ADVANCES IN UPPER BODY FUNCTION, HERE COME THE ROBOTS!

Chantal Bérubé, Reg OTClinical Educational Manager

Instructional Course Sessions75 min

DISCLOSURE

Presenter: Chantal Bérubé

• Employee of Kinova Robotics

LEARNING OBJECTIVES

• Understand assistive robotic principles as they

relate to persons with disabilities.

• Discuss differences in having an integrated robot

control system versus an independent robot control

system.

• Identify three characteristics of suitable candidates

for assistive robotic arms.

PREHENSION

• Act of reaching and grasping which includes the

approach (reach), grasp, and releasing the object.

ASSISTIVE TECHNOLOGY

Promotes personal independence and increases

quality-of-life, it also helps prevent costs to society by

reducing risks of secondary conditions and reduces

caregiver costs.

Assistive technology is cost effective in that

appropriate devices can increase the capacity of both

children and adults with disabilities in the home,

workplace and community.1

1 Galvin JC: Assistive technology: Federal policy and practice since 1982. Technol Disabil 1997; 6:3–15

ROBOT

A robot is an actuated mechanism programmable

in two or more axes with a degree of autonomy,

moving within its environment, to perform intended

tasks. Autonomy in this context means the ability

to perform intended tasks based on current state

and sensing, without human intervention.

ROBOTS

Robots

Industrial robots

Service Robots

Personal service robots

Domestic robots

Assistive robots

Companions or pets

…

Professional service robots

Defense, rescue & security

applications

Logistic systems

Medical robotics

…

Adapted from the International Federation of Robotics http://www.ifr.org

WHAT IS ASSISTIVE ROBOTICS?

An assistive robot performs a physical task for the

well-being of a person with a disability. The task is

embedded in the context of normal human activities of

daily living (ADLs) and would otherwise have to be

performed by an attendant. The person with the

disability controls the functioning of the robot.2

2VDL’s definition

OBJECTIVE OF ASSISTIVE ROBOTIC

• To assist the user to function with a maximum of

autonomy in the environment:

• To be autonomous in the execution of certain tasks.

• To be autonomous at a specific working station.

• To be able to function in daily life with less human

assistance, thereby reducing the cost for attendants.

• To be able to function for a number of hours without

human attendance.

TASK AREAS FOR ASSISTIVE ROBOTICS

Eating & drinking•

Personal hygiene•

Washing, shaving, makeup•

Work & leisure•

Computer use, video, •

games

• Mobility

• Doors, windows, lift

buttons

• General reaching

• Floor to shelves

***A robot is a general-purpose tool

MAIN CONFIGURATIONS TO ASSISTIVE ROBOTICS

• Workstation/fixed site

• Feeding

• Mobile robots

• Wheelchair-mounted robotic systems

WORKSTATION ROBOTS

WORKSTATION

First• robots designed for disabled people.

Aim• : to give disabled people more autonomy in their

daily work.

Fixed• to a desk or a shelf.

Programmed• to get various objects, such as a

telephone, book, etc.

Specific• type: dedicated to self-feeding tasks.

WORKSTATION

• The Heidelberg Manipulator (Germany, 1970s)

• Spartacus Project (France, 1975)

• AA/Regenesis Workstation Robot (Canada, 1983)

• RAID (Britain, France, and Sweden, 1991)

• DeVar ProVar (USA, 1996)

• MASTER-RAID (France, 1998)

Master-RAID

RAID

WORKSTATIONDedicated to self-feeding

• Handy-I (University of Keele, UK, 1987)

• Neater-Eater (UK, 1988)

• My Spoon (Japan, 2002)

• Obi (USA, 2016)

Electric Neater-Eater

My Spoon

Obi

WORKSTATION

Pros Cons

Less complex Confined to one space

Less expensive Limited by the range of the arm

Reliable Not useful for ADLs

Easier to localize Tasks limited

Program pre-define tasks

MOBILE ROBOTS

MOBILE ROBOTS

Consists• of two robots: a mobile robot base and a

robot arm.

Follow• the user’s wheelchair.

Usually• equipped with navigation systems, user

communication interfaces and various sensors to

avoid collisions with objects and people.

