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Feingold-Polak R, Barzel O, Levy-Tzedek S. Socially Assistive Robot for Stroke Rehabilitation: A Long-Term in-the-Wild Pilot Randomized Controlled Trial. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1616-1626. [PMID: 38598401 DOI: 10.1109/tnsre.2024.3387320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Socially assistive robots (SARs) have been suggested as a platform for post-stroke training. It is not yet known whether long-term interaction with a SAR can lead to an improvement in the functional ability of individuals post-stroke. The aim of this pilot study was to compare the changes in motor ability and quality of life following a long-term intervention for upper-limb rehabilitation of post-stroke individuals using three approaches: 1) training with a SAR in addition to usual care; 2) training with a computer in addition to usual care; and 3) usual care with no additional intervention. Thirty-three post-stroke patients with moderate-severe to mild impairment were randomly allocated into three groups: two intervention groups - one with a SAR (ROBOT group) and one with a computer (COMPUTER group) - and one control group with no intervention (CONTROL group). The intervention sessions took place three times/week, for a total of 15 sessions/participant; The study was conducted over a period of two years, during which 306 sessions were held. Twenty-six participants completed the study. Participants in the ROBOT group significantly improved in their kinematic and clinical measures which included smoothness of movement, action research arm test (ARAT), and Fugl-Meyer upper-extremity assessment (FMA-UE). No significant improvement in these measures was found in the COMPUTER or the control groups. 100% of the participants in the SAR group gained improvement which reached - or exceeded - the minimal clinically important difference in the ARAT, the gold standard for upper-extremity activity performance post-stroke. This study demonstrates both the feasibility and the clinical benefit of using a SAR for long-term interaction with post-stroke individuals as part of their rehabilitation program. Trial Registration: ClinicalTrials.gov NCT03651063.
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Hong R, Li B, Bao Y, Liu L, Jin L. Therapeutic robots for post-stroke rehabilitation. MEDICAL REVIEW (2021) 2024; 4:55-67. [PMID: 38515779 PMCID: PMC10954296 DOI: 10.1515/mr-2023-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/25/2024] [Indexed: 03/23/2024]
Abstract
Stroke is a prevalent, severe, and disabling health-care issue on a global scale, inevitably leading to motor and cognitive deficits. It has become one of the most significant challenges in China, resulting in substantial social and economic burdens. In addition to the medication and surgical interventions during the acute phase, rehabilitation treatment plays a crucial role in stroke care. Robotic technology takes distinct advantages over traditional physical therapy, occupational therapy, and speech therapy, and is increasingly gaining popularity in post-stroke rehabilitation. The use of rehabilitation robots not only alleviates the workload of healthcare professionals but also enhances the prognosis for specific stroke patients. This review presents a concise overview of the application of therapeutic robots in post-stroke rehabilitation, with particular emphasis on the recovery of motor and cognitive function.
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Affiliation(s)
- Ronghua Hong
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bingyu Li
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Yunjun Bao
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Lingyu Liu
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Lingjing Jin
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China
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Fitter NT, Mohan M, Preston RC, Johnson MJ, Kuchenbecker KJ. How should robots exercise with people? Robot-mediated exergames win with music, social analogues, and gameplay clarity. Front Robot AI 2024; 10:1155837. [PMID: 38283804 PMCID: PMC10813396 DOI: 10.3389/frobt.2023.1155837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/08/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction: The modern worldwide trend toward sedentary behavior comes with significant health risks. An accompanying wave of health technologies has tried to encourage physical activity, but these approaches often yield limited use and retention. Due to their unique ability to serve as both a health-promoting technology and a social peer, we propose robots as a game-changing solution for encouraging physical activity. Methods: This article analyzes the eight exergames we previously created for the Rethink Baxter Research Robot in terms of four key components that are grounded in the video-game literature: repetition, pattern matching, music, and social design. We use these four game facets to assess gameplay data from 40 adult users who each experienced the games in balanced random order. Results: In agreement with prior research, our results show that relevant musical cultural references, recognizable social analogues, and gameplay clarity are good strategies for taking an otherwise highly repetitive physical activity and making it engaging and popular among users. Discussion: Others who study socially assistive robots and rehabilitation robotics can benefit from this work by considering the presented design attributes to generate future hypotheses and by using our eight open-source games to pursue follow-up work on social-physical exercise with robots.
