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Bouchard K, Liu PP, Dautenhahn K, Fiedorowicz JG, Afrin J, Dans M, McGuinty C, Tulloch H. Cardiology professionals' views of social robots in augmenting heart failure patient care. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2024; 5:69-76. [PMID: 38264699 PMCID: PMC10802821 DOI: 10.1093/ehjdh/ztad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/14/2023] [Accepted: 10/11/2023] [Indexed: 01/25/2024]
Abstract
Aims Social robots are arriving to the modern healthcare system. Whether patients with heart failure, a prevalent chronic disease with high health and human costs would derive benefit from a social robot intervention has not been investigated empirically. Diverse healthcare provider's perspectives are needed to develop an acceptable and feasible social robot intervention to be adopted for the clinical benefit of patients with heart failure. Using a qualitative research design, this study investigated healthcare providers' perspectives of social robot use in heart failure patient care. Methods and results Interdisciplinary healthcare providers from a tertiary care cardiac hospital completed a structured individual interview and a supplemental questionnaire. The framework method was used to analyse the qualitative data. Respondents (n = 22; saturation was reached with this sample; 77% female; 52% physicians) were open to using social robots to augment their practice, particularly with collecting pertinent data and providing patient and family education and self-management prompts, but with limited responsibility for direct patient care. Prior to implementation, providers required robust evidence of: value-added beyond current remote patient monitoring devices, patient and healthcare provider partnerships, streamlined integration into existing practice, and capability of supporting precision medicine goals. Respondents were concerned that social robots did not address and masked broader systemic issues of healthcare access and equity. Conclusion The adoption of social robots is a viable option to assist in the care of patients with heart failure, albeit in a restricted capacity. The results inform the development of a social robotic intervention for patients with heart failure, including improving social robot efficiencies and increasing their uptake, while protecting patients' and providers' best interest.
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Affiliation(s)
- Karen Bouchard
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Peter P Liu
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Kerstin Dautenhahn
- Faculty of Engineering, University of Waterloo, 200 University Ave W., Waterloo, N2L 3G1 ON, Canada
| | - Jess G Fiedorowicz
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
- Department of Mental Health, The Ottawa Hospital/Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, K1H 8L6 ON, Canada
| | - Jenifar Afrin
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Michael Dans
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
| | - Caroline McGuinty
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
| | - Heather Tulloch
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7 ON, Canada
- Faculty of Medicine, University of Ottawa, 75 Laurier Ave E., Ottawa, K1N 6N5 ON, Canada
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Raz D, Barkan-Slater S, Baum-Cohen I, Vissel G, Lahav-Raz Y, Shapiro A, Levy-Tzedek S. A novel socially assistive robotic platform for cognitive-motor exercises for individuals with Parkinson's Disease: a participatory-design study from conception to feasibility testing with end users. Front Robot AI 2023; 10:1267458. [PMID: 37868274 PMCID: PMC10587405 DOI: 10.3389/frobt.2023.1267458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
The potential of socially assistive robots (SAR) to assist in rehabilitation has been demonstrated in contexts such as stroke and cardiac rehabilitation. Our objective was to design and test a platform that addresses specific cognitive-motor training needs of individuals with Parkinson's disease (IwPD). We used the participatory design approach, and collected input from a total of 62 stakeholders (IwPD, their family members and clinicians) in interviews, brainstorming sessions and in-lab feasibility testing of the resulting prototypes. The platform we developed includes two custom-made mobile desktop robots, which engage users in concurrent cognitive and motor tasks. IwPD (n = 16) reported high levels of enjoyment when using the platform (median = 5/5) and willingness to use the platform in the long term (median = 4.5/5). We report the specifics of the hardware and software design as well as the detailed input from the stakeholders.
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Affiliation(s)
- Dor Raz
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shirel Barkan-Slater
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilanit Baum-Cohen
- Tzeadim Neurorehabilitation Center and Parkinson’s and Movement Disorders Rehabilitation Unit, Sheba Medical Center, Beer-Sheva, Israel
| | - Gal Vissel
- Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yeela Lahav-Raz
- Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Amir Shapiro
- Department of Mechanical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Department of Physical Therapy, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
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Lăcraru AE, Busnatu ȘS, Pană MA, Olteanu G, Șerbănoiu L, Gand K, Schlieter H, Kyriazakos S, Ceban O, Andrei CL, Sinescu CJ. Assessing the Efficacy of a Virtual Assistant in the Remote Cardiac Rehabilitation of Heart Failure and Ischemic Heart Disease Patients: Case-Control Study of Romanian Adult Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3937. [PMID: 36900948 PMCID: PMC10002163 DOI: 10.3390/ijerph20053937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of mortality in Europe, with potentially more than 60 million deaths per year, with an age-standardized rate of morbidity-mortality higher in men than women, exceeding deaths from cancer. Heart attacks and strokes account for more than four out of every five CVD fatalities globally. After a patient overcomes an acute cardiovascular event, they are referred for rehabilitation to help them to restore most of their normal cardiac functions. One effective way to provide this activity regimen is via virtual models or telerehabilitation, where the patient can avail themselves of the rehabilitation services from the comfort of their homes at designated timings. Under the funding of the European Union's Horizon 2020 Research and Innovation program, grant no 769807, a virtual rehabilitation assistant has been designed for elderly patients (vCare), with the overall objective of supporting recovery and an active life at home, enhancing patients' quality of life, lowering disease-specific risk factors, and ensuring better adherence to a home rehabilitation program. In the vCare project, the Carol Davila University of Bucharest (UMFCD) was in charge of the heart failure (HF) and ischemic heart disease (IHD) groups of patients. By creating a digital environment at patients' homes, the vCare system's effectiveness, use, and feasibility was evaluated. A total of 30 heart failure patients and 20 ischemic heart disease patients were included in the study. Despite the COVID-19 restrictions and a few technical difficulties, HF and IHD patients who performed cardiac rehabilitation using the vCare system had similar results compared to the ambulatory group, and better results compared to the control group.