MOBILE ROBOTS

• MoVAR (Mobile Vocational Assistive Robot) (USA,

1986)

• CARE-O-BOT (Germany, 1988)

• WALKY (USA, 1995)

• KARES (Kaist Rehabilitation Engineering service

System) (South Korea, 1998)

Care-O-Bot IVMoVAR

MOBILE ROBOT

Pros Cons

Move independently for the wheelchair Technical solution becomes much

more complex

Move from one room to another Number of sources of errors increases

Fetch and carry objects Risk of functional disturbances rises

Can be shared by more than one

person

Poor dexterity

Can be kept out of sight when not in

use

Mainly indoor use

Ease of storage when not in use

Little interference in the physical

environment

Can be use at home and at work

WHEELCHAIR-MOUNTED ROBOTIC ARM (WMRA)

WMRA

• Installed on a user’s power wheelchair and travels

with the user when he or she uses the power

wheelchair.

• Uses the power wheelchair on-board power supply.

• May be controlled through a variety of input devices.

• Allows disabled people to feed themselves and

reach objects on the floor, on a table or above their

head.

WMRA

• MANUS iArm (Netherlands, 1984)

• RAPTOR (USA, 2000)

• MATS (Espagne, 2004)

• BRIDGIT (Netherlands, 2008)

• JACO (Canada, 2009)

RaptorMATS

Manus

WMRA

Pros Cons

Freedom of movement May reduce the mobility of the

wheelchair

Enhances the manipulation

capabilities of individuals with

disabilities

Requires to always transport this

device

Reduces dependence on human aides Sometimes can limit the user's

accessibility

Can use his auxiliary arm to

manipulate objects at any place in his

home

Preprogrammed tasks are limited

Always next to the user wherever he is

Can be used outside

Multi-tasks device

POTENTIAL USERS

• Nearly 70 million people worldwide require

wheelchairs for mobility and function.3

• 3.6 million: number of people in the US over the

age of 15 who use a wheelchair. 4

• Approximately 1.5 million people are daily user of

motorized wheelchairs in the United-States.5

• Between 100,000 and 500,000 could benefit from a

robotic arm based on the type and extent of their

disability.3

3 International Society of Wheelchair Professionals4 https://www.census.gov/newsroom/facts-for-features/2015/cb15-ff10.html5 Johnson, C., Kocher, T., O’Donnell, C., Stevens, M., Weaver, A., Webb, J., … Step II Machining & Manufacturing Class. (n.d.). Final Report

on Robotic Manipulator Project (Rep.).

INDICATIONS

Muscular dystrophy•

Spinal cord injury•

Spinal muscular •

atrophy

Multiple sclerosis•

Amyotrophic lateral •

sclerosis

• Cerebral palsy

• Rheumatoid arthritis

• Post-polio syndrome

• Locked-in syndrome

• Other severe motor

paralysis

REQUIREMENT

• Have very limited or non-existent arm and/or handfunction.

• Use and control an electric powered wheelchair.• Have sufficient learning skills to learn how to operate the

arm.• Have sufficient concentration, attention and judgment to

use the arm safely.• Have a strong will and determination to gain

independence.• Have sufficient visual discrimination to distinctly perceive

objects with arm reach.• Have no unresolved issues of self-harm or self-abuse.• Have no unresolved issues of violence toward

caregivers.

DESIGN CONSIDERATIONSUser Requirements

• Intended User

• Aesthetics

• Simplicity

• Safety

• Cost

DESIGN CONSIDERATIONSFunctional Requirements

• Weight

• Degrees of Freedom

• System control

• Power consumption

• Payload and Reach

• Width and Force of grasp

• Reaching speed

• Care and Maintenance

• Shock Robustness

• Safety

MOUNTING LOCATIONRear mount

• Potential benefits• Will not increase the width of the wheelchair when not in

use.• Would not create a distraction for individuals interacting

with the person.• Would not be a physical obstruction during transfer into and

out of the wheelchair.

• Drawbacks• Must have longer link lengths than a front- or side-mounted

design.• Require greater torque from the motors and increased

loads on the bearings.• No commercially available WMRAs that are mounted to the

rear of the wheelchair.

MOUNTING LOCATIONFront Mount

• Potential benefits• Allows for good manipulation of objects that are above the plane

of the wheelchair seat, and most importantly the operator’s faceand lap.

• Offers greater access to the operator’s immediate workingenvironment.

• Objects in front of the chair are also readily manipulated.• Provides excellent accessibility to high shelves.• Allows the execution of various activities of daily living.