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Affiliation(s)
- Naomi T. Fitter
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Mayumi Mohan
- Haptic Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Rhian C. Preston
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Michelle J. Johnson
- Rehabilitation Robotics Lab, Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, United States
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Huang X, Xiang X, Liu Y, Wang Z, Jiang Z, Huang L. The Use of Gamification in the Self-Management of Patients With Chronic Diseases: Scoping Review. JMIR Serious Games 2023; 11:e39019. [PMID: 38133907 PMCID: PMC10770795 DOI: 10.2196/39019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 02/26/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Chronic disease self-management is a public health issue of worldwide concern, and gamification is an emerging strategy to improve patients' participation in chronic disease self-management. Some studies have summarized designs for the gamification of chronic disease self-management from the perspective of eHealth technology, but they have not mentioned differences in design methods, functions, and evaluation methods of gamified designs for self-management in different chronic diseases. OBJECTIVE This scoping review aims to synthesize the characteristics of realization forms, functions, and evaluation methods in chronic disease self-management gamification to improve self-management among the chronic disease population. METHODS We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. As of January 7, 2023, we systematically searched 9 databases for relevant studies from January 2012 to December 2022. Related data were extracted based on the research questions. We calculated the frequencies, charted the quantitative data, and coded the extracted material for qualitative content analysis. RESULTS We retrieved 16,221 records, of which 70 (0.43%) met the eligibility criteria. In the included research, the target populations for gamified designs for self-management of chronic diseases included patients with stroke, cancer, diabetes, chronic obstructive pulmonary disease, coronary heart disease, obesity, and hypertension. Almost all studies mentioned technical support for gamification (68/70, 97%), mainly in the form of active video games (58/70, 83%); however, less than half of the studies mentioned the theoretical basis for gamification (31/70, 44%). There were 37 concepts or theories relevant to gamification design, most of which were in the field of psychology or were cross-disciplinary (n=33, 89%). Gamification for the self-management of chronic diseases has been widely recognized, including for promoting physical exercise and rehabilitation training (48/99, 48%), increasing initiative for symptom management (18/99, 18%), providing psychological support (14/99, 14%), improving cognitive function (12/99, 12%), and improving medication adherence (7/99, 7%). A total of 39 studies mentioned the gamification effect; however, we did not find a unified evaluation standard. CONCLUSIONS This scoping review focuses on gamification designs for chronic disease self-management and summarizes the realization forms and functions of gamification in self-management for different patient populations. With practice in a gamified internet-based environment, patients can not only master the knowledge and skills of self-management in fascinating scenarios but also benefit from gaming experience and make better health-related decisions in real life. It is worth noting that a comprehensive evaluation of the users as well as a personalized and targeted intervention should be developed before gamification.
