{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T08:30:04Z","timestamp":1775637004731,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014440","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["RTI2018-094346-B-I00"],"award-info":[{"award-number":["RTI2018-094346-B-I00"]}],"id":[{"id":"10.13039\/100014440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Recovery of therapeutic or functional ambulatory capacity in patients with rotator cuff injury is a primary goal of rehabilitation. Wearable powered exoskeletons allow patients to perform repetitive practice with large movements to maximize recovery, even immediately after the acute event. The aim of this paper is to describe the usability, acceptability and acceptance of a hybrid exoskeleton for upper-limb passive rehabilitation using the System Usability Scale (SUS) questionnaire. This equipment, called ExoFlex, is defined as a hybrid exoskeleton since it is made up of rigid and soft components. The exoskeleton mechanical description is presented along with its control system and the way motion is structured in rehabilitation sessions. Seven patients (six women and one man) have participated in the evaluation of this equipment, which are in the range of 50 to 79 years old. Preliminary evidence of the acceptance and usability by both patients and clinicians are very promising, obtaining an average score of 80.71 in the SUS test, as well as good results in a questionnaire that evaluates the clinicians\u2019 perceived usability of ExoFlex.<\/jats:p>","DOI":"10.3390\/s21217342","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T22:25:54Z","timestamp":1636064754000},"page":"7342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Validation of a Hybrid Exoskeleton for Upper Limb Rehabilitation. A Preliminary Study"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-3622","authenticated-orcid":false,"given":"Isabel-Mar\u00eda","family":"Alguacil-Diego","sequence":"first","affiliation":[{"name":"Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation Department, Universidad Rey Juan Carlos, Campus de Alcorc\u00f3n, Av. de Atenas, s\/n, 28922 Alcorc\u00f3n, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-2717","authenticated-orcid":false,"given":"Alicia","family":"Cuesta-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation Department, Universidad Rey Juan Carlos, Campus de Alcorc\u00f3n, Av. de Atenas, s\/n, 28922 Alcorc\u00f3n, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0627-1832","authenticated-orcid":false,"given":"Aldo-Francisco","family":"Contreras-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Centro de Autom\u00e1tica y Rob\u00f3tica (CAR) UPM-CSIC, ETS Ingenieros Industriales, Universidad Polit\u00e9cnica de Madrid, Calle de Jos\u00e9 Guti\u00e9rrez Abascal, 2, 28006 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5889-7816","authenticated-orcid":false,"given":"David","family":"Pont-Esteban","sequence":"additional","affiliation":[{"name":"Centro de Autom\u00e1tica y Rob\u00f3tica (CAR) UPM-CSIC, ETS Ingenieros Industriales, Universidad Polit\u00e9cnica de Madrid, Calle de Jos\u00e9 Guti\u00e9rrez Abascal, 2, 28006 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8328-2231","authenticated-orcid":false,"given":"David","family":"Cantalejo-Escobar","sequence":"additional","affiliation":[{"name":"Centro de Autom\u00e1tica y Rob\u00f3tica (CAR) UPM-CSIC, ETS Ingenieros Industriales, Universidad Polit\u00e9cnica de Madrid, Calle de Jos\u00e9 Guti\u00e9rrez Abascal, 2, 28006 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6652-0090","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"S\u00e1nchez-Ur\u00e1n","sequence":"additional","affiliation":[{"name":"Centro de Autom\u00e1tica y Rob\u00f3tica (CAR) UPM-CSIC, ETS Ingenieros Industriales, Universidad Polit\u00e9cnica de Madrid, Calle de Jos\u00e9 Guti\u00e9rrez Abascal, 2, 28006 Madrid, Spain"},{"name":"ETS Ingenier\u00eda y Dise\u00f1o Industrial, Universidad Polit\u00e9cnica de Madrid, Ronda de Valencia, 3, 28012 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0030-1551","authenticated-orcid":false,"given":"Manuel","family":"Ferre","sequence":"additional","affiliation":[{"name":"Centro de Autom\u00e1tica y Rob\u00f3tica (CAR) UPM-CSIC, ETS Ingenieros Industriales, Universidad Polit\u00e9cnica de Madrid, Calle de Jos\u00e9 Guti\u00e9rrez Abascal, 2, 28006 Madrid, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.rifk.2008.11.003","article-title":"Tratamiento f\u00edsico rehabilitador en el hombro doloroso","volume":"12","author":"Acosta","year":"2009","journal-title":"Rev. Iberoam. Fisioter. Kinesiol."