Abstract

Technological advances in game-mediated robotics provide an opportunity to engage children with cerebral palsy (CP) and other neuromotor disabilities in more frequent and intensive therapy by making personalized, programmed interventions available 24/7 in children’s homes. Though shown to be clinically effective and feasible to produce, little is known of the subjective factors impacting acceptance of what we term assistive/rehabilitative (A/R) gamebots by their target populations. This research describes the conceptualization phase of an effort to develop a valid and reliable instrument to guide the design of A/R gamebots. We conducted in-depth interviews with 8 children with CP and their families who had trialed an exemplar A/R gamebot, PedBotHome, for 28 days in their homes. The goal was to understand how existing theories and instruments were either appropriate or inappropriate for measuring the subjective experience of A/R gamebots. Key findings were the importance of differentiating the use case of therapy from that of assistance in rehabilitative technology assessment, the need to incorporate the differing perspectives of children with CP and those of their parents into A/R gamebot evaluation, and the potential conflict between the goals of preserving the quality of the experience of game play for the child while also optimizing the intensity and duration of therapy provided during play.

Highlights

  • The global incidence and prevalence of brain injuries occurring in the time around birth that manifest as permanent motor disabilities in children is unknown

  • The sole existing scale measuring the subjective experience of explicitly robotic and/or rehabilitative technologies (A/Rehabilitation technologies (RT)), the PYTHEIA, was itself developed according to the ESS process [33]

  • We present the alignment of families’ experience of the PedBotHome A/R gamebot with factors synthesized from two home exercise programs (HEP) adherence theories proposed based on work with children with cerebral palsy (CP)

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Summary

Introduction

The global incidence and prevalence of brain injuries occurring in the time around birth that manifest as permanent motor disabilities in children is unknown. CP is a permanent, movement disorder stemming from nonprogressive disturbances to the brain during gestation or from injury in the postnatal period up to age five [2]. Current gait-therapeutic options for children with CP are insufficient to provide consistent and adequate stretching and strengthening of the muscles that cause walking disorders [4,5]. As a result, intervening to stretch and strengthen key muscle groups currently requires time-intensive, in-clinic therapies as well as an intensive home exercise regimen to provide an optimal program for improving gait [5,11,12]

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