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Affiliation(s)
- Xiting Huang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinyue Xiang
- Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yang Liu
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiqian Wang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhili Jiang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lihua Huang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Baer R, Feingold-Polak R, Ostrovsky D, Kurz I, Levy-Tzedek S. Correlation between kinetic and kinematic measures, clinical tests and subjective self-evaluation questionnaires of the affected upper limb in people after stroke. Front Neurosci 2023; 17:1264513. [PMID: 38178833 PMCID: PMC10765579 DOI: 10.3389/fnins.2023.1264513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Assessment of stroke recovery should include multiple sources of information in order to obtain a complete understanding of the individual's rehabilitation progress. Self-evaluation questionnaires' scores do not always correspond to the scores of commonly used clinical evaluation tools. The purpose of this study was to assess the relationship between self-evaluation questionnaires, clinical tests, and kinematic and kinetic analyses of the affected upper limb after stroke, and to determine the correlation between these measures and self-reported general function 2-4 years after the stroke. Methods Twenty-six subjects recovering from stroke were included in the study. Spearman's correlation coefficient was used to measure the correlation between Stroke Impact Scale (SIS), Motor activity Log (MAL), Fugl-Meyer Assessment (FMA) and Action Reach Arm Test (ARAT) scores, and kinematic and kinetic analyses. A logistic regression was used to assess the extent to which these measures may predict the participants' functional self-reported status 2-4 years post stroke. Results Sections regarding hand function, hand force and general ADL of the self-evaluation questionnaires correlated with kinematic variables. However, only questionnaires that focus on hand function correlated with clinical tests. Mean and maximal hand velocity had the strongest correlations with self-evaluation questionnaires and with the clinical tests, more than other kinematic variables. Self-evaluation questionnaires and clinical tests were found to be correlated with hand kinetic metrics force-to-time ratio and number of force peaks. SIS hand force domain, mean velocity and maximal velocity predicted self-reported general function 2-4 years after the stroke. Conclusion Self-evaluation questionnaires should be considered for wider use in the clinical evaluation of a patient's stroke recovery, since they add important information on the individual's functional status, which is not reflected in the clinical tests.
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Affiliation(s)
- Ronnie Baer
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Ronit Feingold-Polak
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Herzog Medical Center, Jerusalem, Israel
| | - Daniel Ostrovsky
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Ilan Kurz
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Shelly Levy-Tzedek
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
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Dennler N, Cain A, De Guzman E, Chiu C, Winstein CJ, Nikolaidis S, Matarić MJ. A metric for characterizing the arm nonuse workspace in poststroke individuals using a robot arm. Sci Robot 2023; 8:eadf7723. [PMID: 37967205 DOI: 10.1126/scirobotics.adf7723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/19/2023] [Indexed: 11/17/2023]
Abstract
An overreliance on the less-affected limb for functional tasks at the expense of the paretic limb and in spite of recovered capacity is an often-observed phenomenon in survivors of hemispheric stroke. The difference between capacity for use and actual spontaneous use is referred to as arm nonuse. Obtaining an ecologically valid evaluation of arm nonuse is challenging because it requires the observation of spontaneous arm choice for different tasks, which can easily be influenced by instructions, presumed expectations, and awareness that one is being tested. To better quantify arm nonuse, we developed the bimanual arm reaching test with a robot (BARTR) for quantitatively assessing arm nonuse in chronic stroke survivors. The BARTR is an instrument that uses a robot arm as a means of remote and unbiased data collection of nuanced spatial data for clinical evaluations of arm nonuse. This approach shows promise for determining the efficacy of interventions designed to reduce paretic arm nonuse and enhance functional recovery after stroke. We show that the BARTR satisfies the criteria of an appropriate metric for neurorehabilitative contexts: It is valid, reliable, and simple to use.
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Affiliation(s)
- Nathaniel Dennler
- Department of Computer Science, University of Southern California, Los Angeles, CA, USA
| | - Amelia Cain
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Erica De Guzman
- Department of Computer Science, University of Southern California, Los Angeles, CA, USA
| | - Claudia Chiu
- Department of Computer Science, University of Southern California, Los Angeles, CA, USA
| | - Carolee J Winstein
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Stefanos Nikolaidis
- Department of Computer Science, University of Southern California, Los Angeles, CA, USA
| | - Maja J Matarić
- Department of Computer Science, University of Southern California, Los Angeles, CA, USA
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Raz D, Barkan-Slater S, Baum-Cohen I, Vissel G, Lahav-Raz Y, Shapiro A, Levy-Tzedek S. A novel socially assistive robotic platform for cognitive-motor exercises for individuals with Parkinson's Disease: a participatory-design study from conception to feasibility testing with end users. Front Robot AI 2023; 10:1267458. [PMID: 37868274 PMCID: PMC10587405 DOI: 10.3389/frobt.2023.1267458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
The potential of socially assistive robots (SAR) to assist in rehabilitation has been demonstrated in contexts such as stroke and cardiac rehabilitation. Our objective was to design and test a platform that addresses specific cognitive-motor training needs of individuals with Parkinson's disease (IwPD). We used the participatory design approach, and collected input from a total of 62 stakeholders (IwPD, their family members and clinicians) in interviews, brainstorming sessions and in-lab feasibility testing of the resulting prototypes. The platform we developed includes two custom-made mobile desktop robots, which engage users in concurrent cognitive and motor tasks. IwPD (n = 16) reported high levels of enjoyment when using the platform (median = 5/5) and willingness to use the platform in the long term (median = 4.5/5). We report the specifics of the hardware and software design as well as the detailed input from the stakeholders.
