Robotic System for Physical Training of Older Adults

Artificial intelligence-powered social robots for promoting physical activity in older adults: A systematic review

BACKGROUND

The aging global population necessitates innovative strategies to enhance older adults' health and quality of life. Physical activity (PA) is crucial for healthy aging, yet many older adults struggle to exercise regularly. Artificial intelligence (AI)-powered social robots offer an interactive, engaging, and personalized solution to promote PA among this demographic. This systematic review investigates the role of AI-powered social robots in encouraging PA in older adults.

METHODS

We conducted a systematic literature search in databases including PubMed, IEEE Xplore, Scopus, Cochrane Library, and Web of Science, focusing on studies published until February 2024. We included peer-reviewed articles reporting empirical findings on designing, implementing, and evaluating AI-enabled social robots to promote PA among older adults. Studies were conducted in nursing homes, rehabilitation centers, community centers, and home environments.

RESULTS

A total of 19 studies were included in the review. Analysis reveals that AI-powered social robots effectively motivate older adults to engage in PAs, leading to increased exercise adherence, higher engagement levels, and extended training durations. Social robots have demonstrated effectiveness across various environments, including nursing homes, rehabilitation centers, community centers, home environments, and elder care facilities. In structured environments like nursing homes and rehabilitation centers, robots help maintain regular exercise routines, improving adherence and recovery outcomes. In community and elder care centers, robots promote PA and social engagement by facilitating group exercises and enhancing participation. In home environments, robots provide personalized support for daily activities, offering reminders and engagement, which fosters long-term activity engagement. User acceptance and satisfaction are high, with participants finding the robots engaging and enjoyable. Additionally, several studies indicate potential health benefits, such as improved medication adherence, better sleep patterns, and enhanced overall well-being. Nevertheless, additional research is imperative to address unresolved issues concerning the technological maintenance costs, design constraints, and adaptability of AI-powered social robots to specific user demographics.

CONCLUSION

AI-powered social robots play a promising role in promoting PA among older adults, enhancing their health, well-being, and independence. This review provides insights for researchers, designers, and healthcare professionals developing AI-enabled social robotic systems for older adults.

Acceptance of a mobile telepresence robot used to teach adapted physical activity to isolated older adults: extending and testing the technology acceptance model

This study aimed to investigate the acceptance of adapted physical activity (APA) by teachers and students before the use of a mobile telepresence robot (MTR), used to remotely supervise isolated older adults' physical activity. While previous studies have shown MTR to be fairly well accepted by older adults, nothing is known about its acceptance by APA teachers themselves. However, if they did not accept it, the MTR would not be used in the end. This would be a public health issue because isolated older adults would not benefit from supervised APA, yet beneficial to their health. To this end, 334 participants answered a survey that measured different psychological variables, based on the technology acceptance model (TAM). Student's t-tests and structural equation modeling were used for data processing. Results showed that, before use, there was not any significant difference between teachers' and students' acceptance of the MTR. Then, perceived usefulness for teaching APA, perceived ease of use, perceived enjoyment, and intention to use the MTR were lower than the mean of the scale, while perceived usefulness for older adults was higher than the mean of the scale. Finally, this study has validated an extended version of the TAM (including the need for competence and MTR self-efficacy), which allowed it to explain 84.3% of the variance of the students' and APA teachers' intention to use the MTR for teaching APA to isolated older adults. Initial obstacles to the use of the MTR seem to exist on the part of APA teachers, prior to their first use, whereas this is not the case for older adults. APA teachers' acceptance should therefore be investigated in future studies to examine whether this trend is confirmed after the effective use of the MTR.

[Samii: a robotic mediation application to improve geriatric care]

The emergence of social robots in gerontology has introduced new playful and reassuring media into nursing homes and geriatric wards. Despite promising results, their complexity hinders their widespread adoption. The Intelligent Interactive Care System aims to remedy these limitations by offering interactive therapeutic workshops. This study evaluates residents' involvement in these workshops within an adapted activity and care center, revealing a high level of involvement and satisfaction.

