Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial

doi:10.1016/J.JAMDA.2017.03.018

Home
/
Papers
/
Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial

Journal Article•DOI•

Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial

Wendy Moyle¹, Cindy Jones¹, Jenny Murfield¹, Lukman Thalib², Elizabeth Beattie³, David K.H. Shum¹, Siobhan O'Dwyer⁴, M. Cindy Mervin¹, Brian Draper⁵ - Show less +5 more•Institutions (5)

Griffith University¹, College of Health Sciences, Bahrain², Queensland University of Technology³, University of Exeter⁴, University of New South Wales⁵

01 Sep 2017-Journal of the American Medical Directors Association (Elsevier)-Vol. 18, Iss: 9, pp 766-773

TL;DR: Although moreeffective than usual care in improving mood states and agitation, PARO was only more effective than a plush toy in encouraging engagement.

read less

About: This article is published in Journal of the American Medical Directors Association.The article was published on 2017-09-01 and is currently open access. It has received 185 citations till now. The article focuses on the topics: Paro.

...read moreread less

Citations

PDF

Open Access

More filters

Journal Article•DOI•

Scoping review on the use of socially assistive robot technology in elderly care

[...]

Jordan Abdi¹, Ahmed Al-Hindawi, Tiffany Ng, Marcela P. Vizcaychipi•Institutions (1)

Imperial College London¹

12 Feb 2018-BMJ Open

TL;DR: Although many positive outcomes were reported, a large proportion of the studies have methodological issues, which limit the utility of the results, and the reported value of SAR in elderly care does warrant further investigation.

...read moreread less

Abstract: Objective With an elderly population that is set to more than double by 2050 worldwide, there will be an increased demand for elderly care. This poses several impediments in the delivery of high-quality health and social care. Socially assistive robot (SAR) technology could assume new roles in health and social care to meet this higher demand. This review qualitatively examines the literature on the use of SAR in elderly care and aims to establish the roles this technology may play in the future. Design Scoping review. Data sources Search of CINAHL, Cochrane Library, Embase, MEDLINE, PsychINFO and Scopus databases was conducted, complemented with a free search using Google Scholar and reference harvesting. All publications went through a selection process, which involved sequentially reviewing the title, abstract and full text of the publication. No limitations regarding date of publication were imposed, and only English publications were taken into account. The main search was conducted in March 2016, and the latest search was conducted in September 2017. Eligibility criteria The inclusion criteria consist of elderly participants, any elderly healthcare facility, humanoid and pet robots and all social interaction types with the robot. Exclusions were acceptability studies, technical reports of robots and publications surrounding physically or surgically assistive robots. Results In total, 61 final publications were included in the review, describing 33 studies and including 1574 participants and 11 robots. 28 of the 33 papers report positive findings. Five roles of SAR were identified: affective therapy, cognitive training, social facilitator, companionship and physiological therapy. Conclusions Although many positive outcomes were reported, a large proportion of the studies have methodological issues, which limit the utility of the results. Nonetheless, the reported value of SAR in elderly care does warrant further investigation. Future studies should endeavour to validate the roles demonstrated in this review. Systematic review registration NIHR 58672.

...read moreread less

322 citations

Journal Article•DOI•

The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

[...]

Lihui Pu¹, Wendy Moyle¹, Cindy Jones¹, Michael Todorovic¹•Institutions (1)

Griffith University¹

09 Jan 2019-Gerontologist

TL;DR: Results from a narrative review indicated that social robot interactions could improve engagement, interaction, and stress indicators, as well as reduce loneliness and the use of medications for older adults.

