How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Hands-Off Therapist Robot Behavior Adaptation to User Personality for Post-Stroke Rehabilitation Therapy

This paper describes a hands-off therapist robot that monitors, assists, encourages, and socially interacts with post-stroke users in the process of rehabilitation exercises. We developed a behavior adaptation system that takes advantage of the users introversion-extroversion personality trait and the number of exercises performed in order to adjust its social interaction parameters (e.g., interaction distances/proxemics, speed, and vocal content) toward a customized post-stroke rehabilitation therapy. The experimental results demonstrate the robot's autonomous behavior adaptation to the user's personality and the resulting user improvements of the exercise task performance

Coaching through technology: a systematic review into efficacy and effectiveness for the ageing population

Background: Despite the evidence on the positive role of self-management, the adoption ofhealth coaching strategies for older people is still limited. To address these gaps, recent efforts havebeen made in the ICT sector in order to develop systems for delivering coaching and overcomingbarriers relating to scarcity of resources. The aim of this review is to examine the efficacy of personalhealth coaching systems for older adults using digital virtual agents.Methods: A systematic reviewof the literature was conducted in December 2019 analyzing manuscripts from four databases overthe last 10 years. Nine papers were included.Results: Despite the low number of studies, there wasevidence that technology-integrated interventions can deliver benefits for health over usual care.However, the review raises important questions about how to maintain benefits and permanence ofbehavior change produced by short-term interventions.Conclusion: These systems offer a potentialtool to reduce costs, minimize therapist burden and training, and expand the range of clients who canbenefit from them. It is desirable that in the future the number of studies will grow, considering otheraspects such as the role of the virtual coaches’ characteristics, social-presence, empathy, usability,and health literac

Social Robots to enhance therapy and interaction for children: From the design to the implementation "in the wild"

En les últimes dues dècades els robots socials s'han convertit en un camp emergent en el qual encara hi ha molt per fer. Aquest camp requereix coneixements en mecànica, control, intel·ligència artificial, sistemes, etc., però també en psicologia, disseny, ètica, etc. El nostre grup de recerca de perfil interdisciplinari ha estat treballant en el disseny de robots socials en diferents aplicacions per a nens amb necessitats especials. L'objectiu d'aquesta tesi és investigar diferents escenaris en teràpia o educació on els robots socials podrien ser una eina útil per als nens. Es van realitzar 4 estudis amb diferents propòsits: (1) dissenyar activitats amb robòtica de LEGO per avaluar el comportament social dels nens amb trastorn de l'espectre autista (TEA) (entre companys i amb adults) i analitzar la seva efectivitat, (2) dissenyar un robot social per recuperar les funcionalitats més afectades a causa de traumatismes cranioencefàlics (TCE) en nens i veure l'eficàcia del tractament, (3) proporcionar un robot mascota per alleujar els sentiments d'ansietat, solitud i estrès en nens hospitalitzats, i (4) comprovar com un robot amb comportament social i amb una personalització versus robots sense aquestes característiques mostra diferències en termes d'interacció amb nens i, per tant, pot ajudar en l'efectivitat de diferents tractaments com hem esmentat anteriorment. Els resultats van revelar diferents resultats depenent de l'aplicació: (1) efectivitat amb la plataforma robòtica social que vam dissenyar en el tractament neuropsicològic per a aquells nens afectats per TCE, (2) eficàcia amb les activitats de robòtica de LEGO dissenyades per un grup de terapeutes en termes de millora d'habilitats socials (3) un efecte positiu entre els mediadors i facilitadors de la interacció i les relacions entre els diferents agents involucrats en el procés de la cura: pacients hospitalitzats, familiars, voluntaris i personal clínic, i (4) una interacció diferent, en termes de temps, entre els dos grups durant període de dues setmanes.En las últimas dos décadas los robots sociales se han convertido en un campo emergente en el que todavía hay mucho por hacer. Este campo requiere conocimientos en mecánica, control, inteligencia artificial, sistemas, etc., pero también en psicología, diseño, ética, etc. Nuestro grupo de investigación de perfil interdisciplinar ha estado trabajando en el diseño de robots sociales en diferentes aplicaciones para niños con necesidades especiales. El objetivo de esta tesis es investigar diferentes escenarios en terapia o educación donde los robots sociales podrían ser una herramienta útil para los niños. Se realizaron 4 estudios con diferentes propósitos: (1) diseñar actividades con robótica de LEGO para evaluar el comportamiento social de los niños con trastorno del espectro autista (TEA) (entre compañeros y con adultos) y analizar su efectividad, (2) diseñar un robot social para recuperar las funcionalidades más afectadas a causa de traumatismos craneoencefálicos (TCE) en niños y ver la eficacia del tratamiento, (3) proporcionar un robot mascota para aliviar los sentimientos de ansiedad, soledad y estrés en niños hospitalizados, y (4) comprobar como un robot con comportamiento social y con una personalización versus robots sin esas características muestra diferencias en términos de interacción con niños y, por tanto, puede ayudar en la efectividad de diferentes tratamientos como mencionamos anteriormente. Los resultados revelaron diferentes resultados dependiendo de la aplicación: (1) efectividad con la plataforma robótica social que diseñamos en el tratamiento neuropsicológico para aquellos niños afectadas por TCE, (2) eficacia con las actividades de robótica de LEGO diseñadas por un grupo de terapeutas en términos de mejora de habilidades sociales (3) un efecto positivo entre los mediadores y facilitadores de la interacción y las relaciones entre los diferentes agentes involucrados en el proceso del cuidado: pacientes hospitalizados, familiares, voluntarios y personal clínico, y (4) una interacción diferente, en términos de tiempo, entre ambos grupos en el promedio de un período de dos semanas.Over the past two decades social robots have become an emerging field where there are many things still to work on. This field not only requires knowledge in mechanics, control, artificial intelligence, systems, etc., but also in psychology, design, ethics, etc. Our multidisciplinary research group has been working on designing social robotic platforms in different applications for children with special needs. The aim of this thesis is to investigate different scenarios in therapy or education where social robots could be a useful tool for children. We ran 4 studies with different purposes: (1) to design activities with LEGO robotics to assess children with autism spectrum disorder (ASD) social behaviour (between peers and with adults) and to analyze the effectiveness, (2) to design a social robotic platform to recover the functionalities most affected by traumatic brain injuries (TBI) in children and see the effectiveness of the treatment, (3) to provide a pet robot to alleviate feelings of anxiety, loneliness and stress of long-term children inpatient and their bystanders, and (4) to verify how a robot with social behaviour and personalization verses those robots without, shows differences in terms of interaction with children and thus, helps the effectiveness of different treatments as we mention above. The results revealed different outcomes depending on the application: (1) effectiveness with the social robotic platform that we designed in neuropsychological treatment in those areas affected by TBI, (2) effectiveness with the LEGO robotics activities designed by a group of therapists in terms of improvement of the social skills and engagement, (3) a positive effect within mediators and facilitators of interaction and relationships between the different agents involved in the caring process: in-patients, relatives, volunteers and clinical staff (4) slight evidence towards a different interaction, in terms of time, between both groups in the average of a two-week period

