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Kalderon L, Kaplan A, Wolfovitz A, Levy-Tzedek S, Gimmon Y. Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives. J Neurol Phys Ther 2024; 48:140-150. [PMID: 38426842 PMCID: PMC11208053 DOI: 10.1097/npt.0000000000000470] [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] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND PURPOSE Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. METHODS A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. RESULTS Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. DISCUSSION AND CONCLUSIONS Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. VIDEO ABSTRACT AVAILABLE for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).
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Affiliation(s)
- Liran Kalderon
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Azriel Kaplan
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Amit Wolfovitz
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
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Platz T, Pedersen AL, Deutsch P, Umlauft AN, Bader S. Analysis of the therapeutic interaction provided by a humanoid robot serving stroke survivors as a therapeutic assistant for arm rehabilitation. Front Robot AI 2023; 10:1103017. [PMID: 36950283 PMCID: PMC10025290 DOI: 10.3389/frobt.2023.1103017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Abstract
Objective: To characterize a socially active humanoid robot's therapeutic interaction as a therapeutic assistant when providing arm rehabilitation (i.e., arm basis training (ABT) for moderate-to-severe arm paresis or arm ability training (AAT) for mild arm paresis) to stroke survivors when using the digital therapeutic system Evidence-Based Robot-Assistant in Neurorehabilitation (E-BRAiN) and to compare it to human therapists' interaction. Methods: Participants and therapy: Seventeen stroke survivors receiving arm rehabilitation (i.e., ABT [n = 9] or AAT [n = 8]) using E-BRAiN over a course of nine sessions and twenty-one other stroke survivors receiving arm rehabilitation sessions (i.e., ABT [n = 6] or AAT [n = 15]) in a conventional 1:1 therapist-patient setting. Analysis of therapeutic interaction: Therapy sessions were videotaped, and all therapeutic interactions (information provision, feedback, and bond-related interaction) were documented offline both in terms of their frequency of occurrence and time used for the respective type of interaction using the instrument THER-I-ACT. Statistical analyses: The therapeutic interaction of the humanoid robot, supervising staff/therapists, and helpers on day 1 is reported as mean across subjects for each type of therapy (i.e., ABT and AAT) as descriptive statistics. Effects of time (day 1 vs. day 9) on the humanoid robot interaction were analyzed by repeated-measures analysis of variance (rmANOVA) together with the between-subject factor type of therapy (ABT vs. AAT). The between-subject effect of the agent (humanoid robot vs. human therapist; day 1) was analyzed together with the factor therapy (ABT vs. AAT) by ANOVA. Main results and interpretation: The overall pattern of the therapeutic interaction by the humanoid robot was comprehensive and varied considerably with the type of therapy (as clinically indicated and intended), largely comparable to human therapists' interaction, and adapted according to needs for interaction over time. Even substantially long robot-assisted therapy sessions seemed acceptable to stroke survivors and promoted engaged patients' training behavior. Conclusion: Humanoid robot interaction as implemented in the digital system E-BRAiN matches the human therapeutic interaction and its modification across therapies well and promotes engaged training behavior by patients. These characteristics support its clinical use as a therapeutic assistant and, hence, its application to support specific and intensive restorative training for stroke survivors.
