by Ruggiero Corcella
Santa Lucia Foundation IRCCS is testing social robotics as part of a European project to identify and prevent cognitive impairment
Can social robotics become a tool to detect signs of cognitive decline and perform cognitive exercises at the same time? To find an answer, the neuropsychologist and researcher Federica Piras, together with the team of the Neuropsychiatry laboratory of the Santa Lucia IRCCS Foundation, is studying the possibilities offered by robots to keep cognitive functions constantly in exercise, even at home, especially in the elderly.
The three-year research project ReMember-Me it is part of the initiative supported by the European Union Advanced Aging Living, #AAL (funded by the European Union with 1.2 million euros) and intends to verify the effectiveness of an intelligent system potentially capable of identifying and preventing the decrease in cognitive abilities at an early stage, in particular memory, attention and the language. To date – says Dr. Piras – 70 elderly Italians have participated in the project who have welcomed the presence of this technology in their homes, demonstrating, even in the elderly population, an adhesion to the unexpected technological innovation.
The test in Neurorehabilitation
Now the new social robots are also entering the Neurorehabilitation COUs, with the aim of interacting with patients by stimulating their cognitive functions and increasing emotional well-being and social interactions. The intelligent system made up of a social robot and a tablet, which has been undergoing experimentation for over a year at the homes of some elderly people who have joined the project, has undergone further development, with new functions suitable for use within departments of highly specialized hospital Neurorehabilitation For over three months he has been employed in the UOC of Neurorehabilitation 3, directed by Professor Ugo Nocentini and in the UOC of Neurorehabilitation 6, directed by Dr. Stefano Paolucci, of the hospital of the Santa Lucia IRCCS Foundation.
James, i.e. this model of social robot that we are helping to develop comments Federica Piras, psychologist, speech therapist and researcher responsible for the project can be of support for the patient and the staff for and perform a series of functions such as facilitating communications with the outside world to reduce the sense of loneliness and isolation, provide cognitive stimulation activities (serious games) personalized and adapted to the patient’s conditions, provide entertainment for the patient (reading newspapers or books, watching films, documentaries, virtual trips ) while also providing content (meditation sessions, sounds of nature, music) that can reduce the hospitalization-related distress.
How the robot James works
What is the modus operandi of James robot? Is there always the presence of an operator? Are the commands touch or even vocal? The James robot is able to perform a series (for the moment limited) of voice commands such as responding to greetings (Hello; how are you?), opening multimedia contents and stopping file playback by returning to the previous screen. The touch screen allows you to perform the same operations as if you were operating on a tablet -says Dr. Piras -. The robot is managed through a control app that can be downloaded to your smartphone or tablet and used to create compositions (as we did to set the voice commands) and to “guide” James around the environment.
In fact, James has the ability to autonomously navigate within a space he has previously mapped and has a number of ground-level obstacle detectors. Since the department is very large, it was decided to use navigation through a virtual joystick available in the control app that was installed on the tablet. In this phase, therefore, it is the operators (nurses, healthcare operators, therapists) who move James around the ward, while the patient (if able to interact cognitively with the environment) chooses which activity to perform.
The work in the department
How does the work of the Robot fit into the Neurorehabilitation department? In various ways – replies the researcher -. The contents were defined through a “needs questionnaire” administered to doctors and nurses of the department with which functions were selected to allow both “active” use, for example serious games for cognitive stimulation, dance lessons , physical exercises, is “passive”, reproducing the sounds of nature, music, guided meditations, so that even patients with minimal abilities (for example with severe cognitive impairment) can use them. In the wards James has been placed in the common room and patients and family members can interact with the robot autonomously, while operators can decide, during their activity, to bring the robot into a specific room so that it interacts with a specific patient.
The obstacles at home and the opinion of patients
With respect to use at patients’ homes, what were the major criticalities encountered? At the home of the elderly, James is programmed to supply at certain times and based on the detection of a series of parameters (levels of physical activity, quality of sleep, frequency of interaction with the Remember-Me system on tablets, execution of the daily, etc.) ad hoc suggestions to stimulate, for example, subjective well-being, socialization or to keep the mind active. The activities available on the robot, unlike the one brought to the Neurorehabilitation UOCs, do not include the cognitive stimulation which is instead administered by the tablet through the ReMember-Me app, says the psychologist.
While a high percentage (about 80%) of the elderly judged the interaction with the stimulating robot believing that it could be effective in achieving the goal of keeping the mind active, a significant proportion (about 20% also among subjects without cognitive impairment and regardless of how often they use the technology) complained of difficulty in learning its use. The percentage of those who believe the robot is useful in providing significant cognitive stimulation is higher among those who typically do not use electronic devices (and therefore independent of the level of technological literacy), while those who frequently use technology find the robot less innovative and stimulating.
The results achieved
Compared to the objectives set by the ReMember-Me project, what are the results obtained so far? The preliminary results of the ReMember-Me project, relating to the usefulness of the home solution in slowing down cognitive decline, indicate that patients with impairment who used the system (50% without the social robot due essentially to space problems at home or lest they don’t know how to use it) improve after 8 weeks on a measure of general cognitive functioning (which loosely assesses multiple abilities simultaneously), Dr. Piras points out.
However, the same improvement is not observable in patients who have undergone conventional stimulation (who indeed show a slight progression of decline). Similarly, use of the system produced a marginally significant change in self-perceived well-being in older adults without cognitive decline. The family members interviewed believe that the use of the system has increased the socialization opportunities of the elderly, improved the level of technological literacy and also reduced their own personal level of stress.
The problem of the reimbursement of robotic services
Are there already fees for the reimbursement of sessions? We are studying, with European partners, a marketing in “packages” that include different functions (assessment and stimulation module with or without sensors and the robot as a motivator; evaluation module only; web app for remote patient management; etc. .) with the possibility that it may be purchased by the center where the professional works. For the patient it will be included in the price of the service provided, concludes the researcher.
July 26, 2023 (change July 26, 2023 | 2:41 pm)
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