Robotic Systems that Rehabilitate as well as Motivate: Three Strategies for Motivating Impaired Arm Use

Johnson, Michelle J.; Feng, Xin; Johnson, Laura; Ramachandran, Brinda; Winters, Jack M.; Kosasih, Judith B.

doi:10.1109/biorob.2006.1639095

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…Impairments are quantitatively measured by various clinical and bio-mechanical methods. Kinematic analysis identifies these weaknesses by end-point analysis [ 24 ], inter-joint (intra-limb) coordination [ 25 ] and sensorimotor analysis [ 20 ]. Besides movement kinematics, the kinetic and biometric aspects such as torque and force trends at selected joints to evaluate abnormal muscle tone [ 26 ] and paresis [ 27 ], and the use of EMG signal [ 10 , 28 , 29 ] to diagnose the muscle co-activation during movements are also reported.…”

Section: Methodsmentioning

confidence: 99%

Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: a review

Nordin

Xie

Wünsche

2014

J NeuroEngineering Rehabil

230

198

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Electronic supplementary materialStudies of stroke patients undergoing robot-assisted rehabilitation have revealed various kinematic parameters describing movement quality of the upper limb. However, due to the different level of stroke impairment and different assessment criteria and interventions, the evaluation of the effectiveness of rehabilitation program is undermined. This paper presents a systematic review of kinematic assessments of movement quality of the upper limb and identifies the suitable parameters describing impairments in stroke patients. A total of 41 different clinical and pilot studies on different phases of stroke recovery utilizing kinematic parameters are evaluated. Kinematic parameters describing movement accuracy are mostly reported for chronic patients with statistically significant outcomes and correlate strongly with clinical assessments. Meanwhile, parameters describing feed-forward sensorimotor control are the most frequently reported in studies on sub-acute patients with significant outcomes albeit without correlation to any clinical assessments. However, lack of measures in coordinated movement and proximal component of upper limb enunciate the difficulties to distinguish the exploitation of joint redundancies exhibited by stroke patients in completing the movement. A further study on overall measures of coordinated movement is recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-137) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: a review

Nordin

Xie

Wünsche

2014

J NeuroEngineering Rehabil

230

198

View full text Add to dashboard Cite

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“…Social interaction in the form of multiplayer gameplay has been emphasized as a potentially very important element of motor rehabilitation, both between a patient and a therapist [ 13 ] and between individual patients [ 14 ]. It has already been incorporated into games for weight loss, where cooperative gameplay can significantly increase motivation and energy expenditure [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although social elements were suggested for rehabilitation robots as early as 2006 [ 13 ], work on the topic has been limited. Perhaps the first technical implementation (though with no evaluation) was demonstrated by Carignan and Krebs [ 19 ], who envisioned it for patient-therapist collaboration in telerehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Increasing motivation in robot-aided arm rehabilitation with competitive and cooperative gameplay

Novak

Nagle

Keller

et al. 2014

J NeuroEngineering Rehabil

173

136

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BackgroundSeveral strategies have been proposed to improve patient motivation and exercise intensity during robot-aided stroke rehabilitation. One relatively unexplored possibility is two-player gameplay, allowing subjects to compete or cooperate with each other to achieve a common goal. In order to explore the potential of such games, we designed a two-player game played using two ARMin arm rehabilitation robots.MethodsThe game was an air-hockey task displayed on a computer monitor and controlled using shoulder movements in the ARMin robot. Three game modes were tested: single-player (competing against computer), competitive (competing against human), and cooperative (cooperating with human against computer). All modes were played by 30 unimpaired subjects and 8 impaired chronic stroke subjects. The subjects filled out the Intrinsic Motivation Inventory questionnaire after each game mode, as well as a final questionnaire about game preferences and their personality.ResultsNearly all unimpaired subjects preferred playing the two-player game modes to the single-player one, as they enjoyed talking and interacting with another person. However, there were two distinct player groups: one liked the competitive mode but not the cooperative mode while the other liked the cooperative but not the competitive mode. Unimpaired subjects who liked the competitive mode also put significantly more effort into it than into the other modes. Results from impaired subjects were similar, with even impaired subjects over 60 years old enjoying competitive gameplay. The subjects’ personalities roughly predicted which mode they would prefer, which was especially evident in a poorly-matched impaired pair that preferred the single-player mode.ConclusionsResults indicate great potential for two-player rehabilitation games, in the form of greater enjoyment as well as potentially more intensive exercise compared to single-player games. However, the right game type needs to be chosen for each subject depending on skill and personality, along with selecting an appropriate co-player. Further studies with patients that are currently enrolled in rehabilitation programs are recommended, and the subjective measures used in our study should be augmented with objective measures such as electromyography.

