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Evaluating the Child–Robot Interaction of the NAOTherapist Platform in Pediatric Rehabilitation

DOI:10.1007/s12369-017-0402-2
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José Carlos Pulido at University Carlos III de Madrid
José Carlos Pulido
José Carlos González Dorado at University Carlos III de Madrid
José Carlos González Dorado
Cristina Suárez at Servicio Andaluz de Salud
Cristina Suárez
Antonio Bandera at University of Malaga
Antonio Bandera
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Abstract and Figures

NAOTherapist is a cognitive robotic architecture whose main goal is to develop non-contact upper-limb rehabilitation sessions autonomously with a social robot for patients with physical impairments. In order to achieve a fluent interaction and an active engagement with the patients, the system should be able to adapt by itself in accordance with the perceived environment. In this paper, we describe the interaction mechanisms that are necessary to supervise and help the patient to carry out the prescribed exercises correctly. We also provide an evaluation focused on the child-robot interaction of the robotic platform with a large number of schoolchildren and the experience of a first contact with three pediatric rehabilitation patients. The results presented are obtained through questionnaires, video analysis and system logs, and have proven to be consistent with the hypotheses proposed in this work.
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Int J of Soc Robotics (2017) 9:343–358
DOI 10.1007/s12369-017-0402-2
Evaluating the Child–Robot Interaction of the NAOTherapist
Platform in Pediatric Rehabilitation
José Carlos Pulido1·José Carlos González1·Cristina Suárez-Mejías2·
Antonio Bandera3·Pablo Bustos4·Fernando Fernández1
Accepted: 16 March 2017 / Published online: 8 April 2017
© Springer Science+Business Media Dordrecht 2017
Abstract NAOTherapist is a cognitive robotic architecture
whose main goal is to develop non-contact upper-limb reha-
bilitation sessions autonomously with a social robot for
patients with physical impairments. In order to achieve a flu-
ent interaction and an active engagement with the patients,
the system should be able to adapt by itself in accordance
with the perceived environment. In this paper, we describe the
interaction mechanisms that are necessary to supervise and
help the patient to carry out the prescribed exercises correctly.
We also provide an evaluation focused on the child-robot
interaction of the robotic platform with a large number of
José Carlos Pulido and José Carlos González contributed equally to this
work.
BJosé Carlos Pulido
jcpulido@inf.uc3m.es
José Carlos González
josgonza@inf.uc3m.es
Cristina Suárez-Mejías
cristina.suarez.exts@juntadeandalucia.es
Antonio Bandera
ajbandera@uma.es
Pablo Bustos
pbustos@unex.es
Fernando Fernández
ffernand@inf.uc3m.es
1Computer Science and Engineering, Universidad Carlos III de
Madrid, Av. de la Universidad 30, 28911 Madrid, Spain
2Hospital Universitario Virgen del Rocío, Av. Manuel Siurot,
s/n, 41013 Sevilla, Spain
3Universidad de Málaga, Campus de Teatinos, s/n,
29071 Málaga, Spain
4Robolab, Universidad de Extremadura, Campus Universitario,
s/n, 10071 Cáceres, Spain
schoolchildren and the experience of a first contact with three
pediatric rehabilitation patients. The results presented are
obtained through questionnaires, video analysis and system
logs, and have proven to be consistent with the hypotheses
proposed in this work.
Keywords Social human–robot interaction ·Rehabilitation
robotics ·Socially assistive robotics ·Control architectures
and programming ·Automated planning
1 Introduction
Socially Assistive Robotics (SAR) is a growing field whose
purpose is to use robots to undertake certain social needs.
This term represents all those robotic platforms that provide
a service or assistance to people through social interaction
[13]. In the last ten years, a wide variety of assistive devices
have been developed as support systems and many of them
have gained far-reaching acceptance among users and profes-
sionals alike [30]. This has opened up new lines of research
in different application domains, including physical and cog-
nitive rehabilitation.
Traditional methods of physical rehabilitation comprise
continuous repetitions of movements according to the clin-
ical conditions of the patient. This can bring about a loss
of interest and reduced therapy engagement on the part of
the patient (especially children). Consequently, the therapists
need more time and effort when carrying out the therapy ses-
sions.
Our proposed system is called NAOTherapist and it is the
result of a new development phase in the Therapist project
[5]. In the first approach, a bear-like robotic platform called
Ursus executed a sequence of preprogrammed behaviors to
carry out rehabilitation movements with the upper limbs [38].
123
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... The presence of neurocognitive disorder affects the ability to carry out activities of daily living, hence impairing older people's independence and quality of life. Cognitive rehabilitation programs have been shown to be effective in improving the quality of life of affected people, but they are usually very expensive ( [7]) , and need different 25 professionals depending on client's needs. individuals with MCI are more suit-2 able for possible therapeutic interventions and receive positive benefits from multi-centric rehabilitation approaches ( [5]). ...
... So far, 105 SAR robots have been developed to assist older adults with physical disabilities and with cognitive impairment. Some examples are PARO robot, for improving social interaction and for reducing psychiatric disorder [23]; Care-O-Bot [24], which helps to assist in home tasks (e.g kitchen tasks); Softbank Robotics NAO robot for upper-limb rehabilitation and giving verbal feedback on how well 110 they do the exercises [25], assisting children with autism [26], as well as foster learning through encouragement during cognitive games [27]. Krebs et al. [28] developed a robot that engaged the user during a memory card game using verbal and non-verbal behaviours while, Tangibot [11] was designed as a homecare robot to offer functional support, track physical and psychological well-being 115 and deliver therapeutic support, in particular participants with memory problems, mild cognitive impairment or mild dementia as well as their carers. ...
