable robotic exoskeletons (WREs) are commonly incorporated into neurological rehabilitation in both clinical and community settings, there is a need to examine the applicability of different usability instruments in this context. The Assistive Technology Usability Questionnaire for People with Neurological Diseases (NATU Quest) was developed to evaluate the usability of assistive technology in individuals with neurological conditions. However, its reliability and validity have been established only for assistive devices such as wheelchairs and canes, restricting its generalizability.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to cross-culturally adapt a Taiwan Chinese version of the NATU Quest and to preliminarily evaluate its applicability, reliability, and validity for assessing WRE use among patients who had a stroke as an expanding application context.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Cross-cultural adaptation was achieved through a structured translation from Spanish to Taiwan Chinese, followed by content validation by an expert panel of 10 raters. Following the adaptation process, psychometric testing of the NATU Quest was administered to 20 patients who had a stroke following the completion of a comprehensive course of robot-assisted gait training facilitated by a WRE. The internal consistency of the NATU Quest was evaluated using the Cronbach \u03b1 coefficient. The reliability of the test-retest procedure was evaluated using the intraclass correlation coefficient (ICC). Convergent validity was ascertained by examining the correlation between the NATU Quest scores and the System Usability Scale (SUS).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The culturally adapted NATU Quest showed acceptable content validity, with item-level content validity index (CVI) values ranging from 0.80 to 1.00 and scale-level CVI values of 0.93 for clarity and 0.97 for relevance. Cronbach \u03b1 was 0.943, indicating high internal consistency. Of the 20 participants who completed all 6 rehabilitation sessions, 13 participants completed repeat testing. Preliminary test-retest reliability was acceptable (ICC=0.823;\n P<\/jats:italic>\n <.001; SE of measurement=0.31). NATU Quest scores were strongly correlated with SUS scores (Spearman \u03c1=0.818;\n P<\/jats:italic>\n <.001), providing preliminary support for convergent validity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The adapted NATU Quest demonstrated promising preliminary psychometric properties when applied to WRE use among individuals who had a stroke. Further studies with larger sample sizes are warranted to examine additional psychometric properties such as construct validity and responsiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/89556","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:41:01Z","timestamp":1784583661000},"page":"e89556-e89556","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Taiwan Chinese Version of the Assistive Technology Usability Questionnaire for People With Neurological Diseases for Wearable Robotic Exoskeletons: Usability Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2438-5459","authenticated-orcid":false,"given":"Hander","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9796-9744","authenticated-orcid":false,"given":"Jian-Jia","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-0046","authenticated-orcid":false,"given":"Yu-Cheng","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0186-3126","authenticated-orcid":false,"given":"Huey-Wen","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.5535\/arm.250093","article-title":"Wearable robots for rehabilitation and assistance of gait: a narrative review","volume":"49","author":"Cha","journal-title":"Ann Rehabil Med"},{"issue":"16","key":"R2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12161636","article-title":"Lower-limb exoskeletons for gait training in Parkinson\u2019s disease: the state of the art and future perspectives","volume":"12","author":"Fortunati","journal-title":"Healthcare (Basel)"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2022.09.082","article-title":"Effectiveness of robotic exoskeletons for improving gait in children with cerebral palsy: a systematic review","volume":"98","author":"Hunt","journal-title":"Gait Posture"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2021.01.001","article-title":"Wearable robotic exoskeleton for gait reconstruction in patients with spinal cord injury: a literature review","volume":"28","author":"Tan","journal-title":"J Orthop Translat"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1453781","article-title":"Effect of robotic exoskeleton training on lower limb function, activity and participation in stroke patients: a systematic review and meta-analysis of randomized controlled trials","volume":"15","author":"Yang","journal-title":"Front Neurol"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1017\/wtc.2025.10015","article-title":"Understanding the perspectives of older adults and physiotherapists on home-based lower-limb exoskeletons","volume":"6","author":"Claeys","journal-title":"Wearable Technol"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2025.3615078","article-title":"Development and validation of Customizable, Adaptive SPring-actuated Hand EXoskeleton (CASPHEX) designed for home-based training of finger movements post-stroke","volume":"33","author":"Phan","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2025.1591866","article-title":"Evaluation of the HAL\u00ae lumbar type exoskeleton in long-term care: protocol for a mixed-methods feasibility study","volume":"7","author":"Hofstetter","journal-title":"Front Digit Health"},{"key":"R9","unstructured":"ISO 9241-11:2018: Ergonomics of Human-System Interaction: Part 11: Usability: Definitions and Concepts. 2nd ed. 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