• Limitations• Makes the manipulator arm obtrusive.• Can create uncomfortable social tensions with people unfamiliar

with robotic technology.• Limited the ability of the operator to put their legs under desks,

tables, and sinks in clinical evaluations.

MOUNTING LOCATIONSide Mount

• Potential benefits• Partially hidden underneath the chair.

• When the arm is not in use, can bestowed relatively inconspicuously.

• Drawbacks• Increases the width of the power wheelchair.

• Requires longer link lengths than a front-mounted arm.

• Require larger and more powerful motors and gear-heads.

GENERAL ARMS

JACO

(Kinova, Canada)

iARM

(Exact Dynamics,

Netherland)

JACO iARM

DOF 7 7

Weight 5.2kg 9.0kg

Payload 1.6kg 1.5kg

Max speed 15 cm/sec 15 cm/sec

Reach 90cm 90cm

Hand 3 fingers 2 fingers

Finger force 7N 20N

Control

Interface

3D joystick,

Keyboard

PWC control

Keypad

Joystick

PWC control

Chung, C.S., and Cooper, R.A. 2012. “Literature review of wheelchair-mounted robotic manipulation: user interface and end-user

evaluation.” Proceedings of the 12th Annual RESNA Conference, Baltimore.

JACO

From Kinova Robotics

JACO

6 Degrees of freedom

Light (5,2 kg)

Payload of 1.6 kg

Simple integration

Intuitive Control

Carbon fiber structure: light and resistant

Use wheelchair’s control

Use wheelchair’s power

Long range of 90 cm

Hand with 2 or 3 fingers

JACO SAFETY FEATURES

• Intrinsically Safe

• Protection Zones

• Current Limitations

CONTROLS

IN CLINIC EVALUATION

• Video taken at about 15 minutes

actual use time.

• Task: Actual drink.

IN SCHOOL ACTIVITY

• User with approximately 2 weeks

unguided practice.

• Task: Self assigned.

IN HOME TRIAL

• First time user using 3D joystick.

• Approx. 30 minutes use time before

the video was taken.

• Task: Self assigned.

REACH A BOTTLE

DRINK FROM A BOTTLE

DRINK FROM A GLASS

EAT

EAT

EAT FINGER FOOD

USE PHONE

TAKING CARE OF OTHERS

TAKING CARE OF ANIMALS

HOUSEHOLD

LEISURE—PHOTOGRAPHY

LEISURE—PUZZLE

PUT SOME MAKEUP

PUT SOME MAKEUP

BENEFITS

• Potential savings on care and assistance.

• Can allow family members to return to the labour market.

• Improved quality of life (self-esteem, security, development, social integration).

• Increased autonomy.• Increases employment

opportunities for users.• Increases participation in

society.

EVALUATION OF THE JACO ROBOTIC ARM

Clinico-economic study for powered wheelchair users with upper-extremity disabilities

• Objectives:

• Demonstrate that the JACO arm is safe, relevant and efficient as

an alternative for increasing the autonomy of its user.

• Evaluate potential economic benefits associated with the daily

use of JACO.

• 34 participants, 18–64 yrs old, using power wheelchairs

with a standard joystick, can press buttons on JACO’s

joystick, having no cognitive or memory impairment.

• 31 completed the trial.

• JACO mounted on a table, joystick on the wheelchair’s

armrest.

EVALUATION OF THE JACO ROBOTIC ARM

Clinico-economic study for powered wheelchair users with upper-extremity disabilities

• Form #1: Physical capacity profile, muscular condition, level of

autonomy, perception of JACO before use.• Test #1: 16 basic movements

• Test #2: 6 tasks• grasping a bottle on the left

• grasping a bottle on a surface near the ground and placing it on the table

• pushing the buttons of a calculator

• taking a tissue from a box on the table

• taking a straw from a glass located on the table

• pouring water from a bottle into a glass.

• 79%-93% performed the tasks successfully in the first attempt.

• The highest # of attempts was four times.

• 95% of participants thought of the tasks as very easy to accomplish.

• 97% of participants believed that JACO represented a significant

assistive device.

EVALUATION OF THE JACO ROBOTIC ARM

Clinico-economic study for powered wheelchair users with upper-extremity disabilities

• Form #2: Contribution of caregivers, perception of daily autonomy with

JACO after the trial, level of satisfaction after the trial, socio-

demographic profile.

