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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
BJosé Carlos Pulido
José Carlos González
Cristina Suárez-Mejías
Antonio Bandera
Pablo Bustos
Fernando Fernández
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-
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].
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... 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 . ...
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
... 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. ...
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.
... 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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This research focuses on whether the use of a cyber-physical robotic system (CPRS) to assist Speech and Language Pathologists (SLP) in a Special Education service is beneficial. The research method is based on a quasi-experiment with a 2k design and a two-way ANOVA, implemented with real high school students over 10 weeks. It was found that the use of this CPRT could improve, preliminarily and as an initial exploratory finding, therapeutic speech effectiveness up to 11.3 percentage points with a statistical confidence of 95%, when SLPs work with students with mild articulation disorder and a restricted time for therapy, but especially when the technology is used without time constraints. It is concluded that assistive CPRT could be a causal factor of improvement in specific treatments performed by SLPs, with the statistical evidence being sufficiently significant (95%) to maintain scientific and educational interest in this research line in the future.
... 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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The increasing presence of robots in our society raises questions about how these objects are perceived by users. Individuals seem inclined to attribute human capabilities to robots, a phenomenon called anthropomorphism. Contrary to what intuition might suggest, these attributions vary according to different factors, not only robotic factors (related to the robot itself), but also situational factors (related to the interaction setting), and human factors (related to the user). The present review aims at synthesizing the results of the literature concerning the factors that influence anthropomorphism, in order to specify their impact on the perception of robots by individuals. A total of 134 experimental studies were included from 2002 to 2023. The mere appearance hypothesis and the SEEK (sociality, effectance, and elicited agent knowledge) theory are two theories attempting to explain anthropomorphism. According to the present review, which highlights the crucial role of contextual factors, the SEEK theory better explains the observations on the subject compared to the mere appearance hypothesis, although it does not explicitly explain all the factors involved (e.g., the autonomy of the robot). Moreover, the large methodological variability in the study of anthropomorphism makes the generalization of results complex. Recommendations are proposed for future studies.
... 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. ...
Full-text available
La parálisis cerebral (PC) es la enfermedad motora más común en pacientes pediátricos, afectando su capacidad para moverse y mantener el balance corporal y la postura. Este estudio se enfoca en las terapias de rehabilitación robóticas, llevadas a cabo con la plataforma CPWalker, para la realización de ejercicios funcionales mediante movimientos precisos. El trabajo presentado en este artículo propone la integración de la robótica de asistencia social en el CPWalker a través del robot social NAO. De esta manera se plantea conseguir reforzar la motivación del paciente y el dinamismo de estas terapias, y automatizar la retroalimentación correctiva al paciente. Se han realizado dos evaluaciones a lo largo de este estudio. La primera ha sido un protocolo clínico de actividades y juegos entre NAO y los pacientes para evaluar la aceptación del robot por parte de los niños. Y, posteriormente, se ha evaluado la integración del nuevo sistema robótico social de rehabilitación desarrollado. Los resultados de este estudio indican que el robot es percibido positivamente por los pacientes.
... 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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The use of service robots is rapidly expanding in many industries, including the retail sector. In some Asian countries retail companies already deploy in-store humanoid robot assistants that interact with customers in a personalized and dynamic way. However, little is known about customers’ perceptions of these robot-assisted interactions. Therefore, we compared customers’ perceived service quality of a human-robot interaction with a human-human interaction in a retail store, using an experiment with hypothetical scenarios (N = 425). Participants’ general attitudes towards robots, their age, gender, and educational level were included as moderators in the analyses (a mixed-design ANOVA model). Results showed that participants valued service quality higher in the human-human interaction scenario. Additionally, findings from the moderation analyses indicated that perceived service quality of the human- robot interaction and the human-human interaction did not statistically significantly differ for participants with relatively high positive attitudes towards robots. Participants with relatively low positive attitudes towards robots, however, held statistically significantly lower perceptions of service quality for the human-robot interaction. Neither age, gender nor educational level statistically significantly influenced participants’ perceived service quality scores for both service encounters.
[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
Social robots hold promise in augmenting education, rehabilitative care, and leisure activities for children. Despite findings suggesting various benefits of social robot use in schools, clinics, and homes, stakeholders have voiced concerns about the potential social and emotional effects of children engaging in long-term interactions with robots. Given the challenges of conducting large long-term studies of child-robot interaction (CRI), little is known about the impact of CRI on children's socio-emotional development. Here we summarize the literature on predictions and expectations of teachers, parents, therapists, and children regarding the effects of CRI on children's socio-emotional functioning and skill building. We then highlight the limited body of empirical research examining how CRI affects children's social behavior and emotional expression, and we provide a summary of available questionnaires for measuring socio-emotional constructs relevant to CRI. We conclude with design recommendations for research studies aimed at better understanding the effects of CRI, before social robots become more ubiquitous. This review is relevant to researchers, educators, roboticists, and clinicians interested in designing and using social robots with developmental populations.