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Affiliation(s)
- Dor Raz
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shirel Barkan-Slater
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilanit Baum-Cohen
- Tzeadim Neurorehabilitation Center and Parkinson’s and Movement Disorders Rehabilitation Unit, Sheba Medical Center, Beer-Sheva, Israel
| | - Gal Vissel
- Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yeela Lahav-Raz
- Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Amir Shapiro
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Department of Physical Therapy, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
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Young R, Sage K, Broom D, Hext A, Snowdon N, Smith C. Evaluating the usability of a co-designed power assisted exercise graphical user interface for people with stroke. J Neuroeng Rehabil 2023; 20:95. [PMID: 37488564 PMCID: PMC10364422 DOI: 10.1186/s12984-023-01207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/19/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Digital advancement of power assisted exercise equipment will advance exercise prescription for people with stroke (PwS). This article reports on the remote usability evaluation of a co-designed graphical user interface (GUI) and denotes an example of how video-conference software can increase reach to participants in the testing of rehabilitation technologies. The aim of this study was to evaluate the usability of two sequential versions of the GUI. METHODS We adopted a mixed methods approach. Ten professional user (PU) (2M/8F) and 10 expert user (EU) participants (2M/8F) were recruited. Data collection included a usability observation, a 'think aloud' walk through, task completion, task duration and user satisfaction as indicated by the Post Study System Usability Questionnaire (PSSUQ). Identification of usability issues informed the design of version 2 which included an additional submenu. Descriptive analysis was conducted upon usability issues and number of occurrences detected on both versions of the GUI. Inferential analysis enabled comparison of task duration and PSSUQ data between the PU and EU groups. RESULTS Analysis of the 'think aloud' walkthrough data enabled identification of 22 usability issues on version 1 from a total of 100 usability occurrences. Task completion for all tasks was 100%. Eight usability issues were directly addressed in the development of version 2. Two recurrent and 24 new usability issues were detected in version 2 with a total of 86 usability occurrences. Paired two tailed T-tests on task duration data indicated a significant decrease amongst the EU group for task 1.1 on version 2 (P = 0.03). The mean PSSUQ scores for version 1 was 1.44 (EU group) and 1.63 (PU group) compared with 1.40 (EU group) and 1.41 (PU group) for version 2. CONCLUSIONS The usability evaluation enabled identification of usability issues on version 1 of the GUI which were effectively addressed on the iteration of version 2. Testing of version 2 identified usability issues within the new submenu. Application of multiple usability evaluation methods was effective in identifying and addressing usability issues in the GUI to improve the experience of PAE for PwS. The use of video-conference software to conduct synchronous, remote usability testing is an effective alternative to face to face testing methods.