Assimilation of socially assistive robots by older adults: an interplay of uses, constraints and outcomes

By supporting autonomy, aging in place, and wellbeing in later life, Socially Assistive Robots are expected to help humanity face the challenges posed by the rapid aging of the world's population. For the successful acceptance and assimilation of SARs by older adults, it is necessary to understand the factors affecting their Quality Evaluations Previous studies examining Human-Robot Interaction in later life indicated that three aspects shape older adults' overall QEs of robots: uses, constraints, and outcomes. However, studies were usually limited in duration, focused on acceptance rather than assimilation, and typically explored only one aspect of the interaction. In the present study, we examined uses, constraints, and outcomes simultaneously and over a long period. Nineteen community-dwelling older adults aged 75-97 were given a SAR for physical training for 6 weeks. Their experiences were documented via in-depth interviews conducted before and after the study period, short weekly telephone surveys, and reports produced by the robots. Analysis revealed two distinct groups: (A) The 'Fans' - participants who enjoyed using the SAR, attributed added value to it, and experienced a successful assimilation process; and (B) The 'Skeptics' - participants who did not like it, negatively evaluated its use, and experienced a disappointing assimilation process. Despite the vast differences between the groups, both reported more positive evaluations of SARs at the end of the study than before it began. Overall, the results indicated that the process of SARs' assimilation is not homogeneous and provided a profound understanding of the factors shaping older adults' QE of SARs following actual use. Additionally, the findings demonstrated the theoretical and practical usefulness of a holistic approach in researching older SARs users.

How should robots exercise with people? Robot-mediated exergames win with music, social analogues, and gameplay clarity

Introduction: The modern worldwide trend toward sedentary behavior comes with significant health risks. An accompanying wave of health technologies has tried to encourage physical activity, but these approaches often yield limited use and retention. Due to their unique ability to serve as both a health-promoting technology and a social peer, we propose robots as a game-changing solution for encouraging physical activity. Methods: This article analyzes the eight exergames we previously created for the Rethink Baxter Research Robot in terms of four key components that are grounded in the video-game literature: repetition, pattern matching, music, and social design. We use these four game facets to assess gameplay data from 40 adult users who each experienced the games in balanced random order. Results: In agreement with prior research, our results show that relevant musical cultural references, recognizable social analogues, and gameplay clarity are good strategies for taking an otherwise highly repetitive physical activity and making it engaging and popular among users. Discussion: Others who study socially assistive robots and rehabilitation robotics can benefit from this work by considering the presented design attributes to generate future hypotheses and by using our eight open-source games to pursue follow-up work on social-physical exercise with robots.

Exploring user engagement with real-time verbal feedback from an exoskeleton-based virtual exercise coach

Objective

Engaging users during physical exercise is crucial for fostering long-term commitment, however, sustaining that engagement remains a significant challenge. This study explores the design of a voice-enabled exoskeleton-based virtual exercise coach (VEC) that provides real-time verbal feedback to enhance user engagement. The objectives of this study are twofold: (i) to compare user engagement with real-time verbal feedback from both VEC and human exercise coach (HEC) during physical exercise, and (ii) to understand users' perceptions and gather their recommendations for improving future VEC technologies.

Methods

We developed an exoskeleton-based VEC that delivers real-time verbal feedback on users' exercise performance. To evaluate its impact on user engagement, we conducted a lab-based mixed-methods study ( N = 32 ) over a period of 6 weeks comparing users' engagement with the VEC and HEC using User Engagement Scale (UES) questionnaire and conducted semi-structured interviews to understand users' perceptions of the VEC.

Results

Participants in this study found the VEC more engaging than the HEC, in terms of focused attention ( Z = 156.5 , p < .001 ) and perceived usability ( Z = 32 , p < .001 ). Post-interaction interviews revealed that (i) users found the VEC to be engaging, intuitive, easy to use, and convenient; (ii) users perceived the VEC as a valuable training companion that could help reduce the emotional insecurities often associated with going to the gym; and (iii) users expressed a desire for the VEC to have a personality and embodiment that motivates and supports personalized interactions.

Conclusion

Based on our results, we discuss the challenges and implications for designing future voice-enabled VECs that support engaging physical exercises.

Effect of Robotic Delivery of Physical Activity and Fall Prevention Exercise in Older Adults: A Pilot Cohort Study