... The database should also be accessible to the caregivers or other relevant professionals in order to make it possible for them to insert and view user data, among other things, in order to keep track of their progress. With this and the option to easily adjust the settings of the training, this project offers a userfriendly robot-caregiver interface, aside from the robot-end user interface that 175 tends to be highlighted in related works ( [25,28]), which makes the caregiver's work easier. For that we designed a webpage using Python's Django framework . ...
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As life expectancy increases, the number of people affected by negative consequences of cognitive aging is also expected to rises. With a view to develop preventative and rehabilitative strategies, a cognitive intervention programme has been designed with the Softbank Robotics' Pepper robot, which integrates cognitive games through an easy-to-use interface alongside other interaction opportunities , to increase participant's motivation. The robot's behaviour has been personalised to the user in terms of personality (interaction distance, verbal feedback) and personalised activities; crucially, it performs a cognitive assessment and can recommend games tailored for each user. By developing an associated external web-based platform, professionals may easily monitor and analyse clients' data. Finally, a part of the prototype has been tested with several experts and users, including older adults, to evaluate the interaction and specify possible improvements. In general, positive results have been received, highlighting that the more sociable the robot appears to be the better is the overall experience. In sum, further developments on social robots delivering cognitive training appear to present great potential to support healthy aging with adaptations to various environments, such as private homes, community
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... Rehabilitation robots defined as socially assistive robots are able to gesture, communicate, motivate, comfort, and teach exercises. They have been tested in pediatric and geriatric interactions in and out of hospital environments [4,27,33,77,85,108,120]. Experiences with these robots have been positive, and the robots have been shown to promote engagement and adherence to prescribed exercise. ...
... This is also the first report that we are aware of which has demonstrated the complex relationship between age, motor function, and cognitive function in determining how a person 125 will react to a social robot. Previous reports have demonstrated, the impact on interaction with a social robot due to cerebral palsy or brachial plexus diagnosis [33,77]. Many reports exist examining how children with behavioral disorders react differently than their typically developing peers to robots. ...
... It would be reasonable to look at how well poses match the instructions in Simon says. This type of measure has been done by the Nao Therapist in a similar activity which focuses only on static poses [77]. That effort could be extended to also handle dynamic movements. ...
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... This type of research has also been conducted in other fields in which social and assistive robotics is developed; for example, in the care of older adults and in the physical rehabilitation and care of people with cognitive disabilities (Gregor, 2016). J. C. Pulido et al. (2017), for instance, present an application for rehabilitation of upper limbs without contact and with robotic autonomy and teleoperation for children with physical disabilities (NAOTherapist), which has been positively evaluated. However, research on social and assistive robotics has often focused on individuals on the autistic spectrum (Tapus et al., 2012), and thus there remains a great opportunity to apply it to other therapeutic fields of speech and language. ...
... Recommended replicas in 2k designs (J. C.Pulido et al., 2017) ...
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... 32.1(11.8) (neurotypical) Japan Niculescu et al. [112] Positive feelings no experience > experience all p < 0.05 OLIVIA, CYNTHIA 28 not specified Singapore Paepcke and Takayama [33] Perceived Social robots are generally well accepted by children aged 5-9 [155], both intentionally (NAO [177]) and behaviorally (KEEPON [104]). We observe similar tendencies with older children (aged 10-15) with good intentional and behavioral acceptance of the robot. ...
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View
... Previo a realizar esta actividad, el robot debe ser retirado de la sala para evitar que la presencia del robot intimide al paciente e influencie sus respuestas. Las respuestas de los pacientes en el cuestionario se analizarán en 3 partes, primero las preguntas de respuesta binaria, luego las de respuesta abierta y, finalmente, las de la serie Godspeed (Bartneck et al., 2009;Pulido et al., 2017). Las preguntas de este cuestionario se encuentran detalladas en la Tabla 1. ...
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View
... Elderly people are often less familiar with new technologies and, therefore, foster more negative attitudes towards robots (Hudson et al., 2017;Onorato, 2018). Song et al. (2016), for example, found that older patients try to avoid contact with robot nurses, whereas Pulido et al. (2017) found that children interact very easily with robots during physical rehabilitation sessions. In an experimental study by Fernandez-Llamas et al. (2018), primary school children even preferred a robot over a human teacher. ...
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On the Use of Social Robots for Rehabilitation: The Case of NAO Physio
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[Context]: Humanoid Social Robots such as the NAO have been successfully used in rehabilitation and socialization experiments for patients with some type of motor limitation. However, the adoption of robots as assistive tools is challenging due to difficulties related to their development, as well as the need to combine the expertise of software developers with the knowledge and skills of the application domain experts. [Objective]: In this paper we evaluate the feasibility of using the NAO robot for physiotherapy rehabilitation. A set of components/boxes will be made available, which are related to exercises to be used during upper limb rehabilitation. [Method]: Initially, we examine previous use of NAO robot in the context of limb rehabilitation. This is followed by the identification of the types of rehabilitation movements that need to be supported. Then we use Choreographe to create the complex behavior of the robot to perform some selected exercises, and finally we perform a SURVEY-type evaluation with physiotherapists. [Results]: The 14 exercises elicited and made available as new components/boxes in the NAO robot were evaluated through a SURVEY by 34 physical therapists. They were considered appropriate and satisfactory by the physiotherapists and the use of the NAO robot as an assistive robot has a good acceptance by, both in terms of its usability and effectiveness.KeywordsSocially Assistive RobotHealth InformaticsSoftware and Systems ModelingHuman–Computer Interaction
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