Available online at www.sciencedirect.com ScienceDirect Procedia Computer Science 105 (2017) 322 – 327 2016 IEEE International Symposium on Robotics and Intelligent Sensors, IRIS 2016, 17-20 December 2016, Tokyo, Japan Interactive Scenario Development of Robot-Assisted Therapy for Cerebral Palsy: A Face Validation Survey Norjasween Abdul Malika*, Hanafiah Yussofa and Fazah Akhtar Hanapiahb a Faculty of Mechanical Engineering, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia Faculty of Medicine, Universiti Teknologi MARA(Sungai Buloh Campus), 47000 Sungai Buloh, Selangor, Malaysia, b Abstract Humanoids have potential in the augmentation of rehabilitation programme for children with cerebral palsy To make the humanoid programme applicable and clinically compliant, correct interactive scenarios had to be developed Development of Human Robot Interaction (HRI) scenario is the main focus of this study Through discussions with clinicians and therapists, four interactive scenarios have been formulated The researchers have designed and developed the interactive scenarios concerning the suitability of measuring items in the Gross Motor Function Measure (GMFM) that is suitable to be applied by humanoid robot NAO Choregraphe software, a programming tool that allows programmer to create and compile the behavior of the robot was used in this study Choregraphe Suite is a multi-platform desktop application, to create animations, behaviors and dialogs The developed interactive scenario had undergone a face validity process This method of validation is used to confirm through peer reviews that the content of the interactive scenario is suitable to be used for children with cerebral palsy Thirty peer reviewers, made up by a group of physiotherapists and occupational therapists validated the suitability of the interactive scenario The result of the validation will be explained in this paper © © 2016 2017 The The Authors Authors.Published Publishedby byElsevier ElsevierB.V B.V This is an open access article under the CC BY-NC-ND license Peer-review under responsibility of organizing committee of the 2016 IEEE International Symposium on Robotics and Intelligent Sensors (http://creativecommons.org/licenses/by-nc-nd/4.0/) (IRIS 2016) under responsibility of organizing committee of the 2016 IEEE International Symposium on Robotics and Intelligent Peer-review Sensors(IRIS 2016) Keywords: Human-robot interaction; humanoid robot; cerebral palsy; rehabilitation robot; social robot Introduction Cerebral palsy (CP) is an umbrella term that encompasses a group of non-progressive and non-contagious motor conditions that causes physical disability, chiefly in the various areas of body movement There are four types of CP which are spastic, ataxic, dyskinetic and mixed It is noted that the awareness on CP had started since the 1860s Early studies by William John Little (1810-1894) related CP to perinatal anoxia, injury to the head and neck at birth and difficulty in deliveries which findings were agreed by Sigmund Freud The biggest challenges faced by children with CP are limitations in the fundamental areas of humanity: mobility, communication, manipulation, orientation and cognition Since CP has no cure, management for CP focuses on how best to help individual maximize his or her potential to improve their quality of life Humanoid robot NAO is a 58-cm tall humanoid robot which is made with the aim of robotic applications for education and research purpose At present, NAO is widely used as a social companion, a learning tool in the classroom and autism rehabilitation purposes6 This biped robot comes with 25 degrees of freedom (DOF), an array of sensors, giving it good motion and artificial intelligence Human-robot interaction (HRI) has widened their wing to help people with disabilities to improve their quality of life In fact, robotic therapy hold promise for managing children with CP to learn motor skills 7,8 Some previous studies have used social robot in their study in rehabilitation for children with CP such as Cosmobot 9, Kinetron 10, and Ursus11 Since children with CP 1877-0509 © 2017 The Authors Published by Elsevier B.V This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Peer-review under responsibility of organizing committee of the 2016 IEEE International Symposium on Robotics and Intelligent Sensors(IRIS 2016) doi:10.1016/j.procs.2017.01.229 Norjasween Abdul Malik et al / Procedia Computer Science 105 (2017) 322 – 327 react positively towards robots 12, humanoid robot with HRI architecture has great potential to facilitate motor development and to enhance motor skills by repetitive exercising 13 This study proposes the use of NAO as an adjunct tool in physical therapy sessions for children with CP NAO has good potentials to be used as a therapeutic tool due to its human-like figure The robot acts as a therapy aid to promote human to human interaction between the child and the therapist However, it is important to know that the robot is not to replace the function of the therapist The effectiveness of management for children with CP is expected to be improved by initiating joint attention between child, therapist and the robot The robot is aimed to maintain the child’s motivation and engagement during therapy The developed interactive scenario has undergone a face validation process This method of peer review is essential to confirm the interactive scenario suitability to be used for children with CP The content of the interactive scenarios have been peer reviewed and face validated by a group of physiotherapists and occupational therapists (n=30 people) Interactive scenarios After discussions with clinicians