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Affiliation(s)
- Rachel Young
- Department of Allied Health Professions, Advanced Wellbeing Research Centre, Sheffield Hallam University, 2 Old Hall Road, Sheffield, S9 3TU UK
| | - Karen Sage
- Faculty of Health and Education, Manchester Metropolitan University, Manchester Brooks Building, 53 Bonsall Street, Manchester, M15 6GX UK
| | - David Broom
- Centre for Sport Exercise and Life Sciences, Institute of Health and Well-Being, Coventry University, Coventry, CV1 2DS UK
| | - Andrew Hext
- Sports Engineering Research Group, Advanced Wellbeing Research Centre, Sheffield Hallam University, 2 Old Hall Road, Sheffield, S9 3TU UK
| | - Nicky Snowdon
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
| | - Christine Smith
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
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Van Assche M, Moreels T, Petrovic M, Cambier D, Calders P, Van de Velde D. The role of a socially assistive robot in enabling older adults with mild cognitive impairment to cope with the measures of the COVID-19 lockdown: A qualitative study. Scand J Occup Ther 2023; 30:42-52. [PMID: 34871144 DOI: 10.1080/11038128.2021.2009560] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, mandatory containment measures led to lockdowns and severely diminished social interaction, with older adults being one vulnerable group. Socially assistive robots (SARs) could prove to be an effective intervention. OBJECTIVES To explore the experiences of older adults with mild cognitive impairment (MCI) with a SAR during the first lockdown in Belgium. METHODS Inductive thematic analysis was used. After a two-week interaction period with robot James®, semi-structured interviews were conducted. RESULTS Four people were interviewed (median: 86 years; range: 70-90 years; 2 men, 2 women). Four themes were identified. The first theme described the robot as a companion, alleviating feelings of loneliness and social isolation. The second theme explored the robot in light of meaningful activity. The third theme detailed the technical aspects of the robot and the fourth theme described notable barriers and areas of improvement. CONCLUSION The study demonstrated the potential of SARs during the first lockdown period in Belgium. The robot proved to be promising in terms of alleviating feelings of loneliness and social isolation. It was found to be both motivating and facilitating in terms of meaningful activity. SIGNIFICANCE The study provided valuable insights for the care of lonely and occupationally deprived older adults.
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Affiliation(s)
- Maaike Van Assche
- Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Timothy Moreels
- Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Mirko Petrovic
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Dirk Cambier
- Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
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Socially Assistive Robots for Parkinson's Disease: Needs, Attitudes and Specific Applications as Identified by Healthcare Professionals. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2022. [DOI: 10.1145/3570168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To explore how socially assistive robots (SARs) may assist the specific needs of individuals with Parkinson's disease (IwPD), we conducted three focus groups with 12 clinicians who treat IwPD. We present a thematic analysis of their perceptions of the needs of the patients, and their own expectations, perceived advantages, disadvantages and concerns regarding the use of SARs for IwPD. Clinicians were positive towards using SARs for IwPD, if used in the patient's home, for motor, communication, emotional, and cognitive needs, especially for practice and for help with activities of daily living. They were concerned that a SAR might be used to replace clinicians’ work, and stressed it should only
augment
the clinicians’ work. They thought a SAR may relieve some of the burden experienced by informal caregivers, and identified specific applications for SARs for PD. We asked 18 stakeholders (nine IwPD, nine family members) to rate their level of agreement with the clinicians’ statements. The greatest divergence between their views and those of the clinicians was on the topic of using a SAR as a companion, or as a feeding assistant, to which they objected. This work may be used as a basis for future studies designing SARs for IwPD.