• Average care time supplied daily by attendants to participants is 3,2

hours.

FORM #2 Time devoted (hr/day)

“Fully able”

“Very able”

Mean time saving

Time saving (hr/day)

Feeding/Drinking 0,28 48% 82% 65% 0,18

Preparing meal/beverage 0,69 42% 73% 57% 0,39

Dressing/Washing 1,07 27% 50% 39% 0,41

Other 1,16 30% 30% 30% 0,34

Total 3,20 1,33

BENEFITS OF JACO ROBOTIC ARM ON INDEPENDENT LIVING AND SOCIAL PARTICIPATION: AN EXPLORATORY

STUDY

• 7 participants, 18-64 yrs old, using power wheelchairs with a

standard joystick, having no cognitive or memory impairment,

having normal or corrected vision.

Assessment• :Baseline• assessment without JACO (T0).

Assessment• with JACO, after a short training (1–2 x 60-minute

sessions, depending on their needs) (T1).

Assessment• with JACO after 1-month in-home trial (T2).

Participants• had a positive perception of their QoL when using

a robotic arm such as JACO (PIADS-10=1.3/3.0).

Satisfaction• level using QUEST: 4.2 out of 5.0.

This• exploratory project demonstrates the potential benefits of

JACO for individuals with upper limb impairments.

CHALLENGES

• High cost

• Lack of evidence on real-world effectiveness

• Technology limitations

• Lack of reimbursement

• Guideline for prescription and training

CONCLUSION

• Assistive robots provide assistance with personal

tasks, could have a large impact on activity,

participation, and quality of life, and may reduce

reliance on caregivers.

• Assistive robots improve independent living and

social participation.

• Assistive robots provide direct and indirect economic

benefits, in terms of employment or decreased need

for care.

QUESTIONS?

REFERENCES

• Alqasemi, R., Edwards, K., & Dubey, R. (2006). Design, Construction and Control of a 7 DoF Wheelchair-Mounted Robotic Arm. 2006 IEEE/RSJ International Conference on Intelligent Robots and Systems. doi:10.1109/iros.2006.282573

• Awad, R E., & Engelhardt, K. G. (1984) Dissemination issues for medical robots. In RESNA Proceedings (pp. 102–104) Memphis, TN RESNA in Glass, K., & Hall, K. (1987). Occupational Therapists’ Views About the Use of Robotic Aids for People With Disabilities. American Journal of Occupational Therapy, 41(11), 745–747. doi:10.5014/ajot.41.11.745.

• Biard, N. (2008). Robotique d’assistance et compensation des limitations de préhension — Implémentation d’une commande référencée vision sur le bras manipulateur Manus : Évaluation du projet AVISO (Unpublished master’s thesis). Université René Descartes Paris 5.

• Bien, Z., Chung, M., Chang, P., Kwon, D., Kim, D., Han, J., . . . Lim, S. (2004). Integration of a Rehabilitation Robotic System (KARES II) with Human-Friendly Man-Machine Interaction Units. Autonomous Robots, 16(2), 165–191. doi:10.1023/b:auro.0000016864.12513.77

• Capille, J. W. (2010). Kinematic and experimental evaluation of commercial wheelchair-mounted robotic arms. University of South Florida. Graduate School Theses and Dissertations. Paper 3569. Retrieved from http://scholarcommons.usf.edu/etd/3569/

• Care-O-bot I. (n.d.). Retrieved October 28, 2016, from http://www.care-o-bot.de/en/care-o-bot-3/history/care-o-bot-i.html