and therapists, four interactive scenarios had been formulated The researcher have designed and developed the interactive scenarios concerning the suitability of measuring items in the Gross MFM that is suitable to be applied by NAO GMFM looks at the ability of the child to roll, crawl, kneel, sit, stand, walk, run and jump Choregraphe software, a programming tool that allows programmer to create and compile the behavior of the robot was used in this study This section will briefly explain all the formulated scenario covers the aim, the protocol, and the programming 2.1 Interactive Scenario 1: Introductory rapport Interactive scenario involves a two-way communication that requires interaction between the NAO and the participant It consists of several simple questions to the child and duration of scenario is two minutes The aims are to observe the child’s reaction to the presence of a robot and to create rapport between the child and the robot START NAO greeting the child “Hello Good day! Nice to meet you! Let me introduce myself My name is NAO I am a robot from France, far away from here I came here to be your friend Now please introduce yourself What is your name?” OTHER ANSWER ANS: CHILD’S NAO: WhatNAME a beautiful name! NAO: “Never mind Maybe you are too shy” “Is your name (child’s name)?” NO/OTHER ANSWER YES “Opps! I am sorry” Great! NAO: Are you happy today? NO/OTHER ANSWER YES Great Let us playing together “Oh Dear! Hopefully you will be happy after this session” NAO: “Do you want to play with me?” YES NO/OTHER ANSWER “Good I am glad to hear that you want to play with me” “Oh! maybe you are shy” END Fig Flowchart of Interactive Scenario Figure shows the scenario flowchart Initially, the robot is in a sitting position and will be placed on the table facing towards the child Then the robot greets the child, introduces itself and continues to the next question 323 324 Norjasween Abdul Malik et al / Procedia Computer Science 105 (2017) 322 – 327 2.2 Interactive Scenario 2: sit to stand The Interactive Scenario involves sitting to stand activity Besides encourages imitation learning for the participants, the scenario aims to improve the child’s lower extremity function During the scenario, NAO is facing the child, both in sitting position At first, the NAO explains and demonstrates the exercise to the child Next, NAO starts to stand up from sitting position and maintain in the standing position for 10 seconds After that, th NAO will return to sitting position Then, NAO asks the child to mimic the motions that the robot makes.The stability of NAO during sitting is the most important issue during the development of the programming NAO need to replicate as close as possible the typical sitting and standing position of a typically developing child 2.3 Interactive Scenario 3: balance Interactive scenario involves body balancing activity The aims are to achieve therapeutic standing, left and right single leg stand Figure illustrates the posture of left single leg stand The scenario starts with the robot in standing position After greeting the child, NAO will explain and a demonstration of the movement as per below: • Lift Left foot for 10 seconds • Stand on both feet for 10 seconds • Lift Right foot for 10 seconds After the demonstration, the robot will ask the subject to the activity together The cycle will be repeated for five minutes Therapist shall help the subject to complete the task Table shows the complete flowcharts of the Interactive Scenario and Table Flowchart of Interactive Scenario and Interactive Scenario Interactive Scenario Sitting and standing Humanoid Robot NAO demonstrate balance 2.4 Interactive Scenario 4: ball kicking Play is a major activity during childhood, and it is important for the development of a healthy child 14 Incorporating play activity into the Interactive Scenario combined both physical and social development Ball kicking is an activity to improve lower limb function and to train the participant’s focus and attention to complete the activity In this interactive Norjasween Abdul Malik et al / Procedia Computer Science 105 (2017) 322 – 327 scenario, NAO begins at a standing position NAO asks the child to stand up together with him At the same time, physiotherapist will put a ball in front of the child and the robot Then, the robot will kick the ball to the goal post with right feet and ask children with CP to imitate the movement The steps are then repeated with the left leg Turn taking to kick the ball with the robot has been introduced in this scenario Similar to interactive scenario and 3, the duration of the scenario is five minutes If the child manages to score a goal, NAO has been programmed to cheer and give a praise, while if the goal is missed; the robot will encourage the child to try again Fig Flowchart of Interactive Scenario Questionnaire-Based Face Validity Survey The content of the interactive scenarios has been peer reviewed by a group of physiotherapists and occupational therapists before the experiment started The validation survey form for Interactive scenario consists of between nine to eleven questions related to: x x x x x x x Aim of the scenario To seek the opinion from the expert are they agreed that the scenario content can achieve the objectives Simplicity of the scenario This survey is to know whether the scenario is simple and suitable to be applied for children with CP Languages To survey whether they agreed that the sentence used by the humanoid robot is easy to understand by the children with CP Safety for child To confirm whether the scenario is considered safe to be done by the subject Duration of the interactive scenario To seek