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Plohl N, Flis V, Bergauer A, Kobilica N, Kampič T, Horvat S, Vidovič D, Musil B, Smrke U, Mlakar I. A protocol on the effects of interactive digital assistance on engagement and perceived quality of care of surgery patients and self-efficacy and workload of staff. Front Med (Lausanne) 2022; 9:989808. [DOI: 10.3389/fmed.2022.989808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe workforce shortage in the healthcare context is a growing issue that exerts detrimental effects on employees (e.g., higher workload) and patients (e.g., suboptimal patient care). Since traditional approaches alone may not be enough to solve this problem, there is a need for complementary innovative digital health solutions, such as socially assistive robots. Hence, the proposed study aims to investigate the effects of gamified nursing education and physiotherapy delivered by a socially assistive robot on patient- (engagement, perceived quality of care) and employee-related outcomes (perceived self-efficacy, workload).Methods and analysisApproximately 90 vascular and thoracic surgery patients will receive either standard care or standard care with additional robot interactions over the course of 3–5 days. Additionally, approximately 34 nursing and physiotherapeutic employees will fill out self-report questionnaires after weeks of not using a social robot and weeks of using a social robot. The main hypotheses will be tested with mixed-design analyses of variance and paired-samples t-tests.DiscussionWhile the proposed study has some limitations, the results will provide high-quality and comprehensive evidence on the effectiveness of socially assistive robots in healthcare.Ethics and disseminationThe study was approved by the Medical Ethics Commission of the University Medical Center and registered in the ISRCTN registry (ISRCTN96689284). The study findings will be summarized in international peer-reviewed scientific journals and meetings and communicated to relevant stakeholders.
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Dembovski A, Amitai Y, Levy-Tzedek S. A Socially Assistive Robot for Stroke Patients: Acceptance, Needs, and Concerns of Patients and Informal Caregivers. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:793233. [PMID: 36188775 PMCID: PMC9397920 DOI: 10.3389/fresc.2021.793233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/20/2021] [Indexed: 01/14/2023]
Abstract
Stroke patients often contend with long-term physical challenges that require treatment and support from both formal and informal caregivers. Socially Assistive Robots (SARs) can assist patients in their physical rehabilitation process and relieve some of the burden on the informal caregivers, such as spouses and family members. We collected and analyzed information from 23 participants (11 stroke patients and 12 informal caregivers) who participated in a total of six focus-group discussions. The participants responded to questions regarding using a SAR to promote physical exercises during the rehabilitation process: (a) the advantages and disadvantages of doing so; (b) specific needs that they wish a SAR would address; (c) patient-specific adaptations they would propose to include; and (d) concerns they had regarding the use of such technology in stroke rehabilitation. We found that the majority of the participants in both groups were interested in experiencing the use of a SAR for rehabilitation, in the clinic and at home. Both groups noted the advantage of having the constant presence of a motivating entity with whom they can practice their rehabilitative exercises. The patients noted how such a device can assist formal caregivers in managing their workload, while the informal caregivers indicated that such a system could ease their own workload and sense of burden. The main disadvantages that participants noted related to the robot not possessing human abilities, such as the ability to hold a conversation, to physically guide the patient's movements, and to express or understand emotions. We anticipate that the data collected in this study-input from the patients and their family members, including the similarities and differences between their points of view-will aid in improving the development of SARs for rehabilitation, so that they can better suit people who have had a stroke, and meet their individual needs.
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Affiliation(s)
- Ayelet Dembovski
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Amitai
- Department of Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg im Breisgau, Germany
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Koren Y, Feingold Polak R, Levy-Tzedek S. Extended Interviews with Stroke Patients Over a Long-Term Rehabilitation Using Human–Robot or Human–Computer Interactions. Int J Soc Robot 2022; 14:1893-1911. [PMID: 36158255 PMCID: PMC9483483 DOI: 10.1007/s12369-022-00909-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
AbstractSocially assistive robots (SARs) have been proposed to assist post-stroke patients in performing their exercise during their rehabilitation process, with the trust in the robot identified as an important factor in human–robot interaction. In the current study, we aimed to identify and characterize factors that influence post-stroke patients’ trust in a robot-operated and a computer-operated rehabilitation platform during and after a long-term experience with the platform. We conducted 29 interviews with 16 stroke patients who underwent a long-term rehabilitation process, assisted by either a SAR or a computer interface. The intervention lasted 5–7 weeks per patient, for a total of 229 sessions over 18 months. By using a qualitative research method—extended interviews “in the wild” with stroke patients, over a long-term rehabilitation process—our study reveals users’ perspectives regarding factors affecting trust in the SAR or in the computer interface during their rehabilitation process. The results support the assertion that SARs have an added value in the rehabilitative care of stroke patients; It appears that personal characteristics, such as age and gender, have an effect on the users’ acceptance of a non-human operator as a practice assistant. Our findings support the notion that SARs augment rehabilitative therapies beyond a standard computer; Importantly, patients appreciated different aspects of the non-human operator in the two groups: In the SAR group, users preferred its functional performance over its anthropomorphized social skills; In the Computer group, users highlighted its contribution to the training of their memory skills.
