Can Robotic Feedback and Adaptation Possibilities Match Therapeutic Needs? - An Observational Study

Abstract

An observational study with the Swiss Paraplegic Centre, Nottwil, aimed to tailor robotic systems to therapists’ preferences by quantifying therapist-patient interactions, as understanding the therapists’ adaptation strategies is essential for effective customization. A total of 2297 interactions were recorded in 198 exercises with 16 patient-therapist pairs, either directly or through a robotic device with enhanced analysis tools. Derived correlation maps quantified three preferred interaction strategies: Observation of compensatory movement and posture issues caused direct tactile reaction, issues with robotic settings led to robotic support adaptations, and robotic support adaptations preceded additional support adaptations without intermediate patient observation. Strategies varied by exercise type, with direct tactile reactions dominating reach-goal exercises and robotic adjustments dominating in nominal path exercises. We conclude that a limited set of robotic feedback and adaptation options fails to meet therapeutic needs, given the wide variability in individual rehabilitation strategies. In contrast, offering an exhaustive range of options overwhelms therapists, often causing them to favor direct patient interaction over engaging with the robotic system. Therefore, an optimal robotic system must incorporate methods that understand the therapist’s strategic intent and dynamically adapt the presented information and adjustable parameters to the specific needs and preferences of the operating therapist.