the expert’s opinion whether the duration of the interactive scenario is adequate (CP child not easy to get boring) Involvement of parents and therapist To know if it is suitable for parents and physiotherapist to help the child to complete the scenario Humanoid robot NAO indicates the end of the session To survey that whether it is suitable for humanoid robot NAO to indicates the end of the session There are five choices of the answer: x x x Strongly Disagree Disagree Neutral x x Agree Strongly Agree During the validation survey, a video of each scenario was played at the projector screen and were explained briefly All the data were compiled and analyzed 325 326 Norjasween Abdul Malik et al / Procedia Computer Science 105 (2017) 322 – 327 Result 4.1 Interactive Scenario 1: Introductory rapport x x x 86.67% of the respondent agreed that Interactive scenario can achieve 2-way communication between the robot and the child 80% of the expert agreed that Interactive scenario can achieve 2-way communication between the robot and the child and achieve engaging experience NAO does not have body languages during speech and too much Tremor during movement 4.2 Interactive Scenario 2: Sit to stand x x x x 56.67% of the respondents agree that the interactive scenario can achieve sitting skill Several amendments have been proposed by the experts to improve the scenario 93.3% of the respondents agree that physiotherapist shall help the child to complete the task NAO sitting posture is not natural Installation of armrest to offer NAO to perform a proper sitting posture like a typical human Table Component of Interactive Scenario Table Component of Interactive Scenario 4.3 Interactive Scenario 3: balance x x x x x 60.0% of the respondents agree that scenario can achieve body balancing of the CP child through this activity 96.67% of the respondents agree that the physiotherapist shall help the child to complete the task The percentage of the respondent that agrees that the interactive scenario can achieve left single leg stand and right single leg stand are 70.0% and 73.33% respectively Improper posture during one leg stand Nao’s body languages during speech need to be added to increase the attraction of the child 4.4 Interactive Scenario 4: ball kicking x x x 63.3% of the respondent agreed that the Interactive scenario can achieve balance and coordination through play by kicking a ball with left foot and right left foot NAO does not have body language while it speaks Kicking posture and tremor of the robot needs to be improved Norjasween Abdul Malik et al / Procedia Computer Science 105 (2017) 322 – 327 Table Component of Interactive Scenario Table Component of Interactive Scenario Conclusion After the survey has been successfully done, the result shows that most of the therapists were agreed with the content of the entire interactive scenario From the result, it can be seen that there is a sceptical on the ability of the robot to achieve the aimed goal for each scenario (but all achieved score more than 60%) with the exception of sitting skills, in which the necessary modifications were done The highest scores are related to the simplicity of the scenario, easy to understand, motivation, engaging, therapist involvement and the duration of the scenario All the necessary action has been made after the peer reviews to improve the content of the interactive scenario to make it suitable to be used for children with cerebral palsy Acknowledgements The researchers wish to thank the Ministry of Education Malaysia for funding the research project through the Niche Research Grant Scheme (NRGS) [Ref.No.600- RMI/NRGS 5/3 (11/2013)] The authors are grateful for the support given from the Research Management Institute, Universiti Teknologi MARA (UiTM) References Peter Rosenbaum, N P., Alan Leviton MD, Murray Goldstein, Martin Bax A report: the definition and classification of cerebral palsy April 2006 (2006) Konstantinos P.Michmizos, H I K in The Fourth IEEE RAS/EMBS International Conference on Biomedical Robotics and Biomechatronics Schifrin BS, L D a L L Eponym: William John Little and cerebral palsy: A reappraisal European Journal of Obstetrics and Gynecology and Reproductive Biology 90, 139-144 (2000) Marjolijn Ketelaar, A V., Harm't Hart, Els van Petegem-van Beek and Paul JM Helders Effects of a Functional Therapy Program on Motor Abilities of Children with Cerebral Palsy Journal of American Physical Therapy Association 81, 1534-1545 (2001) Keren, G., Ben-David, A & Fridin, M in Intelligent Robots and Systems (IROS), 2012 IEEE/RSJ International Conference on 1084-1089 Ismail, L I., Shamsudin, S., Yussof, H., Hanapiah, F A & Zahari, N I Estimation of Concentration by Eye Contact Measurement in Robot–based Intervention Program with Autistic Children Procedia Engineering 41, 1548-1552, doi:http://dx.doi.org/10.1016/j.proeng.2012.07.348 (2012) Trafton, A Robotic therapy holds promise for cerebral palsy, 2009) Marie Fukudome (PY), H W in The 21 st Annual Conference ofthe Japanese Neural Network Society Amy J Brisben, A D L., Charlotte S Safos , Jack M Vice, Corinna E Lathan 10 %UDQLVODY%RURYDF056UÿDQ6DYLüDQG0LOXWLQ1LNROLüLQ0HGLFDO$QG6HUYLFH5RERWLFV 0(652% 11 Andrew G Brooks, M B., Jesse Gray in ACE 27-34 12 Malik, N A., Yussof, H & Hanapiah, F A Development of Imitation Learning through Physical Therapy Using a Humanoid Robot Procedia Computer Science 42, 191-197, doi:http://dx.doi.org/10.1016/j.procs.2014.11.051 (2014) 13 Robins, B & Dautenhahn, K Tactile Interactions with a Humanoid Robot: Novel Play Scenario Implementations with Children with Autism Int J of Soc Robotics 6, 397-415, doi:10.1007/s12369-014-0228-0 (2014) 327