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Affiliation(s)
- Thomas Platz
- Neurorehabilitation research group, University Medical Centre, Greifswald, Germany
- BDH-Klinik Greifswald, Institute for Neurorehabilitation and Evidence-Based Practice, “An-Institut,” University of Greifswald, Greifswald, Germany
- *Correspondence: Thomas Platz,
| | - Ann Louise Pedersen
- Neurorehabilitation research group, University Medical Centre, Greifswald, Germany
| | - Philipp Deutsch
- Neurorehabilitation research group, University Medical Centre, Greifswald, Germany
| | | | - Sebastian Bader
- Department of Computer Science, University of Rostock, Rostock, Germany
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Kodate N, Maeda Y, Hauray B, Tsujimura M, Chan WCH, Mannan H, Yu W, Dalgalarrondo S, Cheung MC, Yumoto A, Suwa S, Donnelly S, Sakata N, O’Shea D, Obayashi K, Masuyama S. Hopes and fears regarding care robots: Content analysis of newspapers in East Asia and Western Europe, 2001-2020. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1019089. [PMID: 36569638 PMCID: PMC9773842 DOI: 10.3389/fresc.2022.1019089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022]
Abstract
Background As a type of welfare technology, care robotics is now widely seen as a potential aide to rehabilitation, increasing independence and enhancing the wellbeing of people with disabilities and older adults. Research into and development of care robots have both been vigorously promoted in North America, Europe and Asia, and the competition for technological advancement in robotics is becoming fierce. AI ethics and policy guidelines are being established. However, there are still differences in attitudes and perceptions, as well as national policies regarding this type of welfare technology. Moreover, despite the anticipated usefulness, it is believed that progress has been slow in the diffusion of care robots. Purpose In order to explore how public discourses support technological innovation, such as care robots, while preparing society for potential risks and impact, we sought to ascertain whether public discourse on care robots varies from region to region. For example, what are the hopes and promises associated with care robots and what are the concerns? Methods To address these questions, this article explored how care robots have been portrayed in five major broadsheet newspapers in five jurisdictions in Asia and Europe (France, Great Britain, Hong Kong SAR, Ireland and Japan). We obtained 545 articles for the period between January 2001 and September 2020, more than half of which originated in Japan. A thematic analysis was conducted of these articles written in four languages (Chinese, English, French and Japanese). Results Positive and negative narratives were teased out, alongside other key prominent themes identified, such as Japan as the land of robots, the pandemic, and the impact of robots on the economy. As the number of robot-related articles grew from the year 2012 onwards, narratives became more nuanced in European newspapers, but not in Asian ones. Furthermore, recent articles began to address the social and relational impact of care robots, while providing concrete examples of improvements in the quality of life for users. Further careful examination will be necessary in the future in order to establish the impact of robotics use in rehabilitation for people with disabilities, older adults, their carers and society at large.
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Affiliation(s)
- N. Kodate
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland,Public Policy Research Center, Hokkaido University, Sapporo, Japan,La Fondation France-Japon, School for Advanced Studies in the Social Sciences (EHESS), Paris, France,Institute for Future Initiatives, University of Tokyo, Tokyo, Japan,Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan,Correspondence: N. Kodate
| | - Y. Maeda
- Faculty of Business, Technological University DublinDublin, Ireland
| | - B. Hauray
- Institut de recherche interdisciplinaire sur les enjeux sociaux, School for Advanced Studies in the Social Sciences (EHESS), Paris, France,French National Institute of Health and Medical Research (INSERM), Paris, France
| | - M. Tsujimura
- School of Nursing, Shiga University of Medical Science, Otsu, Japan
| | - W. C. H. Chan
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - H. Mannan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland,Flame University, Pune, India
| | - W. Yu
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - S. Dalgalarrondo
- Institut de recherche interdisciplinaire sur les enjeux sociaux, School for Advanced Studies in the Social Sciences (EHESS), Paris, France,French National Centre for Scientific Research (CNRS), Paris, France
| | - M. C. Cheung
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - A. Yumoto
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - S. Suwa
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - S. Donnelly
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - N. Sakata
- Center for Information and Communication Technology, Dokkyo Medical University, Mibu, Japan
| | - D. O’Shea
- St Vincent’s University Hospital, Dublin, Ireland,Royal College of Physicians of Ireland, Dublin, Ireland
| | - K. Obayashi
- Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan,Faculty of Healthcare Management, Nihon Fukushi University, Mihama, Japan,Social Welfare Corporation Tokyo Seishin-kai, Nishitokyo, Japan
| | - S. Masuyama
- Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan,Traveler’s Medical Center, Tokyo Medical University, Tokyo, Japan
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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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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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