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“…The mere interaction with inanimate socially assistive robots was demonstrated to increase patients’ engagement in therapy and alleviate their feelings of stress and depression [52-54]. Building on this evidence, interhuman social interactions were introduced between the patient and their practitioner [52,55,56] and subsequently extended to include interactions with relatives and friends, and even strangers [30,52,57-59]. In all cases, patients expressed a strong preference to perform exercise with another person rather than alone and with a human partner rather than a virtual one [30,57,60].…”

Section: Introductionmentioning

confidence: 99%

The Role of Social Interactions in Motor Performance: Feasibility Study Toward Enhanced Motivation in Telerehabilitation

et al. 2019

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Background Robot-mediated telerehabilitation has the potential to provide patient-tailored cost-effective rehabilitation. However, compliance with therapy can be a problem that undermines the prospective advantages of telerehabilitation technologies. Lack of motivation has been identified as a major factor that hampers compliance. Exploring various motivational interventions, the integration of citizen science activities in robotics-based rehabilitation has been shown to increase patients’ motivation to engage in otherwise tedious exercises by tapping into a vast array of intrinsic motivational drivers. Patient engagement can be further enhanced by the incorporation of social interactions. Objective Herein, we explored the possibility of bolstering engagement in physical therapy by leveraging cooperation among users in an environmental citizen science project. Specifically, we studied how the integration of cooperation into citizen science influences user engagement, enjoyment, and motor performance. Furthermore, we investigated how the degree of interdependence among users, such that is imposed through independent or joint termination (JT), affects participation in citizen science-based telerehabilitation. Methods We developed a Web-based citizen science platform in which users work in pairs to classify images collected by an aquatic robot in a polluted water canal. The classification was carried out by labeling objects that appear in the images and trashing irrelevant labels. The system was interfaced by a haptic device for fine motor rehabilitation. We recruited 120 healthy volunteers to operate the platform. Of these volunteers, 98 were cooperating in pairs, with 1 user tagging images and the other trashing labels. The other 22 volunteers performed both tasks alone. To vary the degree of interdependence within cooperation, we implemented independent and JTs. Results We found that users’ engagement and motor performance are modulated by their assigned task and the degree of interdependence. Motor performance increased when users were subjected to independent termination ( P =.02), yet enjoyment decreased when users were subjected to JT ( P =.005). A significant interaction between the type of termination and the task was found to influence productivity ( P <.001) as well as mean speed, peak speed, and path length of the controller ( P =.01, P =.006, and P <.001, respectively). Conclusions Depending on the type of termination, cooperation was not always positively associated with engagement, enjoyment, and motor performance. Therefore, enhancing user engagement, satisfaction, and motor performance through cooperative citizen science tasks relies on both the degree of interdependence among users and the perceived nature of...

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Robotic Systems that Rehabilitate as well as Motivate: Three Strategies for Motivating Impaired Arm Use

Cited by 11 publications

References 17 publications

Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: a review

Assessment of movement quality in robot- assisted upper limb rehabilitation after stroke: a review

Increasing motivation in robot-aided arm rehabilitation with competitive and cooperative gameplay

The Role of Social Interactions in Motor Performance: Feasibility Study Toward Enhanced Motivation in Telerehabilitation

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