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Affiliation(s)
- Andreea-Elena Lăcraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Ștefan-Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Maria-Alexandra Pană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Gabriel Olteanu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Liviu Șerbănoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Kai Gand
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, 7400 Aarhus, Denmark
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, University of Economic Studies, 010374 Bucharest, Romania
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Crina-Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
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Irfan B, Céspedes N, Casas J, Senft E, Gutiérrez LF, Rincon-Roncancio M, Cifuentes CA, Belpaeme T, Múnera M. Personalised socially assistive robot for cardiac rehabilitation: Critical reflections on long-term interactions in the real world. USER MODELING AND USER-ADAPTED INTERACTION 2023; 33:497-544. [PMID: 35874292 PMCID: PMC9294801 DOI: 10.1007/s11257-022-09323-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/04/2022] [Indexed: 05/03/2023]
Abstract
Lack of motivation and low adherence rates are critical concerns of long-term rehabilitation programmes, such as cardiac rehabilitation. Socially assistive robots are known to be effective in improving motivation in therapy. However, over longer durations, generic and repetitive behaviours by the robot often result in a decrease in motivation and engagement, which can be overcome by personalising the interaction, such as recognising users, addressing them with their name, and providing feedback on their progress and adherence. We carried out a real-world clinical study, lasting 2.5 years with 43 patients to evaluate the effects of using a robot and personalisation in cardiac rehabilitation. Due to dropouts and other factors, 26 patients completed the programme. The results derived from these patients suggest that robots facilitate motivation and adherence, enable prompt detection of critical conditions by clinicians, and improve the cardiovascular functioning of the patients. Personalisation is further beneficial when providing high-intensity training, eliciting and maintaining engagement (as measured through gaze and social interactions) and motivation throughout the programme. However, relying on full autonomy for personalisation in a real-world environment resulted in sensor and user recognition failures, which caused negative user perceptions and lowered the perceived utility of the robot. Nonetheless, personalisation was positively perceived, suggesting that potential drawbacks need to be weighed against various benefits of the personalised interaction.
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Affiliation(s)
- Bahar Irfan
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, UK
- Present Address: Evinoks Service Equipment Industry and Commerce Inc., Bursa, Turkey
| | - Nathalia Céspedes
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
- Present Address: Department of Computer Science and Electronic Engineering, Queen Mary University of London, London, UK
| | - Jonathan Casas
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
- Present Address: Mechanical and Aerospace Engineering Department, Syracuse University, Syracuse, NY USA
| | - Emmanuel Senft
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, UK
- Present Address: Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI USA
| | | | | | - Carlos A. Cifuentes
- Present Address: School of Engineering, Science and Technology, Universidad del Rosario, Bogotá, Colombia
| | - Tony Belpaeme
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, UK
- IDLab-imec, Ghent University, Ghent, Belgium
| | - Marcela Múnera
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
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Pinto-Bernal MJ, Cifuentes CA, Perdomo O, Rincón-Roncancio M, Múnera M. A Data-Driven Approach to Physical Fatigue Management Using Wearable Sensors to Classify Four Diagnostic Fatigue States. SENSORS (BASEL, SWITZERLAND) 2021; 21:6401. [PMID: 34640722 PMCID: PMC8513020 DOI: 10.3390/s21196401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/03/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023]
Abstract
Physical exercise contributes to the success of rehabilitation programs and rehabilitation processes assisted through social robots. However, the amount and intensity of exercise needed to obtain positive results are unknown. Several considerations must be kept in mind for its implementation in rehabilitation, as monitoring of patients' intensity, which is essential to avoid extreme fatigue conditions, may cause physical and physiological complications. The use of machine learning models has been implemented in fatigue management, but is limited in practice due to the lack of understanding of how an individual's performance deteriorates with fatigue; this can vary based on physical exercise, environment, and the individual's characteristics. As a first step, this paper lays the foundation for a data analytic approach to managing fatigue in walking tasks. The proposed framework establishes the criteria for a feature and machine learning algorithm selection for fatigue management, classifying four fatigue diagnoses states. Based on the proposed framework and the classifier implemented, the random forest model presented the best performance with an average accuracy of ≥98% and F-score of ≥93%. This model was comprised of ≤16 features. In addition, the prediction performance was analyzed by limiting the sensors used from four IMUs to two or even one IMU with an overall performance of ≥88%.
