Older adults' acceptance of a robot for partner dance-based exercise.

Partner dance has been shown to be beneficial for the health of older adults. Robots could potentially facilitate healthy aging by engaging older adults in partner dance-based exercise. However, partner dance involves physical contact between the dancers, and older adults would need to be accepting of partner dancing with a robot. Using methods from the technology acceptance literature, we conducted a study with 16 healthy older adults to investigate their acceptance of robots for partner dance-based exercise. Participants successfully led a human-scale wheeled robot with arms (i.e., a mobile manipulator) in a simple, which we refer to as the Partnered Stepping Task (PST). Participants led the robot by maintaining physical contact and applying forces to the robot's end effectors. According to questionnaires, participants were generally accepting of the robot for partner dance-based exercise, tending to perceive it as useful, easy to use, and enjoyable. Participants tended to perceive the robot as easier to use after performing the PST with it. Through a qualitative data analysis of structured interview data, we also identified facilitators and barriers to acceptance of robots for partner dance-based exercise. Throughout the study, our robot used admittance control to successfully dance with older adults, demonstrating the feasibility of this method. Overall, our results suggest that robots could successfully engage older adults in partner dance-based exercise.

Older Users' Acceptance of an Assistive Robot: Attitudinal Changes Following Brief Exposure.

INTRODUCTION: Many older adults wish to age-in-place. Robot assistance at home may be beneficial for older adults who are experiencing limitations in performing home activities. In this study we investigate older Americans' robot acceptance before and after exposure to a domestic mobile manipulator, with an emphasis on understanding trialability (i.e., "trying out" a robot for a short time period) and result demonstrability (i.e., observing the results of the robot's functionality). METHOD: Older adult participants observed a mobile manipulator robot autonomously demonstrating three tasks: delivering medication, learning to turn off a light switch, and organizing home objects. We administered pre and post exposure questionnaires about participants' opinions and attitudes toward the robot, as well as a semi-structured interview about each demonstration. RESULTS: We found that demonstration of a mobile manipulator assistive robot did, in fact, influence older adults' acceptance. There was a significant increase, pre vs. post, in positive perceptions of robot usefulness and ease of use for 8 of the 12 Robot Opinions Questionnaire items. Furthermore, in the Assistance Preference Checklist, eighteen tasks significantly differed between pre and post exposure, with older adults showing a greater openness to robot assistance after exposure to the robot. CONCLUSION: Thus, demonstration of robot capability positively affected older adults' preferences for robot assistance for tasks in the home. Interview data suggest that the robot's capability and reliability influenced older adults' first impressions of the robot.

Evaluation by Expert Dancers of a Robot That Performs Partnered Stepping via Haptic Interaction.

Our long-term goal is to enable a robot to engage in partner dance for use in rehabilitation therapy, assessment, diagnosis, and scientific investigations of two-person whole-body motor coordination. Partner dance has been shown to improve balance and gait in people with Parkinson's disease and in older adults, which motivates our work. During partner dance, dance couples rely heavily on haptic interaction to convey motor intent such as speed and direction. In this paper, we investigate the potential for a wheeled mobile robot with a human-like upper-body to perform partnered stepping with people based on the forces applied to its end effectors. Blindfolded expert dancers (N=10) performed a forward/backward walking step to a recorded drum beat while holding the robot's end effectors. We varied the admittance gain of the robot's mobile base controller and the stiffness of the robot's arms. The robot followed the participants with low lag (M=224, SD=194 ms) across all trials. High admittance gain and high arm stiffness conditions resulted in significantly improved performance with respect to subjective and objective measures. Biomechanical measures such as the human hand to human sternum distance, center-of-mass of leader to center-of-mass of follower (CoM-CoM) distance, and interaction forces correlated with the expert dancers' subjective ratings of their interactions with the robot, which were internally consistent (Cronbach's α=0.92). In response to a final questionnaire, 1/10 expert dancers strongly agreed, 5/10 agreed, and 1/10 disagreed with the statement "The robot was a good follower." 2/10 strongly agreed, 3/10 agreed, and 2/10 disagreed with the statement "The robot was fun to dance with." The remaining participants were neutral with respect to these two questions.

Domestic Robots for Older Adults: Attitudes, Preferences, and Potential.