REFERENCES

Chiasson, K. (• 2008). Analyse de l’interface de contrôle d’un robot manipulateur intégré à un fauteuil roulant motorisé (Unpublished master’s thesis). Université de Montréal.Christopher and Dana Reeve Foundation. (• 2008) One degree of separation: paralysis and spinal cord injury in the United States, available online www.christopherreeve.org/site/c.ddJFKRNoFiG/ b.5091685/k.58BD/One Degree of Separation.htmChung, C.• -S., & Cooper, R. a. (2011). Literature Review of Wheelchair-Mounted Robotic Manipulation: User Interface and End-user Evaluation. RESNA Annual Conference. Retrieved from http://web.resna.org/conference/proceedings/2012/PDFs/StudentScientific/Robotics/LITERATUREREVIEWOFWHEELCHAIR-MOUNTEDROBOTICMANIPULATION-USERINTERFACEANDEND-USEREVALUATION.pdfCook, A. M., & Hussey, S. M. (• 2002). Chapter 2: Framework for Assistive Technologies. In Assistive technologies: Principles and practice (3rd ed.).Dune, C., & Marchand, E. (• 2009). Localisation et caractérisation d’objets inconnus àpartir d’informations visuelles vers une saisie intuitive pour les personnes en situation de handicap (Unpublished master’s thesis). Université de Rennes 1.Dune, C., Leroux, C., & Marchand, E. (• 2007). Intuitive human interaction with an arm robot for severely handicapped people—A One Click Approach. 2007 IEEE 10th International Conference on Rehabilitation Robotics. doi:10.1109/icorr.2007.4428484

REFERENCES

• Eftring, H. (1999). The Useworthiness of Robots for People with Physical Disabilities(Unpublished master’s thesis, 1999). Lund University.

• Frappier, J. (2011). Clinico-economic study of the JACO robotic arm for poweredwheelchair users with upper-extremity disabilities—To justify reimbursement to thirdparty payers (Rep.). Data 4 Actions.

• Garcia, E., Jimenez, M., Santos, P. D., & Armada, M. (2007). The evolution ofrobotics research. IEEE Robotics & Automation Magazine, 14(1), 90–103.doi:10.1109/mra.2007.339608

• Glass, K., & Hall, K. (1987). Occupational Therapists’ Views About the Use of RoboticAids for People With Disabilities. American Journal of Occupational Therapy, 41(11),745–747. doi:10.5014/ajot.41.11.745

• Groothuis, S. S., Stramigioli, S., & Carloni, R. (2013). Lending a helping hand: towardnovel assistive robotic arms. IEEE Robotics & Automation Magazine,20(1), 20–29.doi:10.1109/mra.2012.2225473

• Haigh, K. Z., & Yanco, H. A. (2002). Automation as caregiver: A survey of issues andtechnologies. AAAI 02 Workshop “Automation as Caregiver” (pp. 39–53).

• Hammel, J., Hall, K., Lees, D., Leifer, L., Loos, M. V., Perkash, I., & Crigler, R. (1989,Summer). Clinical evaluation of a desktop robotic assistant. Journal of RehabilitationResearch and Development, 26(3), 1–16.

• Johnson, C., Kocher, T., O’Donnell, C., Stevens, M., Weaver, A., Webb, J., … Step IIMachining & Manufacturing Class. (n.d.). Final Report on Robotic Manipulator Project(Rep.).

REFERENCES

• Kawamura, K., & Iskarous, M. (1994, October). Trends in service robots for the disabled and the elderly. Proceedings of IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS’94), 1647–1654. doi:10.1109/iros.1994.407636

• Laffont, I., Biard, N., Chalubert, G., Delahoche, L., Marhic, B., Boyer, F. C., & Leroux, C. (2009, October). Evaluation of a graphic interface to control a robotic grasping arm: A multicenter study. Arch Phys Med Rehabil, 90, 1740–1748. doi:10.1016/j.apmr.2009.05.009

• Neveryd, H., & Bolmsjö, G. (1995). WALKY, an ultrasonic navigating mobile robot for the disabled. Proceedings of the 2nd TIDE Congress (pp. 366–370).

• Obi | Robotic feeding device designed for home care. (n.d.). Retrieved November 04, 2016, from https://meetobi.com/

• Rosier, J., Woerden, J. V., Kolk, L. V., Driessen, B., Kwee, H., Duimel, J., . . . Bruyn, P. (1991). Rehabilitation robotics: The MANUS concept. Fifth International Conference on Advanced Robotics ’Robots in Unstructured Environments. doi:10.1109/icar.1991.240560

• Santis, A. D., Gironimo, G. D., Marzano, A., Siciliano, B., & Tarallo, A. (2008). A Virtual-Reality-based evaluation environment for wheelchair-mounted manipulators. EurographicsItalian Chapter Conference, 1–8.

• Stanger, C. A., Anglin, C., Harwin, W. S., & Romilly, D. P. (1994, December). Devices for assisting manipulation: A summary of user task priorities. IEEE Transactions on Rehabilitation Engineering, 2(4), 256–265. doi:10.1109/86.340872