...read moreread less

Abstract: Background and Objectives: Social robots may promote the health of older adults by increasing their perceived emotional support and social interaction. This review aims to summarize the effectiveness of social robots on outcomes (psychological, physiological, quality of life, or medications) of older adults from randomized controlled trials (RCTs). Research Design and Methods: A mixed-method systematic review of RCTs meeting the study inclusion criteria was undertaken. Eight databases were electronically searched up to September 2017. Participants’ characteristics, intervention features, and outcome data were retrieved. The mean difference and standardized mean difference with 95% confidence intervals (CI) were synthesized to pool the effect size. Results: A total of 13 articles from 11 RCTs were identified from 2,204 articles, of which 9 studies were included in the meta-analysis. Risk of bias was relatively high in allocation concealment and blinding. Social robots appeared to have positive impacts on agitation, anxiety, and quality of life for older adults but no statistical significance was found in the meta-analysis. However, results from a narrative review indicated that social robot interactions could improve engagement, interaction, and stress indicators, as well as reduce loneliness and the use of medications for older adults. Discussion and Implications: Social robots appear to have the potential to improve the well-being of older adults, but conclusions are limited due to the lack of high-quality studies. More RCTs are recommended with larger sample sizes and rigorous study designs.

...read moreread less

258 citations

Journal Article•DOI•

The benefits of and barriers to using a social robot PARO in care settings: a scoping review

[...]

Lillian Hung¹, Lillian Hung², Cindy Liu², Evan Woldum², Andy Au-Yeung³, Annette Berndt³, Christine Wallsworth³, Neil Horne³, Mario Gregorio³, Jim Mann³, Habib Chaudhury¹ - Show less +7 more•Institutions (3)

Simon Fraser University¹, University of British Columbia², Vancouver Coastal Health³

23 Aug 2019-BMC Geriatrics

TL;DR: A review of social robots in care settings and research gaps reveals 3 research gaps: the users’ needs and experiences remain unexplored, few studies investigate the process of how to use the robot effectively to meet clinical needs, and theory should be used to guide implementation.

...read moreread less

Abstract: Given the complexity of providing dementia care in hospitals, integrating technology into practice is a high challenge and an important opportunity. Although there are a growing demand and interest in using social robots in a variety of care settings to support dementia care, little is known about the impacts of the robotics and their application in care settings, i.e., what worked, in which situations, and how. Scientific databases and Google Scholar were searched to identify publications published since 2000. The inclusion criteria consisted of older people with dementia, care setting, and social robot PARO. A total of 29 papers were included in the review. Content analysis identified 3 key benefits of and 3 barriers to the use of PARO. Main benefits include: reducing negative emotion and behavioral symptoms, improving social engagement, and promoting positive mood and quality of care experience. Key barriers are: cost and workload, infection concerns, and stigma and ethical issues. This review reveals 3 research gaps: (a) the users’ needs and experiences remain unexplored, (b) few studies investigate the process of how to use the robot effectively to meet clinical needs, and (c) theory should be used to guide implementation. Most interventions conducted have been primarily researcher-focused. Future research should pay more attention to the clinical needs of the patient population and develop strategies to overcome barriers to the adoption of PARO in order to maximize patient benefits.

...read moreread less

138 citations

Journal Article•DOI•

Psychosocial health interventions by social robots: Systematic review of randomized controlled trials

[...]

Nicole Robinson¹, Timothy Vaughan Cottier¹, David J. Kavanagh¹•Institutions (1)

Queensland University of Technology¹

10 May 2019-Journal of Medical Internet Research

TL;DR: Research on social robot interventions in clinical and health settings needs to transition from exploratory investigations to include large-scale controlled trials with sophisticated methodology, to increase confidence in their efficacy.