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Affiliation(s)
- Maria J. Pinto-Bernal
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá 111166, Colombia; (M.J.P.-B.); (M.M.)
| | - Carlos A. Cifuentes
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá 111166, Colombia; (M.J.P.-B.); (M.M.)
| | - Oscar Perdomo
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111711, Colombia;
| | | | - Marcela Múnera
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá 111166, Colombia; (M.J.P.-B.); (M.M.)
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6
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Céspedes N, Irfan B, Senft E, Cifuentes CA, Gutierrez LF, Rincon-Roncancio M, Belpaeme T, Múnera M. A Socially Assistive Robot for Long-Term Cardiac Rehabilitation in the Real World. Front Neurorobot 2021; 15:633248. [PMID: 33828473 PMCID: PMC8020889 DOI: 10.3389/fnbot.2021.633248] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/17/2021] [Indexed: 01/16/2023] Open
Abstract
What are the benefits of using a socially assistive robot for long-term cardiac rehabilitation? To answer this question we designed and conducted a real-world long-term study, in collaboration with medical specialists, at the Fundación Cardioinfantil-Instituto de Cardiología clinic (Bogotá, Colombia) lasting 2.5 years. The study took place within the context of the outpatient phase of patients' cardiac rehabilitation programme and aimed to compare the patients' progress and adherence in the conventional cardiac rehabilitation programme (control condition) against rehabilitation supported by a fully autonomous socially assistive robot which continuously monitored the patients during exercise to provide immediate feedback and motivation based on sensory measures (robot condition). The explicit aim of the social robot is to improve patient motivation and increase adherence to the programme to ensure a complete recovery. We recruited 15 patients per condition. The cardiac rehabilitation programme was designed to last 36 sessions (18 weeks) per patient. The findings suggest that robot increases adherence (by 13.3%) and leads to faster completion of the programme. In addition, the patients assisted by the robot had more rapid improvement in their recovery heart rate, better physical activity performance and a higher improvement in cardiovascular functioning, which indicate a successful cardiac rehabilitation programme performance. Moreover, the medical staff and the patients acknowledged that the robot improved the patient motivation and adherence to the programme, supporting its potential in addressing the major challenges in rehabilitation programmes.
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Affiliation(s)
- Nathalia Céspedes
- Biomedical Engineering Department, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
| | - Bahar Irfan
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, United Kingdom
| | - Emmanuel Senft
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, United Kingdom
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Carlos A. Cifuentes
- Biomedical Engineering Department, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
| | | | | | - Tony Belpaeme
- Centre for Robotics and Neural Systems, University of Plymouth, Plymouth, United Kingdom
- IDLab-imec, Ghent University, Ghent, Belgium
| | - Marcela Múnera
- Biomedical Engineering Department, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
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Céspedes N, Raigoso D, Múnera M, Cifuentes CA. Long-Term Social Human-Robot Interaction for Neurorehabilitation: Robots as a Tool to Support Gait Therapy in the Pandemic. Front Neurorobot 2021; 15:612034. [PMID: 33732130 PMCID: PMC7959832 DOI: 10.3389/fnbot.2021.612034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/27/2021] [Indexed: 12/20/2022] Open
Abstract
COVID-19 pandemic has affected the population worldwide, evidencing new challenges and opportunities for several kinds of emergent and existing technologies. Social Assistive Robotics could be a potential tool to support clinical care areas, promoting physical distancing, and reducing the contagion rate. In this context, this paper presents a long-term evaluation of a social robotic platform for gait neurorehabilitation. The robot's primary roles are monitoring physiological progress and promoting social interaction with human distancing during the sessions. A clinical validation with ten patients during 15 sessions were conducted in a rehabilitation center located in Colombia. Results showed that the robot's support improves the patients' physiological progress by reducing their unhealthy spinal posture time, with positive acceptance. 65% of patients described the platform as helpful and secure. Regarding the robot's role within the therapy, the health care staff agreed (>95%) that this tool can promote physical distancing and it is highly useful to support neurorehabilitation throughout the pandemic. These outcomes suggest the benefits of this tool to be further implemented in the pandemic.
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Affiliation(s)
- Nathalia Céspedes
- Departament of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
| | - Denniss Raigoso
- Departament of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
| | - Marcela Múnera
- Departament of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
| | - Carlos A Cifuentes
- Departament of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia
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