Social robots in cognitive interventions. Advances, problems and perspectives

Social Assistive Robots are being used in therapeutic interventions for elderly people affected by cognitive impairments. The present paper reports our research lines aiming at investigating the role of a social robot in aiding therapists during cognitive stimulation sessions for elders with Mild Cognitive Impairment and Mild Dementia. We review our studies whose results show that social robots have been positively accepted by the seniors in different experiments. Participants were very attentive and involved in the sessions’ tasks and their experience was mainly positive. Our data suggest that this technology can be a valid tool to support psychotherapists in cognitive stimulation interventions emphasizing the need of multidisciplinary approaches combining assessment of behavior and robotics

Robots for the psychological wellbeing of the elderly

The present paper examines the potential robots may have to motivate and support elderly people psychologically. Two short- and long-term research scenarios are proposed where a robot interacts with an elderly person offering psychological support. We describe one experiment that was carried out probing the short-term scenario. Another study currently under development is also presented, which is based on the long-term scenario. The two scenarios have advantages and disadvantages and appear as complementary to each other

Position paper: robots as companions and therapists in elderly care

Given the increasing portion of elderly people in the western world and severe lacks in care-taking, we believe that we should research possibilities to employ robots in elderly care. Social robots could offer companionship as well as treatment of physical and psychological disturbances. In our research, we propose to adapt treatments from positive psychology to robots in order to increase the wellbeing of elderly people in the long run. In a first study, we suggest that the role that the users will subscribe to the robot (therapist or companion) might make a severe difference on the effectiveness of the treatment and the social acceptance of the robot systems

Inteligentno upravljanje paralelnim robotom sa šest stupnjeva slobode korištenim za rehabilitaciju donjih udova

The process of empowering muscles in order to make them to a normal and common value is an expensive and prolonged work, in common available methods. There are some commercial exercise machines used for this purpose called rehabilitation systems. However, due to their insufficient motion freedom and prospect of being expensive, these machines have limited usage. Hence, it is clearly necessary that Mechatronic technologies should be used in this area. In this paper, an algorithm and an improved rule are presented for controlling a rehabilitation system of lower limbs which is implemented on a 6-Degree Of Freedom (DOF) Stewart parallel robot. Impedance control and adaptive control are used for this purpose. Estimation and optimization of control parameters will be done by artificial neural networks and genetic algorithms, respectively (intelligent strategy). Safety is guaranteed since some of controller parameters can be adapted under the stability conditions given by using Routh stability theory. Thereafter, the results of simulations are presented by defining a physiotherapy standard mode on a desired trajectory. MATLAB/SIMULINK is used for simulations. Finally, a comparative discussion between this strategy and common methods is devised.Proces osposobljavanja mišića za normalne funkcije je skup i dugotrajan uz korištenje dostupnih metoda. Postoje komercijalni strojevi za tu svrhu koji se nazivaju sustavi za rehabilitaciju. Zbog njihove nedostatne slobode pokreta i visoke cijene takvi strojevi imaju ograničenu upotrebu. Stoga je jasno da je u području rehabilitiacije potrebno koristiti mehatroničke sustave. U ovom radu prikazan je algoritam i poboljšano pravilo za upravljanje rehabilitacijskog sustava za donje udove koji je implementiran na Stewart paralelnom robotu sa šest stupnjeva slobode. Pritom je korišteno upravljanje impedancijom i adaptivno upravljanje. Za estimaciju i optimiranje parametara upravljanja koriste se neuronske mreže i genetički algoritmi. Sigurnost je garantirana jer se neki parametri regulatora adaptiraju prema uvjetima stabilnosti koji su dobiveni korištenjem Ruthove teorije stabilnosti. Nakon toga, rezultati simulacija prikazani su definiranjem standardnog fizioterapijskog rada na željenoj trajektoriji. Za simulacije se koristi MATLAB/SIMULINK. Konačno, u radu je dana i usporedba predložene strategije s uobičajenim metodama