Platz Thomas, Pedersen Ann Louise, Bobe Stephanie
Neurorehabilitation research group, University Medical Centre, Greifswald, Germany.
BDH-Klinik Greifswald, Institute for Neurorehabilitation and Evidence-Based Practice, An-Institut, University of Greifswald, Greifswald, Germany.
Front Robot AI. 2023 Feb 23;10:1091283. doi: 10.3389/frobt.2023.1091283. eCollection 2023.
The instrument THERapy-related InterACTion (THER-I-ACT) was developed to document therapeutic interactions comprehensively in the human therapist-patient setting. Here, we investigate whether the instrument can also reliably be used to characterise therapeutic interactions when a digital system with a humanoid robot as a therapeutic assistant is used. Seventeen stroke survivors receiving arm rehabilitation (i.e., arm basis training (ABT) for moderate-to-severe arm paresis [n = 9] or arm ability training (AAT) for mild arm paresis [n = 8]) using the digital therapy system E-BRAiN over a course of nine sessions. A total of 34 therapy sessions were videotaped. All therapeutic interactions provided by the humanoid robot during the first and the last (9th) session of daily training were documented both in terms of their frequency and time used for that type of interaction using THER-I-ACT. Any additional therapeutic interaction spontaneously given by the supervising staff or a human helper providing physical assistance (ABT only) was also documented. All ratings were performed by two trained independent raters. Intraclass correlation coefficients (ICCs) were calculated for the frequency of occurrence and time used for each category of interaction observed. Therapeutic interactions could comprehensively be documented and were observed across the dimensions provision of information, feedback, and bond-related interactions. ICCs for therapeutic interaction category assessments from 34 therapy sessions by two independent raters were high (ICC ≥0.90) for almost all categories of the therapeutic interaction observed, both for the occurrence frequency and time used for categories of therapeutic interactions, and both for the therapeutic interaction performed by the robot and, even though much less frequently observed, additional spontaneous therapeutic interactions by the supervisory staff and a helper being present. The ICC was similarly high for an overall subjective rating of the concentration and engagement of patients (0.87). Therapeutic interactions can comprehensively and reliably be documented by trained raters using the instrument THER-I-ACT not only in the traditional patient-therapist setting, as previously shown, but also in a digital therapy setting with a humanoid robot as the therapeutic agent and for more complex therapeutic settings with more than one therapeutic agent being present.
治疗相关交互（THER-I-ACT）工具旨在全面记录人类治疗师与患者之间的治疗性互动。在此，我们研究当使用以人形机器人作为治疗助手的数字系统时，该工具是否也能可靠地用于描述治疗性互动。17名中风幸存者使用数字治疗系统E-BRAiN进行了为期9节的手臂康复训练（即针对中度至重度手臂麻痹的手臂基础训练（ABT）[n = 9]或针对轻度手臂麻痹的手臂能力训练（AAT）[n = 8]）。总共录制了34节治疗课程的视频。使用THER-I-ACT工具，记录了人形机器人在每日训练的第一节和最后一节（第9节）中提供的所有治疗性互动的频率以及用于该类型互动的时间。还记录了监督人员或提供身体协助的人类助手（仅ABT）自发进行的任何额外治疗性互动。所有评分均由两名经过培训的独立评分者进行。计算了观察到的每类互动的发生频率和使用时间的组内相关系数（ICC）。治疗性互动能够得到全面记录，并且在信息提供、反馈和与关系建立相关的互动维度上均有观察到。两名独立评分者对34节治疗课程的治疗性互动类别评估的ICC在几乎所有观察到的治疗性互动类别中都很高（ICC≥0.90），无论是治疗性互动类别的发生频率还是使用时间，对于机器人进行的治疗性互动以及监督人员和助手进行的额外自发治疗性互动（尽管观察频率低得多）都是如此。患者注意力和参与度的总体主观评分的ICC同样很高（0.87）。训练有素的评分者使用THER-I-ACT工具不仅可以在传统的患者 - 治疗师环境中（如先前所示）全面且可靠地记录治疗性互动，而且在以人形机器人作为治疗媒介的数字治疗环境中以及存在不止一个治疗媒介的更复杂治疗环境中也能如此。
