Robot-assisted therapy for upper limb impairments in cerebral palsy:A scoping review and suggestions for future research

A growing number of studies investigate the use of robotics therapy for motor (re)habilitation with children with cerebral palsy (CP). Most of these studies use functional robots in very repetitive sessions. While the therapy is effective, very few studies employ social robots, which appears to be a missed opportunity to design more compelling and enjoyable sessions for the children. In this article, we will review robot-assisted upper limb motor (re)habilitation for children with CP. Previous reviews of robot-assisted therapy for CP had mostly focused on lower limbs, or the review was made from a medical point of view, with the sole concern being the therapy's effectiveness. Here, we focus our review on robot-assisted upper limb (re)habilitation and address human-robot interaction considerations. We searched PubMed, Scopus, and IEEE databases and argue that although this area of research is promising and already effective, it would benefit from the inclusion of social robots for a more engaging and enjoyable experience. We suggest four scenarios that could be developed in this direction. The goal of this article is to highlight the relevance of the past work and encourage the development of new ideas where therapy will socially engage and motivate children.</p

Social Robot Augmented Telepresence For Remote Assessment And Rehabilitation Of Patients With Upper Extremity Impairment

With the shortage of rehabilitation clinicians in rural areas and elsewhere, remote rehabilitation (telerehab) fills an important gap in access to rehabilitation. We have developed a first of its kind social robot augmented telepresence (SRAT) system --- Flo --- which consists of a humanoid robot mounted onto a mobile telepresence base, with the goal of improving the quality of telerehab. The humanoid has arms, a torso, and a face to play games with and guide patients under the supervision of a remote clinician. To understand the usability of this system, we conducted a survey of hundreds of rehab clinicians. We found that therapists in the United States believe Flo would improve communication, patient motivation, and patient compliance, compared to traditional telepresence for rehab. Therapists highlighted the importance of high-quality video to enable telerehab with their patients and were positive about the usefulness of features which make up the Flo system for enabling telerehab. To compare telepresence interactions with vs without the social robot, we conducted controlled studies, the first to rigorously compare SRAT to classical telepresence (CT). We found that for many SRAT is more enjoyable than and preferred over CT. The results varied by age, motor function, and cognitive function, a novel result. To understand how therapists and patients respond to and use SRAT in the wild over long-term use, we deployed Flo at an elder care facility. Therapists used Flo with their own patients however they deemed best. They developed new ways to use the system and highlighted challenges they faced. To ease the load of performing assessments via telepresence, I constructed a pipeline to predict the motor function of patients using RGBD video of them doing activities via telepresence. The pipeline extracts poses from the video, calculates kinematic features and reachable workspace, and predicts level of impairment using a random forest of decision trees. Finally, I have aggregated our findings over all these studies and provide a path forward to continue the evolution of SRAT

Exploring the Use of Assistive Robotics in Play and Education for Children with Disabilities