The population of older adults in America is expected to reach an unprecedented level in the near future. Some of them have difficulties with performing daily tasks and caregivers may not be able to match pace with the increasing need for assistance. Robots, especially mobile manipulators, have the potential for assisting older adults with daily tasks enabling them to live independently in their homes. However, little is known about their views of robot assistance in the home. Twenty-one independently living older Americans (65-93 years old) were asked about their preferences for and attitudes toward robot assistance via a structured group interview and questionnaires. In the group interview, they generated a diverse set of 121 tasks they would want a robot to assist them with in their homes. These data, along with their questionnaire responses, suggest that the older adults were generally open to robot assistance but were discriminating in their acceptance of assistance for different tasks. They preferred robot assistance over human assistance for tasks related to chores, manipulating objects, and information management. In contrast, they preferred human assistance to robot assistance for tasks related to personal care and leisure activities. Our study provides insights into older adults' attitudes and preferences for robot assistance with everyday living tasks in the home which may inform the design of robots that will be more likely accepted by older adults.

Identifying the Potential for Robotics to Assist Older Adults in Different Living Environments.

As the older adult population grows and becomes more diverse, so will their needs and preferences for living environments. Many adults over 65 years of age require some assistance [1, 2]; yet it is important for their feelings of well-being that the assistance not restrict their autonomy [3]. Not only is autonomy correlated with quality of life [4], autonomy enhancement may improve functionality [2, 5]. The goal of this paper is to provide guidance for the development of technology to enhance autonomy and quality of life for older adults. We explore the potential for robotics to meet these needs. We evaluated older adults' diverse living situations and the predictors of residential moves to higher levels of care in the United States. We also examined older adults' needs for assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and medical conditions when living independently or in a long-term care residence. By providing support for older adults, mobile manipulator robots may reduce need-driven, undesired moves from residences with lower levels of care (i.e., private homes, assisted living) to those with higher levels of care (i.e., skilled nursing).

Older Adults' Medication Management in the Home: How can Robots Help?

Successful management of medications is critical to maintaining healthy and independent living for older adults. However, medication non-adherence is a common problem with a high risk for severe consequences [5], which can jeopardize older adults' chances to age in place [1]. Well-designed robots assisting with medication management tasks could support older adults' independence. Design of successful robots will be enhanced through understanding concerns, attitudes, and preferences for medication assistance tasks. We assessed older adults' reactions to medication hand-off from a mobile manipulator robot with 12 participants (68-79 yrs). We identified factors that affected their attitudes toward a mobile manipulator for supporting general medication management tasks in the home. The older adults were open to robot assistance; however, their preferences varied depending on the nature of the medication management task. For instance, they preferred a robot (over a human) to remind them to take medications, but preferred human assistance for deciding what medication to take and for administering the medication. Factors such as perceptions of one's own capability and robot reliability influenced their attitudes.

Dusty: an assistive mobile manipulator that retrieves dropped objects for people with motor impairments.

People with physical disabilities have ranked object retrieval as a high-priority task for assistive robots. We have developed Dusty, a teleoperated mobile manipulator that fetches objects from the floor and delivers them to users at a comfortable height. In this paper, we first demonstrate the robot's high success rate (98.4%) when autonomously grasping 25 objects considered being important by people with amyotrophic lateral sclerosis (ALS). We tested the robot with each object in five different configurations on five types of flooring. We then present the results of an experiment in which 20 people with ALS operated Dusty. Participants teleoperated Dusty to move around an obstacle, pick up an object and deliver the object to themselves. They successfully completed this task in 59 out of 60 trials (3 trials each) with a mean completion time of 61.4 SD = 20.5 seconds), and reported high overall satisfaction using Dusty (7-point Likert scale; 6.8 SD = 0.6). Participants rated Dusty to be significantly easier to use than their own hands, asking family members, and using mechanical reachers (p < 0.03, paired t-tests). Fourteen of the 20 participants reported that they would prefer using Dusty over their current methods. [Box: see text].

The Domesticated Robot: Design Guidelines for Assisting Older Adults to Age in Place.

Many older adults wish to remain in their own homes as they age [16]. However, challenges in performing home upkeep tasks threaten an older adult's ability to age in place. Even healthy independently living older adults experience challenges in maintaining their home [13]. Challenges with home tasks can be compensated through technology, such as home robots. However, for home robots to be adopted by older adult users, they must be designed to meet older adults' needs for assistance and the older users must be amenable to robot assistance for those needs. We conducted a needs assessment to (1) assess older adults' openness to assistance from robots; and (2) understand older adults' opinions about using an assistive robot to help around the home. We administered questionnaires and conducted structured group interviews with 21 independently living older adults (ages 65-93). The questionnaire data suggest that older adults prefer robot assistance for cleaning and fetching/organizing tasks overall. However their assistance preferences discriminated between tasks. The interview data provided insight as to why they hold such preferences. Older adults reported benefits of robot assistance (e.g., the robot compensating for limitations, saving them time and effort, completing undesirable tasks, and performing tasks at a high level of performance). Participants also reported concerns such as the robot damaging the environment, being unreliable at or incapable of doing a task, doing tasks the older adult would rather do, or taking up too much space/storage. These data, along with specific comments from participant interviews, provide the basis for preliminary recommendations for designing mobile manipulator robots to support aging in place.