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Although the global population is aging, the proportion of potential caregivers is not keeping pace. It is necessary for society to adapt to this demographic change, and new technologies are a powerful resource for achieving this. New tools and devices can help to ease independent living and alleviate the workload of caregivers. Among them, socially assistive robots (SARs), which assist people with social interactions, are an interesting tool for caregivers thanks to their proactivity, autonomy, interaction capabilities, and adaptability. This article describes the different design and implementation phases of a SAR, the CLARA robot, both from a physical and software point of view, from 2016 to 2022. During this period, the design methodology evolved from traditional approaches based on technical feasibility to user-centered co-creative processes. The cognitive architecture of the robot, CORTEX, keeps its core idea of using an inner representation of the world to enable inter-procedural dialogue between perceptual, reactive, and deliberative modules. However, CORTEX also evolved by incorporating components that use non-functional properties to maximize efficiency through adaptability. The robot has been employed in several projects for different uses in hospitals and retirement homes. This paper describes the main outcomes of the functional and user experience evaluations of these experiments.
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This chapter builds on temporal reasoning techniques for planning by presenting some adequate representations for planning involving explicit time and by developing two related approaches to temporal planning. Time is dealt with mainly within point algebra (PA) and the simple temporal networks. Other approaches that rely on interval algebra (IA) are discussed. The chapter focuses on temporal planners that extend certain planning techniques. However, it departs significantly from the model of state-transition systems. It views an action not as a single state transition but as a collection of local change and persistence conditions that are spread out in time but are focused on just a few state variables or propositions. Such a view offers several advantages in expressiveness. In particular, explicit time is essential for handling the interaction of concurrent actions properly.
This manuscript focuses on the description of a novel cognitive architecture called NAOTherapist, which provides a social robot with enough autonomy to carry out a non-contact upper limb rehabilitation therapy for patients with physical impairments, such as cerebral palsy and obstetric brachial plexus palsy. NAOTherapist comprises three levels of Automated Planning. In the high-level planning, the physician establishes the parameters of the therapy such as the scheduling of the sessions, the therapeutic objectives to be achieved and certain constraints based on the medical records of the patient. This information is used to establish a customized therapy plan. The objective of the medium-level planning is to execute and monitor every previous planned session with the humanoid robot. Finally, the low-level planning involves the execution of path-planning actions by the robot to carry out different low-level instructions such as performing poses. The technical evaluation shows an accurate definition and monitoring of the therapies and sessions and a fluent interaction with the robot. This automated process is expected to save time for the professionals while guaranteeing the medical criteria.
Recent research shows that Human Robot Interaction (HRI) can play an important role in the screening and therapy of many disorders, and suggests broad range of applications for children with developmental disorders. This paper presents the design, development, and application of a parrot-like robot as a screening tool to diagnose autistic children. The interactions of several autistic children with the robot have been observed and compared to the interaction of a group of normal children with the robot to determine the important behavioral features separating the autistic children from the normal ones. Based on these observations, we developed a descriptive research methodology to specify important and discriminating features for screening autism using behavioral aspects in social interaction, communication, and stereotyped and repetitive behaviors. Our experiments show that there are significant differences between autistic and normal children pertaining to their communication with the robot, repetitive behaviors and sustaining attention. The results show the effectiveness of using robots in screening developmental disorders such as autism, highlighting the importance of Robot Assisted Screening (RAS) or intelligent toys in this field. We have determined 6 features extracted from the children’s behavior, and Random Forest method is used to distinguish between the autistic and normal children. The system has been tested on 51 children, 35 autistic and 16 normal, with maximum 90 % correct classification rate.
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Kindergarten Social Assistive Robot (KindSAR) is an innovative tool that promotes children's development through social interaction. In this report we describe how KindSAR was introduced to a group of preschool children in a one-to-many setup, and how it engaged the children in play-like interactions. Ethical guidelines were successfully implemented. Children's (N=11) reactions and performance were video-recorded for analysis. Most of the children interacted positively with the robot, exhibited heightened attention, performed motor and cognitive tasks, and reported a high degree of enjoyment of the interaction. A relationship was observed between children's poor social skills and their refusal to participate in interaction with the robot. A many-to-one setup was found to be preferable to a one-to-one setup. This study demonstrates the feasibility and potential benefit of incorporating KindSAR in preschool education.