Assistive technologies in general, and assistive robots in particular, are being studied extensively to maintain and increase the capabilities of individuals with disabilities. However, there are aspects in this field that have not been explored yet. This thesis investigates the use of assistive robots for different groups of children with disabilities, such as learning disabilities, and upper-limb disorders, where the use of robots as tools have not been widely explored. We began by exploring learning disabilities and their challenges. Students with a learning disability (LD) generally require supplementary one-to-one instruction and support to acquire the foundational academic skills learned at school. Because learning is more difficult for students with LD, students can frequently display off-task behaviours to avoid attempting or completing challenging learning tasks. Re-directing students back to their learning task is a frequent strategy used by educators to support students. However, there have been limited studies investigating the use of assistive technology to support student re-direction, specifically in a "real-world" educational setting. We investigated the impact of integrating a socially assistive robot to provide re-direction strategies to students. A commercially available social robot, QT, was employed within the existing learning program during one-to-one remedial instruction sessions. First, we conducted a pilot study to explore the impact of the robot on students' on-task behaviours and progress towards learning goals. The results of our mixed method analysis suggest that the robotic intervention supported students in staying on-task and completing their learning goal. Learning from the lessons of the pilot study, we designed a between-participant study with two conditions, control, and intervention with the QT robot to address the shortcomings of the pilot study. In the main study we aimed a) to evaluate the acceptance of the social robot by the users, i.e., instructors and students in a real-world educational setting; and b) understand the impact of the robot’s intervention on student's engagement during learning tasks over multiple learning sessions. Our qualitative analysis suggests that instructors and students showed positive attitudes towards the social robot in their one-to-one sessions. In addition, the students were more engaged with their task in the presence of the robot, and displayed fewer off-task behaviours in the intervention condition, compared to the control condition. These results suggest that a social robot can be used as an effective educational tool for instructors in boosting engagement and mitigating off-task behaviours for students with learning disabilities. Assistive technology can also be beneficial in play, especially for children that face barriers in physical activities due to their physical impairments. In the third study, we focused on children with upper-limb disorders and the lack of equipment and enjoyable experiences in games. While game-play is widely used in human robot interaction studies, using a robot as a play-mediator, where two individuals interact with each other through a robot, has not been fully studied yet. However, understanding the play dynamics of this type of game is an important step towards designing an engaging experience. In this work, participants played two collaborative games which involved teleoperating a mobile robot. Each game consisted in achieving the same task, but involved two different collaboration strategies: one where the players shared tasks and one where joint action was necessary. In this study, we focused on how both players collaborated with each other in terms of coordination and communication using video and joystick data. Due to Covid-19 restrictions, we were not able to recruit children with physical disabilities. Instead, we recruited university students to participate in the study to collect data. Results indicated different behavioural events, and observed different levels of communication among the two conditions. The present work contributes to robotic assistive technologies by providing support for children with learning disabilities and upper-limb disorders in different aspects of their life, such as education and play

The Influence of Acute Stress on the Perception of Robot Emotional Body Language: Implications for Robot Design in Healthcare and Other High-Risk Domains

University of Minnesota Ph.D. dissertation. July 2017. Major: Human Factors/Ergonomics. Advisors: Kathleen Harder, Wilma Koutstaal. 1 computer file (PDF); viii, 131 pages.In coming years, emotionally expressive social robots will permeate many facets of our lives. Yet, although researchers have explored robot design parameters that may facilitate human-robot interaction, remarkably little attention has been paid to the human perceptual and other psychological factors that may impact human ability to engage with robots. In high-risk settings, such as healthcare—where the use of robots is expected to increase markedly—it is paramount to understand the influence of a patient’s stress level, temperament, and attitudes towards robots as negative interactions could harm a patient’s experience and hinder recovery. Using a novel between-subject paradigm, we investigated how the experimental induction of acute physiological and cognitive stress versus low stress influences perception of normed robot emotional body language as conveyed by a physically-present versus virtual reality generated robot. Following high or low stress induction, participants were asked to rate the valence (negative/unhappy to positive/happy) and level of arousal (calm/relaxed to animated/excited) conveyed by poses in five emotional categories: negative valence-high arousal, negative valence-low arousal, neutral, positive valence-low arousal, positive valence-high arousal. Poses from the categories were randomly intermixed and each pose was presented two or three times. Ratings were then correlated with temperament (as assessed by the Adult Temperament Questionnaire), attitudes towards and experience with robots (a new questionnaire that included measures from the Godspeed Scales and Negative Attitudes about Robots Survey), and chronic stress. The acute stress induction especially influenced the evaluation of high arousal poses – both negative and positive – with both valence and arousal rated lower under high than low stress. Repeated presentation impacted perception of low arousal (negative and positive) and neutral poses, with increases in perceived valence and arousal for later presentations. There were also effects of robot type specifically for positively-valenced emotions, such that these poses were rated as more positive for the physically-present than virtually-instantiated robot. Temperament was found to relate to emotional robot body language. Trait positive affect was associated with higher valence ratings for positive and neutral poses. Trait negative affect was correlated with higher arousal ratings for negative valence-low arousal poses. Subcategories within the robot attitudes questionnaire were correlated with emotional robot poses and temperament. To our knowledge this dissertation is the first exploration of the effects of acute and chronic stress on human perception of robot emotional body language, with implications for robot design, both physical and virtual. Given the largely parallel findings that we observed for the poses presented by the physically-present versus virtually-instantiated robot, it is proposed that the use of virtual reality may provide a viable "sandbox" tool for more efficiently and thoroughly experimenting with possible robot designs, and variants in their emotional expressiveness. Broader psychological, physiological, and other factors that designers should consider as they create robots for high-risk applications are also discussed