...read moreread less

Abstract: Background: Social robots that can communicate and interact with people offer exciting opportunities for improved health care access and outcomes. However, evidence from randomized controlled trials (RCTs) on health or well-being outcomes has not yet been clearly synthesized across all health domains where social robots have been tested. Objective: This study aimed to undertake a systematic review examining current evidence from RCTs on the effects of psychosocial interventions by social robots on health or well-being. Methods: Medline, PsycInfo, ScienceDirect, Scopus, and Engineering Village searches across all years in the English language were conducted and supplemented by forward and backward searches. The included papers reported RCTs that assessed changes in health or well-being from interactions with a social robot across at least 2 measurement occasions. Results: Out of 408 extracted records, 27 trials met the inclusion criteria: 6 in child health or well-being, 9 in children with autism spectrum disorder, and 12 with older adults. No trials on adolescents, young adults, or other problem areas were identified, and no studies had interventions where robots spontaneously modified verbal responses based on speech by participants. Most trials were small (total N=5 to 415; median=34), only 6 (22%) reported any follow-up outcomes (2 to 12 weeks; median=3.5) and a single-blind assessment was reported in 8 (31%). More recent trials tended to have greater methodological quality. All papers reported some positive outcomes from robotic interventions, although most trials had some measures that showed no difference or favored alternate treatments. Conclusions: Controlled research on social robots is at an early stage, as is the current range of their applications to health care. Research on social robot interventions in clinical and health settings needs to transition from exploratory investigations to include large-scale controlled trials with sophisticated methodology, to increase confidence in their efficacy.

...read moreread less

129 citations

Cites background or result from "Use of a Robotic Seal as a Therapeu..."

...In addition, 4 trials had a blind assessment of observations [55-57,62,63], and interrater reliability on at least 1 key measure was reported in 3 trials [59,61-63]....
[...]
...%) aged 55-100 years Robinson et al [53] Robot versus control after intervention (reporting range Quality of Life for Alzheimer’s Disease Scale; Each phase: 3 × 45- min 9-member sesWithin-participant crossover design 18 Australian residential aged care Moyle et al [54] of Cohen d)f: >Quality ofRating Anxiety in Dementia Scale (RAID—self-reported sions per week over 5 weeks; 3-week (random order); Robot first (1 group residents (sex not stated) aged ≥ 65 (mean 85.3, SD 8.4) Life (0.6 to 1.3); < anxiety on RAID Proxy versionand Proxy); Apathy Evalua- tion Scale; Geriatric Depreswashout between phases of 9): PARO -discovery, emotional response, discussion (−0.4 to −0.3) but greater on RAID (0.4 to 0.4), OERSsion Scale; Revised Algase Wandering Scale Nursingabout PARO, touch(0.5 to 0.7)f; > OERS sad-Home version; Observeding PARO and conness (0.4 to 0.6), pleasure (0.7 to 0.7)f Emotion Rating Scale (OERS); (Assessors independent—unclear if blind) trol first (9): Being read to, looking at pictures, discussion of readings iRobiQ or Cafero versus control pre and post: not significant (ns) Geriatric Depression Scale; Health-related Quality of Life; and Medication Adherence Report Scale (Singleblind assessment) 2 × 6-week periods with 18-day washout Within-participant crossover design (random order)g; iRobiQ or Cafero robot at home versus 29 New Zealand retirement village residents (14 male, 48...
[...]
...However, some other results were more disquieting, such as increased negative affect and less interested affect than controls in the study by Srinivasan et al [39], increases in sadness and (on 1 measure) anxiety in the study by Moyle et al [54], and some worsening of symptoms in the study by Valenti Soler et al [57]....
[...]
...The use of a robot had an impact on emotions, such as achieving an increase in neutral and pleasure affect [62,64], and happy, smiling facial expressions [60], with a decrease in depressive symptoms [58,59] and loneliness scores [51,53]....
[...]
...Examples include inconsistent results on emotions in the study by Moyle et al [54] and on cognitive tests in the study by Kim et al [56], and some negative effects on symptoms including irritability/lability in the study by Valenti Soler et al [57]....
[...]

Journal Article•DOI•

How do “robopets” impact the health and well-being of residents in care homes? A systematic review of qualitative and quantitative evidence

[...]

Rebecca Abbott¹, Noreen Orr¹, Paige McGill¹, Rebecca Whear¹, Alison Bethel¹, Ruth Garside¹, Ken Stein¹, Jo Thompson-Coon¹ - Show less +4 more•Institutions (1)

University of Exeter¹

09 May 2019-International Journal of Older People Nursing

TL;DR: Engagement with robopets appears to have beneficial effects on the health and well‐being of older adults living in care homes, but not all chose to engage.