Teaching subcuticular suturing to medical students: video versus expert instructor feedback.

OBJECTIVE: Given limitations in surgical educational resources, more efficient teaching methods are needed. We sought to evaluate 3 strategies for improving skills in subcuticular suturing-practice with an instructional video, practice with expert instructor supervision, and independent practice. DESIGN: Fifty-eight medical students volunteered for this research. Students viewed a video on subcuticular suturing then completed a pretest requiring closure of an incision in a plastic model. Students were randomized among 3 groups: practice with an instructional video (group A), practice with supervision by an expert instructor (group B), and independent practice (group C). After instruction, students completed a posttest, then a retention test 1 week later. Their performances were video recorded and evaluated using a validated scoring instrument composed of global and task-specific subscales. RESULTS: Performances measured using both subscales improved significantly from pretest to post-test only for group B. However, when comparing student performances between pretest and retention posttest, significant improvements on both subscales were seen only in group A. CONCLUSION: These results suggest that practice with an instructional video is an effective method for acquiring skill in subcuticular suturing.

Older Adults' Needs for Assistance as a Function of Living Environment.

As the older adult population grows and becomes more diverse, so will their needs and preferences for living environments. Many adults over 65 years of age require assistance in their living environment (Administration on Aging, 2009), however it is important for their feelings of well-being that the assistance does not restrict their autonomy (e.g., Barkay & Tabak, 2002). Moreover, autonomy enhancement may improve older adults' functionality (e.g., Greiner et al., 1996). This paper provides an overview of older adults' diverse living situations and an assessment of their needs for assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) when living in the community or in a long-term care residence, such as assisted living or skilled nursing. We also examine older adults' residential mobility patterns to understand potential unmet needs for assistance. This needs assessment highlights the specific areas that could benefit from human factors interventions to support older adults in making choice-driven decisions about where they live.

Validation of an instrument for evaluation of subcuticular suturing using a plastic tissue model.

OBJECTIVE: To collect evidence for the validity and reliability of an assessment tool for simulated subcuticular suturing. STUDY DESIGN: Three subjects were videotaped while closing a simulated incision in a plastic model. The 3 trials were viewed independently by 7 faculty examiners masked to subject identity. Global rating and task-specific scales were used to assess subject competence. The mean scores were compared among the 3 subjects and 7 evaluators using analysis of variance. RESULTS: Significant differences were found among the mean global rating scores for the 3 subjects but not among the evaluators. Similarly, significant differences were found between mean task-specific scale scores for the 3 subjects but not among the evaluators. Cronbach's alpha for global rating (0.89) and task-specific (0.93) scores suggested high internal consistency for each scale. CONCLUSIONS: These findings provide evidence for the discriminant validity, internal consistency, and inter-rater reliability of both the global rating and task-specific scales of our assessment tool.

Comparison of pulse wave analysis between persons with white coat hypertension and normotensive persons.

White coat hypertension (WCH) is considered by some but not all investigators to be a benign condition without increased cardiovascular risk. Pulse wave analysis is a noninvasive method to measure how the reflected pressure wave interacts with central aortic blood pressure (BP) and to assess how it is related to vascular stiffness. The purpose of the study was to compare central aortic BP in normotensive and WCH participants. WCH participants were identified after ambulatory BP monitoring. Normotensive participants served as controls. Using radial artery applanation tonometry, aortic pulse wave analysis was performed. Augmentation index (AI), AI75, and differences in systolic BP between central aortic and peripheral vasculatures were calculated. Results show a difference in AI, AI75, (AI standardized to a heart rate of 75 beats per minute), and central aortic systolic pressures between WCH and normotensive participants. The WCH group had significantly higher systolic BP and pulse pressure; however, these were still within the normal range. In summary, WCH participants had increased central aortic pressures compared with normotensives, supporting the potential for increased cardiovascular risk in WCH.