},{"key":"ref_2","first-page":"706","article-title":"Resting injured limbs delays recovery: A systematic review","volume":"53","author":"Nash","year":"2004","journal-title":"J. Fam. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e16784","DOI":"10.1097\/MD.0000000000016784","article-title":"Physical therapy for the treatment of frozen shoulder: A protocol for systematic review of randomized controlled trial","volume":"98","author":"Tang","year":"2019","journal-title":"Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lambercy, O., Ranzani, R., and Gassert, R. (2018). Robot-assisted rehabilitation of hand function. Rehabilitation Robotics, Elsevier.","DOI":"10.1016\/B978-0-12-811995-2.00027-8"},{"key":"ref_5","first-page":"663","article-title":"Development of robots for rehabilitation therapy: The Palo Alto VA\/Stanford experience","volume":"37","author":"Burgar","year":"2000","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12984-018-0383-x","article-title":"Rehabilitation robots for the treatment of sensorimotor deficits: A neurophysiological perspective","volume":"15","author":"Gassert","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s10846-004-7194-y","article-title":"Design issues for therapeutic robot systems: Results from a survey of physiotherapists","volume":"42","author":"Lee","year":"2005","journal-title":"J. Intell. Robot. Syst."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e11066","DOI":"10.2196\/11066","article-title":"Usability study of mainstream wearable fitness devices: Feature analysis and system usability scale evaluation","volume":"6","author":"Liang","year":"2018","journal-title":"JMIR MHealth UHealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1743-0003-11-3","article-title":"A survey on robotic devices for upper limb rehabilitation","volume":"11","author":"Maciejasz","year":"2014","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Stienen, A.H., Hekman, E.E., Van Der Kooij, H., Ellis, M.D., and Dewald, J.P. (2009, January 7\u201312). Aspects of weight-support mechanisms in rehabilitation robotics. Proceedings of the World Congress on Medical Physics and Biomedical Engineering, Munich, Germany.","DOI":"10.1007\/978-3-642-03889-1_105"},{"key":"ref_11","first-page":"4","article-title":"SUS-A quick and dirty usability scale","volume":"189","author":"Brooke","year":"1996","journal-title":"Usability Eval. Ind."},{"key":"ref_12","first-page":"29","article-title":"SUS: A retrospective","volume":"8","author":"Brooke","year":"2013","journal-title":"J. Usability Stud."},{"key":"ref_13","first-page":"55","article-title":"A technique for the measurement of attitudes","volume":"22","author":"Likert","year":"1932","journal-title":"Arch. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An empirical evaluation of the system usability scale","volume":"24","author":"Bangor","year":"2008","journal-title":"Intl. J. Hum.-Interact."},{"key":"ref_15","unstructured":"Miguel Cruz, A., Daum, C., Comeau, A., Salamanca, J.D.G., McLennan, L., Neubauer, N., and Liu, L. (2021). Acceptance, adoption, and usability of information and communication technologies for people living with dementia and their care partners: A systematic review. Disabil. Rehabil. Assist. Technol., 1\u201315."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2340\/16501977-0938","article-title":"The use of raw scores from ordinal scales: Time to end malpractice?","volume":"44","author":"Grimby","year":"2012","journal-title":"J. Rehabil. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1177\/0269215518794069","article-title":"Responsiveness: Is it time to move beyond ordinal scores and approach interval measurements?","volume":"32","author":"Piscitelli","year":"2018","journal-title":"Clin. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Dalla Gasperina, S., Gandolla, M., Calcagno, A., Costa, A., Aquilante, L., Puchinger, M., Gfoehler, M., Braghin, F., and Pedrocchi, A. (2018, January 26\u201329). Multi-modal human-machine control interfaces of upper limb motorized exoskeletons for severely impaired patients. Proceedings of the 2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob), Enschede, The Netherlands.","DOI":"10.1109\/BIOROB.2018.8488001"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Proulx, C.E., Higgins, J., and Gagnon, D.H. (2021). Occupational therapists\u2019 evaluation of the perceived usability and utility of wearable soft robotic exoskeleton gloves for hand function rehabilitation following a stroke. Disabil. Rehabil. Assist. Technol., 1\u201310.","DOI":"10.1080\/17483107.2021.1938710"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.apergo.2018.02.009","article-title":"Evaluation of a passive exoskeleton for static upper limb activities","volume":"70","author":"Huysamen","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.3389\/fnbot.2017.00036","article-title":"An evaluation of the design and usability of a novel robotic bilateral arm rehabilitation device for patients with stroke","volume":"11","author":"Pei","year":"2017","journal-title":"Front. Neurorobot."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lopez-Samaniego, L., and Garcia-Zapirain, B. (2016). A robot-based tool for physical and cognitive rehabilitation of elderly people using biofeedback. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13121176"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1017\/S0263574714001891","article-title":"Functional and usability assessment of a robotic exoskeleton arm to support activities of daily life","volume":"32","author":"Ambrosini","year":"2014","journal-title":"Robotica"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3389\/fnbot.2019.00003","article-title":"Usability assessment of a cable-driven exoskeletal robot for hand rehabilitation","volume":"13","author":"Tsai","year":"2019","journal-title":"Front. Neurorobot."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Jankowski, J., and \u0141ach, P. (2020). A Comparison of Methods of Controlling the Movement of an Exoskeleton, Supporting Movements of the Upper Limb Using Signals of Muscle Activity and Manual Controls. Probl. Mechatroniki Uzbroj. Lotnictwo In\u017cynieria Bezpiecze\u0144stwa, 11.","DOI":"10.5604\/01.3001.0014.3705"},{"key":"ref_26","first-page":"1","article-title":"Exoskeleton home and community use in people with complete spinal cord injury","volume":"10","author":"Geurts","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"153297","DOI":"10.1109\/ACCESS.2020.3018418","article-title":"A Cable-Driven Exosuit for Upper Limb Flexion Based on Fibres Compliance","volume":"8","author":"Ferre","year":"2020","journal-title":"IEEE Access"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Samper-Escudero, J.L., Contreras-Gonz\u00e1lez, A.F., Pont-Esteban, D., S\u00e1ez-S\u00e1ez, F.J., Sanchez-Ur\u00e1n, M.\u00c1., and Ferre, M. (2020, January 7\u20139). Assessment of an upper limb exosuit with textile coupling. Proceedings of the 2020 IEEE International Conference on Human-Machine Systems (ICHMS), Rome, Italy.","DOI":"10.1109\/ICHMS49158.2020.9209462"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"012074","DOI":"10.1088\/1742-6596\/1828\/1\/012074","article-title":"Validation of An Elbow Position Super-Twisting Sliding-Mode Controller for Upper-Limb Exosuit Using A Soft Position Sensor","volume":"1828","author":"Ferre","year":"2021","journal-title":"J. Phys. Conf. Ser."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Silva, M.F., Lu\u00eds Lima, J., Reis, L.P., Sanfeliu, A., and Tardioli, D. (2020). ExoFlex: An Upper-Limb Cable-Driven Exosuit. Advances in Intelligent Systems and Computing, Proceedings of the Robot 2019: Fourth Iberian Robotics Conference, Porto, Portugal, 20\u201322 November 2019, Springer International Publishing.","DOI":"10.1007\/978-3-030-35990-4_55"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/21\/7342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:25:51Z","timestamp":1760167551000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/21\/7342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,4]]},"references-count":30,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["s21217342"],"URL":"https:\/\/doi.org\/10.3390\/s21217342","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,4]]}}}