Introduction The high prevalence of falls, lack of stability and balance, and general physical deconditioning are concerning issues for longevity and quality of life for adults aged 65 years and older. Although supervised delivery of the Otago Exercise Program (OEP) has demonstrated evidence of effectiveness in reducing fall risk of older adults, opportunities for ongoing unsupervised exercise performance are warranted. An option to facilitate exercise and performance of health behaviors may be via a social robot. The purpose of this study was to examine feasibility and initial outcomes of a robot-delivered fall prevention exercise program for community-dwelling older adults. Methods Five participants aged 65 years and older were recruited to receive robot-delivered modified OEP and walking program three times per week for four weeks. Outcomes of demographics, self-reported performance measures (Modified Falls Self-Efficacy Scale, Activities-specific Balance Confidence, and Almere Model assessing various constructs of acceptance of use of robotic technology), and physical performance measures (Timed Up and Go Test, Short Physical Performance Battery, Balance Tracking System [BTrackS] center of pressure sway) were collected. Data were analyzed descriptively and examined for trends in change. Measures of central tendency and distribution were used according to the distribution of the data. Results The mean age of the participants was 75 years (range: 66-83 years; four females and one male). The range of participant exercise session completion was 7-12 (mode=11, n=3). Constructs on the Almere Model that started and remained positive were Attitudes Toward Technology and Perceived Enjoyment with the robot. Anxiety improved from 3.80 to 4.68, while Social Presence of the robot improved from 2.80 to 3.56. The construct of Trust was somewhat negative among participants upon commencing the program and did not substantially change over time. Two participants improved their confidence on the Activities-specific Balance Confidence scale by more than 10%, while all participants showed some improvement in confidence in their balance. Mixed results were found with the Modified Falls Self-Efficacy Scale. Mean gait speed for the participants improved by 0.76 seconds over 3 meters. Improvement was also demonstrated for the Short Physical Performance Battery, with two participants improving scores by 2-3 points out of 12. No appreciable changes were found with the Timed Up and Go test and the BTrackS assessment. Conclusion Using a robot-led exercise program is an accessible and feasible way to deliver exercise to community-dwelling older adults in the home, but some technical constraints remain. Outcomes suggest that a four-week program is sufficient to elicit some positive trends in health outcomes and has the potential to reduce fall risk.

Coaching Robots for Older Seniors: Do They Get What They Expect? Insights from an Austrian Study

To support the increasing number of older people, new (assistive) technologies are constantly being developed. For these technologies to be used successfully, future users need to be trained. Due to demographic change, this will become difficult in the future, as the resources for training will no longer be available. In this respect, coaching robots could have great potential to support younger seniors in particular. However, there is little evidence in the literature about the perceptions and potential impact of this technology on the well-being of older people. This paper provides insights into the use of a robot coach (robo-coach) to train younger seniors in the use of a new technology. The study was carried out in Austria in autumn 2020, involving 34 participants equally distributed among employees in their last three years of service and retirees in their first three years of retirement (23 female; 11 male). The aim was to assess participants' expectations and perceptions by examining the perceived ease of use and user experience of the robot in providing assistance during a learning session. The findings reveal a positive impression of the participants and promising results for using the robot as a coaching assistant in daily tasks.

Evaluating levels of automation with different feedback modes in an assistive robotic table clearing task for eldercare

This paper focuses on how the autonomy level of an assistive robot that offers support for older adults in a daily task and its feedback affect the interaction. Identifying the level of automation (LOA) that prioritizes older adults' preferences while avoiding passiveness and sedentariness is challenging. The feedback mode should match the cognitive and perceptual capabilities of older adults and the LOA. We characterized three LOAs and paired them with two modes of feedback in a human-robot collaborative task. Twenty-seven older adults participated in evaluating the LOA-feedback variations in a mixed experimental design, utilizing an experimental setup of an assistive robot in a table clearing task. The quality of the interaction was evaluated with objective and subjective measures. The combination of high LOA with voice feedback improved the overall interaction when compared to other LOA and feedback combinations. This study emphasizes the importance of appropriate coupling of LOA and feedback for successful interaction of the older adults with an assistive robot.

Robotic Vision for Human-Robot Interaction and Collaboration: A Survey and Systematic Review

Robotic vision for human-robot interaction and collaboration is a critical process for robots to collect and interpret detailed information related to human actions, goals, and preferences, enabling robots to provide more useful services to people. This survey and systematic review presents a comprehensive analysis on robotic vision in human-robot interaction and collaboration over the last 10 years. From a detailed search of 3850 articles, systematic extraction and evaluation was used to identify and explore 310 papers in depth. These papers described robots with some level of autonomy using robotic vision for locomotion, manipulation and/or visual communication to collaborate or interact with people. This paper provides an in-depth analysis of current trends, common domains, methods and procedures, technical processes, data sets and models, experimental testing, sample populations, performance metrics and future challenges. This manuscript found that robotic vision was often used in action and gesture recognition, robot movement in human spaces, object handover and collaborative actions, social communication and learning from demonstration. Few high-impact and novel techniques from the computer vision field had been translated into human-robot interaction and collaboration. Overall, notable advancements have been made on how to develop and deploy robots to assist people.

