Gert Jan Gelderblom

Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness

The ongoing development of robotics on the one hand and, on the other hand, the foreseen relative growth in number of elderly individuals suffering from dementia, raises the question of which contribution robotics could have to rationalize and maintain, or even improve the quality of care. The objective of this review was to assess the published effects and effectiveness of robot interventions aiming at social assistance in elderly care. We searched, using Medical Subject Headings terms and free words, in the CINAHL, MEDLINE, Cochrane, BIOMED, PUBMED, PsycINFO, and EMBASE databases. Also the IEEE Digital Library was searched. No limitations were applied for the date of publication. Only articles written in English were taken into account. Collected publications went through a selection process. In the first step, publications were collected from major databases using a search query. In the second step, 3 reviewers independently selected publications on their title, using predefined selection criteria. In the third step, publications were judged based on their abstracts by the same reviewers, using the same selection criteria. In the fourth step, one reviewer made the final selection of publications based on complete content. Finally, 41 publications were included in the review, describing 17 studies involving 4 robot systems. Most studies reported positive effects of companion-type robots on (socio)psychological (eg, mood, loneliness, and social connections and communication) and physiological (eg, stress reduction) parameters. The methodological quality of the studies was, mostly, low. Although positive effects were reported, the scientific value of the evidence was limited. The positive results described, however, prompt further effectiveness research in this field.

Overview and Categorization of Robots Supporting Independent Living of Elderly People: What Activities Do They Support and How Far Have They Developed

Over the past decades, many robots for the elderly have been developed, supporting different activities of elderly people. A systematic review in four scientific literature databases and a search in article references and European projects was performed in order to create an overview of robots supporting independent living of elderly people. The robots found were categorized based on their development stage, the activity domains they claim to support, and the type of support provided (i.e., physical, non-physical, and/or non-specified). In total, 107 robots for the elderly were identified. Six robots were still in a concept phase, 95 in a development phase, and six of these robots were commercially available. These robots claimed to provide support related to four activity domains: mobility, self-care, interpersonal interaction & relationships, and other activities. Of the many robots developed, only a small percentage is commercially available. Technical ambitions seem to be guiding robot development. To prolong independent living, the step towards physical support is inevitable and needs to be taken. However, it will be a long time before a robot will be capable of supporting multiple activities in a physical manner in the home of an elderly person in order to enhance their independent living.

Effectiveness of Robot Paro in Intramural Psychogeriatric Care: A Multicenter Quasi-Experimental Study

BACKGROUND Together with care professionals, specific psychogeriatric care applications were developed for the seal robot Paro. OBJECTIVES This study aims to evaluate the outcomes of the developed Paro interventions, applying the robot in psychogeriatric care. DESIGN A multicenter quasi-experimental time series ABAB study (n = 91) with within-subject comparison was conducted to assess both the short-term effects of the Paro interventions for therapeutic applications, and the facilitation of daily care activities by care providers. SETTING Small-scale care units (8-10 residents each), spread over 6 different locations, in 3 Dutch care institutions for intramural psychogeriatric care. PARTICIPANTS A total of 91 patients with dementia, in all stages of dementia. INTERVENTION Two user-centered intervention types were applied, one for therapeutic purposes and one for the facilitation of daily care activities. MEASUREMENTS Effectiveness was measured with a goal attainment scale (IPPA) and a mood scale (Coop/Wonca), by means of a registration form. RESULTS A total of 106 user-specific interventions were defined for 91 participants; 71 participants completed the study, 14 were men and 57 were women. All interventions combined show a significant effect (P < .001). CONCLUSION Paro should be seen as a tool for care staff and not as a replacement of care. Successful implementation of Paro in daily intramural psychogeriatric care practice can increase the quality of care and the quality of life for the elderly.

An overview and categorization of dynamic arm supports for people with decreased arm function

Background: Assistive devices that augment arm function were already introduced during the polio era. Devices are still being developed, but a review has not been performed thus far. Objective: To create an overview and categorize assistive devices facilitating arm function in activities of daily living for people with decreased arm function. Study design: Literature review. Methods: A systematic review in three scientific literature databases. Conference proceedings, assistive technology databases, and references were searched and experts consulted. This resulted in a database of dynamic arm supports. Product information was added, and the devices were categorized. Results: A total of 104 dynamic arm supports were found. These could be categorized as nonactuated devices (N = 39), passively actuated devices (N = 24), actively actuated devices (N = 34), or devices using the functional electrical stimulation principle (N = 7). Functionality analysis resulted in second-level categorization: tremor suppression, facilitation of anti-gravity movement, and assistance of specific joint motion. Conclusion: All devices could be ordered in a categorization of low complexity. Many have been developed; most have disappeared and have been succeeded by similar devices. Limitations of the devices found mainly concern interfacing and the range of motion facilitated. Future devices could make use of whatever residual strength is available in the users’ arm for control. Clinical relevance The provided overview of devices in this article and the classification developed is relevant for practitioners seeking assistive solutions for their clients as it makes the range of developed solutions both accessible and comprehensible.

Which activities threaten independent living of elderly when becoming problematic; Inspiration for meaningful service robot functionality.

