Abstract
Adherence to exercise programs for chronic low back pain (CLBP) is a major issue. The R-COOL feasibility study evaluated humanoid robot supervision of exercise for CLBP. Aims are as follows: (1) compare stretching sessions between the robot and a physiotherapist (control), (2) compare clinical outcomes between groups, and (3) evaluate participant perceptions of usability and satisfaction and therapist acceptability of the robot system. Prospective, randomized, controlled, single-blind, 2-centre study comparing a 3-week (3 hours/day, 5 days/week) physical activity program. Stretching sessions (30 minutes/day) were supervised by a physiotherapist (control) or the robot. Primary outcome: daily physical activity time (adherence). Secondary outcomes: lumbar pain, disability and fear and beliefs, participant perception of usability (system usability scale) and satisfaction, and physiotherapist acceptability (technology acceptance model). Clinical outcomes were compared between groups with a Student t-test and perceptions with a Wilcoxon test. Data from 27 participants were analysed (n = 15 control and n = 12 robot group). Daily physical activity time did not differ between groups, but adherence declined (number of movements performed with the robot decreased from 82% in the first week to 72% in the second and 47% in the third). None of the clinical outcomes differed between groups. The median system usability scale score was lower in the robot group: 58 (IQR 11.8) points vs. 87 (IQR 9.4) in the control group at 3 weeks (p < 0.001). Median physiotherapist rating of the technology acceptance model was <3 points, suggesting a negative opinion of the robot. In conclusion, adherence to robot exercise reduced over time; however, lumbar pain, disability, or fear and beliefs did not differ between groups. The results of the participant questionnaires showed that they were willing to use such a system, although several technical issues suggested the KERAAL system could be improved to provide fully autonomous supervision of physical activity sessions.
Highlights
Chronic low back pain (CLBP) is a major public health issue and a leading cause of disability [1] with a large socioeconomic impact [2]
2 participants from the robot group changed their minds about participation and withdrew consent
The work presented in this paper evaluated the feasibility of using a humanoid robot to deliver stretching exercise therapy for individuals with CLBP
Summary
Chronic low back pain (CLBP) is a major public health issue and a leading cause of disability [1] with a large socioeconomic impact [2]. It is well known that long-term patient adherence to exercise programs is poor, this is an area that has been little studied [6] Electronic devices such as socially assistive robots can increase engagement and learning in terms of health, physical activity, and social behaviour [7, 8]. Electronic devices, known as ‘smart’ devices (e.g., watches and or mobile applications), have been marketed to both the general public and to healthcare providers for patients to increase physical activity levels [9] These devices provide reminders, exercise lists, or physiological feedback (e.g., heart rate, blood pressure, or muscle strength), lack the meaningful communication, explanations, and follow-up appointments that are an integral part of therapist-led rehabilitation sessions and interactions that have been shown to benefit patients with chronic low back pain [10]. Smart devices can be programmed by clinicians to include personalized goals and allow activity monitoring for therapeutic use, at the time of writing, we are unaware of any ‘smart’ system that has successfully emulated the therapist-patient interaction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
