IEEE Robotics & Automation Magazine - June 2019 - 25

visual and verbal cues, while encouraging and rewarding
the patient. The Manual Ability Classification System
(MACS), Mallet, and quality of upper extremity skills test
(QUEST) scales were administered to patients, and most
showed a slight improvement in their general motion
ranges. All participants reported that they felt more
engaged in the treatment while playing with the robot, and
clinical staff members and relatives observed improvement
in patients' motor activity.
Neurorehabilitation Treatments
To help patients whose neuromuscular system has some
type of deficit, neurorehabilitation treatments typically
focus on plasticity (induced neuroplasticity) by repeating
certain exercises [1]. Neuroplasticity is the brain's ability to
change its structure throughout its lifetime in response to a
changing environment. It is the potential for adaptation
that allows the nervous system to recover from injuries or
disorders. An intense and continuous training regimen
using exercise repetition leads to the establishment of new
connections that recover the functionality of the affected
part [2].
For children with deficits, or those at risk of suffering from
them, early stimulation is a fundamental part of development
during the first three years of life because it allows enhanced
physical, cognitive, and sensory abilities depending on the
areas affected [3]. In pediatric rehabilitation, one of the main
objectives of early motor stimulation is to optimize the
patient's potential by exploiting the concept of neuroplasticity,
while compensating for deficits so that the patient can
improve the quality of his or her daily activities and lead a full
and satisfying life. To this end, neurorehabilitation therapy
requires a constant commitment from the patient and his or
her relatives as well as adherence to an intensive course of
prolonged treatment. To be effective, a patient should begin
therapy as soon as possible by following a personalized treatment plan adapted to his or her specific condition and progression [4]. Both issues are not always easy to satisfy, given
the limited availability of professionals and the lack of time to
monitor the progression.
Rehabilitation Robotics
Rehabilitation robotics seeks to introduce new and reliable
technologies into the therapeutic process [5]. As with
other fields of application, robotics offers interesting
advantages, such as the possibility of performing automated and personalized treatments that reduce the fatigue
associated with repetitive and monotonous exercises [6] or
its ability to integrate sensors that provide a quantitative
estimation of recovery.
Most of the work developed in the area of robotic rehabilitation has historically been based on physical contact [7]. In some
cases, they have been referred to as hands-on or wearable robotic
technology. These techniques have transformed the practice of
rehabilitation into a guided process of passive rehabilitation [8].
This means that the patient is helped by a robot to appropriately

exercise the affected extremity. This hands-on interaction
between the patient and the robot involves complex restrictions
related to patient safety, which makes this area of research very
promising in the quest for
a solution [9]. Additionally,
compliance with these
Neuroplasticity is the
requirements increases
costs for both the patient
brain's ability to change
and the health-care provider, which is not always
its structure throughout its
affordable. In general, systems based on physical
lifetime in response to a
contact are called assistive
robotics; however, they do
changing environment.
not always encourage
active participation from
the patient, and they are
difficult to adapt to occupational therapy, where rehabilitation is oriented toward functional activities [10].
Clinical experimentation demonstrates that a patient's motivation is key to successful implementation of neural rehabilitation therapies [11] and relates directly to how fully a patient is
engaged in the treatment. Another line of research attempts to
integrate the motivation factor, including the "social" aspect,
into robotic-based rehabilitation therapies. The new robots aim
to provide service and assistance to users through social interaction. As shown in Figure 1, this new area has emerged from
the combination of assistive robotics and social interactive
robotics [12], giving rise to SAR, which is used in this project.
SAR establishes a connection between robotic rehabilitation
(which, to date, has been based only on physical contact) with
hands-off robotic assistance. The lack of contact reduces the
safety risk and facilitates integration into clinical practice.
These platforms seek to improve patients' involvement in and
motivation for treatment because the repetition of the exercises helps their recovery [13]. Many researchers consider the
field of SAR to be one of the most ambitious challenges of current rehabilitation robotics [14].

Physical
Interaction
Assistive
Robotics

Social Interaction

Socially
Assistive
Robotics

Provide Assistance

Socially
Interactive
Robotics
Affective
Bonds

Figure 1. Defining socially assistive robotics.

JUNE 2019

IEEE ROBOTICS & AUTOMATION MAGAZINE

IEEE Robotics & Automation Magazine - June 2019

Table of Contents for the Digital Edition of IEEE Robotics & Automation Magazine - June 2019