A Study on the Effectiveness of IT Application Education for Older Adults by Interaction Method of Humanoid Robots

Education using humanoid robots can have a positive impact in many fields, including in medical or physical training. This study investigated the effects of robot interactions with respect to facial expressions, gestures, voices and their combinations on the education of the elderly regarding information and communications technology (ICT) from functional and emotional perspectives. In this study, the robot's interaction methods were divided into four categories: (1) voice, (2) voice and expression, (3) voice and gesture, and (4) voice and expression and gesture. An experiment involving an educational application with a humanoid robot was conducted with a total of 15 elderly people over the age of 60. The effect of the humanoid robot's interaction method on education was identified by means of subjective survey evaluation and practice performance data analysis, including error rate, task success rate, and number of retrainings. Through the experiment, functional and emotional aspects of effects were measured. The results showed that performance and perceived effectiveness were not significantly affected by the type of robot interaction, but the degree to which the robot felt like it had emotions, the degree to which the robot felt like a human, and the degree to which the robot was friendly were significantly different according to the interaction type employed by the humanoid robot. The best effect was achieved when voice and gesture were used together during tutoring. Recognizing that ICT education using humanoid robots increases interest and participation in education, such robots are concluded to be a suitable method for performing ICT education. In addition, when designing robotic interactions, the use of the robot's voice and gestures together is expected to lead to greater anthropomorphism, resulting in a stronger relationship with humanoid robots.

A Survey on Recent Advances in Social Robotics

Over decades, social robotics has evolved as a concept that presently covers different areas of application, and interacts with different domains in technology, education, medicine and others. Today, it is possible to envision social robots in tasks that were not expected years ago, and that is not only due to the evolution of social robots, but also to the evolution of the vision humans have for them. This survey addresses recent advances in social robotics from different perspectives. Different contexts and areas of application of social robots are addressed, as well as modalities of interaction with humans. Different robotic platforms used in social contexts are shown and discussed. Relationships of social robotics with advances in other technological areas are surveyed, and methods and metrics used for the human evaluation of the interaction with robots are presented. The future of social robotics is also envisioned based on surveyed works and from different points of view.

A Robot-Mediated Activity Using the Nao Robot to Promote COVID-19 Precautionary Measures among Older Adults in Geriatric Facilities

Precautionary measures (e.g., social distancing, mask wearing, washing hands regularly) to limit the transmission of the Coronavirus 19 (COVID-19) have been put in place worldwide. However, a limited understanding of precautionary measures and low compliance with them has been observed in older adults with neurocognitive disorders, persons with intellectual disability, or mental illness. The objective of this study is to create and evaluate a robot-mediated activity to deliver information on COVID-19 precautionary measures in an accessible and engaging way using the humanoid robot Nao. An interactive scenario explaining and demonstrating COVID-19 precautionary measures is created using the verbal and non-verbal behaviours of the robot. The scenario (≈5 min) is presented to 124 users of a geriatric hospital, including the following: older patients (n = 45), accompanying persons (n = 39), and health professionals (n = 40). The data regarding perceived usefulness, acceptability, and accessibility are collected using a questionnaire. A video analysis of the participants' behaviour during the interaction with the robot is performed to examine the quality of engagement in the activity. The results show a good acceptance, satisfaction, and perceived usefulness of the robot-mediated activity. These findings suggest that robot-mediated interventions using humanoid robots can be an effective tool for the delivery of health promotion information.

An analysis of design recommendations for socially assistive robot helpers for effective human-robot interactions in senior care

As the global population ages, there is an increase in demand for assistive technologies that can alleviate the stresses on healthcare systems. The growing field of socially assistive robotics (SARs) offers unique solutions that are interactive, engaging, and adaptable to different users’ needs. Crucial to having positive human-robot interaction (HRI) experiences in senior care settings is the overall design of the robot, considering the unique challenges and opportunities that come with novice users. This paper presents a novel study that explores the effect of SAR design on HRI in senior care through a results-oriented analysis of the literature. We provide key design recommendations to ensure inclusion for a diverse set of users. Open challenges of considering user preferences during design, creating adaptive behaviors, and developing intelligent autonomy are discussed in detail. SAR features of appearance and interaction mode along with SAR frameworks for perception and intelligence are explored to evaluate individual developments using metrics such as trust, acceptance, and intent to use. Drawing from a diverse set of features, SAR frameworks, and HRI studies, the discussion highlights robot characteristics of greatest influence in promoting wellbeing and aging-in-place of older adults and generates design recommendations that are important for future development.