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Affiliation(s)
- Yaacov Koren
- Department of Sociology and Anthropology, Tel-Aviv University, Tel-Aviv, Israel
| | - Ronit Feingold Polak
- Recanati School for Community Health Professions, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Recanati School for Community Health Professions, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
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Fruchter D, Feingold Polak R, Berman S, Levy-Tzedek S. Automating provision of feedback to stroke patients with and without information on compensatory movements: A pilot study. Front Hum Neurosci 2022; 16:918804. [PMID: 36003313 PMCID: PMC9393297 DOI: 10.3389/fnhum.2022.918804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Providing effective feedback to patients in a rehabilitation training program is essential. As technologies are being developed to support patient training, they need to be able to provide the users with feedback on their performance. As there are various aspects on which feedback can be given (e.g., task success and presence of compensatory movements), it is important to ensure that users are not overwhelmed by too much information given too frequently by the assistive technology. We created a rule-based set of guidelines for the desired hierarchy, timing, and content of feedback to be used when stroke patients train with an upper-limb exercise platform which we developed. The feedback applies to both success on task completion and to the execution of compensatory movements, and is based on input collected from clinicians in a previous study. We recruited 11 stroke patients 1–72 months from injury onset. Ten participants completed the training; each trained with the rehabilitation platform in two configurations: with motor feedback (MF) and with no motor feedback (control condition) (CT). The two conditions were identical, except for the feedback content provided: in both conditions they received feedback on task success; in the MF condition they also received feedback on making undesired compensatory movements during the task. Participants preferred the configuration that provided feedback on both task success and quality of movement (MF). This pilot experiment demonstrates the feasibility of a system providing both task-success and movement-quality feedback to patients based on a decision tree which we developed.
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Affiliation(s)
- Daphne Fruchter
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ronit Feingold Polak
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Herzog Medical Center, Jerusalem, Israel
| | - Sigal Berman
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
- *Correspondence: Shelly Levy-Tzedek,
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Geva N, Hermoni N, Levy-Tzedek S. Interaction Matters: The Effect of Touching the Social Robot PARO on Pain and Stress is Stronger When Turned ON vs. OFF. Front Robot AI 2022; 9:926185. [PMID: 35875704 PMCID: PMC9305613 DOI: 10.3389/frobt.2022.926185] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Social touch between humans, as well as between humans and animals, was previously found to reduce pain and stress. We previously reported that touching a social robot can also induce a reduction in pain ratings. However, it is unclear if the effect that touching a robot has on pain perception is due to its appearance and its pleasant touch, or due to its ability to socially interact with humans. In the current experiment, we aimed to assess the contribution of the interactive quality to pain perception. We assessed the effect of touching the social robot PARO on mild and strong pain ratings and on stress perception, on a total of 60 healthy young participants. The robot either interacted with participants (ON group, n = 30) or was turned off (OFF group, n = 30). Touching the robot induced a decrease in mild pain ratings (compared to baseline) only in the ON group while strong pain ratings decreased similarly in both the ON and the OFF groups. The decrease in mild pain ratings in the ON group was significantly greater in participants with a higher positive perception of the interaction with PARO. We conclude that part of the effect that touching the robot has on pain stems from its interactive features.
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Affiliation(s)
- Nirit Geva
- Recanati School for Community Health Professions, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Netta Hermoni
- Department of Biomedical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Recanati School for Community Health Professions, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
- *Correspondence: Shelly Levy-Tzedek,
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