RESUMEN
Rehabilitation after neurological injury can be provided by robots that help patients perform different exercises. Multiple such robots can be combined in a rehabilitation robot gym to allow multiple patients to perform a diverse range of exercises simultaneously. In pursuit of better multipatient supervision, we aim to develop an automated assignment system that assigns patients to different robots during a training session to maximize their skill development. Our previous work was designed for simplified simulated environments where each patient's skill development is known beforehand. The current work improves upon that work by changing the deterministic environment into a stochastic environment where part of the skill development is random and the assignment system must estimate each patient's predicted skill development using a neural network based on the patient's previous training success rate with that robot. These skill development estimates are used to create patient-robot assignments on a timestep-by-timestep basis to maximize the skill development of the patient group. Results from simplified simulation trials show that the schedules produced by our assignment system outperform multiple baseline schedules (e.g., schedules where patients never switch robots and schedules where patients only switch robots once halfway through the session). Additionally, we discuss how some of our simplifications could be addressed in the future.
Asunto(s)
Robótica , Humanos , Robótica/métodos , Terapia por Ejercicio/métodos , Redes Neurales de la Computación , Ejercicio FísicoRESUMEN
A robotic gym with multiple rehabilitation robots allows multiple patients to exercise simultaneously under the supervision of a single therapist. The multi-patient training outcome can potentially be improved by dynamically assigning patients to robots based on monitored patient data. In this paper, we present an approach to learn dynamic patient-robot assignment from a domain expert via supervised learning. The dynamic assignment algorithm uses a neural network model to predict assignment priorities between patients. This neural network was trained using a synthetic dataset created in a simulated rehabilitation gym to imitate a domain expert's assignment behavior. The approach is evaluated in three simulated scenarios with different complexities and different expert behaviors meant to achieve different training objectives. Evaluation results show that our assignment algorithm imitates the expert's behavior with mean accuracies ranging from 75.4% to 84.5% across scenarios and significantly outperforms three baseline assignment methods with respect to mean skill gain. Our approach solves simplified patient training scheduling problems without complete knowledge about the patient skill acquisition dynamics and leverages human knowledge to learn automated assignment policies.
Asunto(s)
Robótica , Humanos , Robótica/métodos , Redes Neurales de la Computación , Algoritmos , Ejercicio FísicoRESUMEN
BACKGROUND: A robotic rehabilitation gym can be defined as multiple patients training with multiple robots or passive sensorized devices in a group setting. Recent work with such gyms has shown positive rehabilitation outcomes; furthermore, such gyms allow a single therapist to supervise more than one patient, increasing cost-effectiveness. To allow more effective multipatient supervision in future robotic rehabilitation gyms, we propose an automated system that could dynamically assign patients to different robots within a session in order to optimize rehabilitation outcome. METHODS: As a first step toward implementing a practical patient-robot assignment system, we present a simplified mathematical model of a robotic rehabilitation gym. Mixed-integer nonlinear programming algorithms are used to find effective assignment and training solutions for multiple evaluation scenarios involving different numbers of patients and robots (5 patients and 5 robots, 6 patients and 5 robots, 5 patients and 7 robots), different training durations (7 or 12 time steps) and different complexity levels (whether different patients have different skill acquisition curves, whether robots have exit times associated with them). In all cases, the goal is to maximize total skill gain across all patients and skills within a session. RESULTS: Analyses of variance across different scenarios show that disjunctive and time-indexed optimization models significantly outperform two baseline schedules: staying on one robot throughout a session and switching robots halfway through a session. The disjunctive model results in higher skill gain than the time-indexed model in the given scenarios, and the optimization duration increases as the number of patients, robots and time steps increases. Additionally, we discuss how different model simplifications (e.g., perfectly known and predictable patient skill level) could be addressed in the future and how such software may eventually be used in practice. CONCLUSIONS: Though it involves unrealistically simple scenarios, our study shows that intelligently moving patients between different rehabilitation robots can improve overall skill acquisition in a multi-patient multi-robot environment. While robotic rehabilitation gyms are not yet commonplace in clinical practice, prototypes of them already exist, and our study presents a way to use intelligent decision support to potentially enable more efficient delivery of technologically aided rehabilitation.
Asunto(s)
Procedimientos Quirúrgicos Robotizados , Robótica , Humanos , Simulación por Computador , Ejercicio FísicoRESUMEN
A robotic rehabilitation gym is a setup that allows multiple patients to exercise together using multiple robots. The effectiveness of training in such a group setting could be increased by dynamically assigning patients to specific robots. In this simulation study, we develop an automated system that dynamically makes patient-robot assignments based on measured patient performance to achieve optimal group rehabilitation outcome. To solve the dynamic assignment problem, we propose an approach that uses a neural network classifier to predict the assignment priority between two patients for a specific robot given their task success rate on that robot. The priority classifier is trained using assignment demonstrations provided by a domain expert. In the absence of real human data from a robotic gym, we develop a robotic gym simulator and create a synthetic dataset for training the classifier. The simulation results show that our approach makes effective assignments that yield comparable patient training outcomes to those obtained by the domain expert.