Abstract Purpose: In light of the increasing elderly population and the growing demand for home care, the potential of robot support is given increasing attention. In this paper, an inventory of activities was made that threaten independent living of elderly when becoming problematic. Results will guide the further development of an existing service robot, the Care-O-bot®. Method: A systematic literature search of PubMed was performed, focused on the risk factors for institutionalization. Additionally, focus group sessions were conducted in the Netherlands, United Kingdom and France. In these focus group sessions, problematic activities threatening the independence of elderly people were discussed. Three separate target groups were included in the focus group sessions: (1) elderly persons (n = 41), (2) formal caregivers (n = 40) and (3) informal caregivers (n = 32). Results: Activities within the International Classification of Functioning domains mobility, self-care, and interpersonal interaction and relationships were found to be the most problematic. Conclusions: A distinct set of daily activities was identified that may threaten independent living, but no single activity could be selected as the main activity causing a loss of independence as it is often a combination of problematic activities that is person-specific. Supporting the problematic activities need not involve a robotic solution. Implications for Rehabilitation Design of assistive robotics for the elderly. Potential of assistive robotics for the elderly. State of the art of assistive robotics.

Evaluation of short term effects of the IROMEC robotic toy for children with developmental disabilities

Research shows a reduced playfulness in children with developmental disabilities. This is a barrier for participation and childrens health and wellbeing. IROMEC is a purposely designed robot to support play in impaired children. The reported study evaluates short-term effects of the IROMEC robot toy supporting play in an occupational therapy intervention for children with developmental disabilities. Two types of play intervention (standard occupational therapy versus robot-facilitated play intervention) were compared regarding their effect on the level of playfulness, on childrens general functional development, goal achievement as well as the therapists evaluation of the added value of a robot-facilitated play intervention. Three young children took part in this single-subject design study. Evaluation was performed through Test of Playfulness (ToP), the IROMEC evaluation questionnaire and qualitative evaluation by the therapists. Results confirmed the IROMEC robot did partly meet the needs of the children and therapists, and positive impact on TOP results was found with two children. This suggests robotic toys can support children with developmental disabilities in enriching play. Long term effect evaluation should verify these positive indications resulting from use of this innovative social robot for children with developmental disabilities. But it also became clear further development of the robot is required.

Accompany: Acceptable robotiCs COMPanions for AgeiNG Years — Multidimensional aspects of human-system interactions

With changes in life expectancy across the world, technologies enhancing well-being of individuals, specifically for older people, are subject to a new stream of research and development. In this paper we present the ACCOMPANY project, a pan-European project which focuses on home companion technologies. The projects aims to progress beyond the state of the art in multiple areas such as empathic and social human-robot interaction, robot learning and memory visualisation, monitoring persons and chores at home, and technological integration of these multiple approaches on an existing robotic platform, Care-O-Bot®3 and in the context of a smart-home environment utilising a multitude of sensor arrays. The resulting prototype from integrating these developments undergoes multiple formative cycles and a summative evaluation cycle towards identifying acceptable behaviours and roles for the robot for example role as a butler or a trainer. Furthermore, the evaluation activities will use an evaluation grid in order to assess achievement of the identified user requirements, formulated in form of distinct scenarios. Finally, the project considers ethical concerns and by highlighting principles such as autonomy, independence, enablement, safety and privacy, it embarks on providing a discussion medium where user views on these principles and the existing tension between some of these principles for example tension between privacy and autonomy over safety, can be captured and considered in design cycles and throughout project developments.

The role of the International Classification of Functioning, Disability, and Health and quality criteria for improving assistive technology service delivery in Europe

ObjectivePeople with disabilities are entitled to access assistive technology (AT) to facilitate their full and effective participation in society and may reasonably expect to be central to the decision-making processes of services that provide these technologies. European projects have improved the knowledge and resources available for AT service delivery in many countries, but the outputs are not consistently implemented or published in scientific literature. This article examines European developments in AT service delivery and the barriers to its effective provision. Specifically, it analyzes the role of the International Classification of Functioning, Disability, and Health in service delivery improvement. DesignPublished scientific papers, as well as reports from and descriptions of European projects related to AT service delivery, were reviewed. The publications were analyzed in relation to six criteria for AT service delivery described in an earlier, major European project. The findings and recommendations from the publications are synthesized in this article to identify advances and gaps in AT service delivery and to assess the current status and direction of AT service delivery improvement in Europe. ResultsMulticountry projects have brought together AT researchers from across Europe to work together and produced promising results that are contextually relevant. Access to AT information and training of practitioners has improved, and efforts are being made to facilitate user involvement. ConclusionsMore effort should be put into integrating research and resources from European projects into practice. Use of the International Classification of Functioning, Disability, and Health model and terminology may support coordination of service delivery systems. The AT research and practice communities in Europe may be able to learn from developments in North America, while continuing to work together, sharing resources and strategies, and communicating results internationally.

Development of PARO interventions for dementia patients in Dutch psycho-geriatric care

Social Robots are believed to have great potential for long term care. The uptake of Social Robots in daily care provision will depend on demonstrated added value of such systems in practice. To assess the added value, the availability of a technical system as such is insufficient. Interventions need to be defined describing the goal, target group, environment and how care staff should act to pursue effective application of a robot system. For the seal robot Paro three such interventions have been developed in collaboration with psychogeriatric care professionals. The interventions provide information on the aims of PARO application in daily care for psycho-geriatric patients and describe concrete outcomes to monitor the added value of robot interventions. The developed interventions also outline the application of PARO in care for a subsequent randomized clinical trial (RCT).

Rehabilitation robotics in robotics for healthcare; A roadmap study for the European Commission

To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for Rehabilitation Robotics are highlighted. The study ultimately resulted in a range of required or foreseen developments foreseen in six areas of Healthcare Robotics regarding societal needs, innovations and technology. These developments were positioned along a timescale running till 2025. This study will guide the policy development of the 7th and 8th framework of the EC.