...read moreread less

Abstract: Background Robopets are small animal-like robots which have the appearance and behavioural characteristics of pets. Objective To bring together the evidence of the experiences of staff, residents and family members of interacting with robopets and the effects of robopets on the health and well-being of older people living in care homes. Design Systematic review of qualitative and quantitative research. Data sources We searched 13 electronic databases from inception to July 2018 and undertook forward and backward citation chasing. Methods Eligible studies reported the views and experiences of robopets from residents, family members and staff (qualitative studies using recognised methods of qualitative data collection and analysis) and the effects of robopets on the health and well-being of care home residents (randomised controlled trials, randomised crossover trials and cluster randomised trials). Study selection was undertaken independently by two reviewers. We used the Wallace criteria and the Cochrane Risk of Bias tool to assess the quality of the evidence. We developed a logic model with stakeholders and used this as a framework to guide data extraction and synthesis. Where appropriate, we used meta-analysis to combine effect estimates from quantitative studies. Results Nineteen studies (10 qualitative, 2 mixed methods and 7 randomised trials) met the inclusion criteria. Interactions with robopets were described as having a positive impact on aspects of well-being including loneliness, depression and quality of life by residents and staff, although there was no corresponding statistically significant evidence from meta-analysis for these outcomes. Meta-analysis showed evidence of a reduction in agitation with the robopet "Paro" compared to control (-0.32 [95% CI -0.61 to -0.04, p = 0.03]). Not everyone had a positive experience of robopets. Conclusions Engagement with robopets appears to have beneficial effects on the health and well-being of older adults living in care homes, but not all chose to engage. Whether the benefits can be sustained are yet to be investigated. Implications for practice Robopets have the potential to benefit people living in care homes, through increasing engagement and interaction. With the robopet acting as a catalyst, this engagement and interaction may afford comfort and help reduce agitation and loneliness.

...read moreread less

72 citations

Cites background or result from "Use of a Robotic Seal as a Therapeu..."

...…et al., 2008; Birks et al., 2016; Chang & Sabanovic, 2015; Chang et al., 2013; Petersen et al., 2017) and four in Australia (Birks et al., 2016; Moyle et al., 2013, 2016, 2017b), with the remaining studies tak‐ ing place in Italy (Giusti & Marti, 2006; Iacono & Marti, 2016), New Zealand…...
[...]
...The majority of the studies performed power calculations, and 4 of the trials clearly accounted for all of their participants in the reporting of the studies (Joranson et al., 2015; Moyle et al., 2013, 2017b; Robinson et al., 2013a)....
[...]
...Robopets were described as a way of entertaining and diverting residents who were “restless or sad” (Jung et al., 2017) and “bored” (Moyle et al., 2017a)....
[...]
...Five trials clearly reported eligibility criteria (Joranson et al., 2015; Moyle et al., 2013, 2017b; Petersen et al., 2017; Valenti Soler et al., 2015)....
[...]
...Most studies performed poorly in terms of the blinding of participants and personnel, with only one study at a low risk of bias for this criterion (Moyle et al., 2017b)....
[...]

1
2
3
4
…
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37

Collapse

References

PDF

Open Access

More filters

Journal Article•DOI•

2016 Alzheimer's disease facts and figures

[...]

Joseph E. Gaugler, Bryan D. James, Tricia Johnson, Ken Scholz, Jennifer Weuve - Show less +1 more

01 Jan 2016-Alzheimers & Dementia

4,479 citations

Journal Article•DOI•

Chlamydia Pneumoniae-Infected Astrocytes Alter Their Expression of ADAM10, BACE1, and Presenilin-1 Proteases

[...]

Zein Al-Atrache¹, Ahmad Cader¹, Denah M. Appelt¹•Institutions (1)

Philadelphia College of Osteopathic Medicine¹

01 Jul 2016-Alzheimers & Dementia

TL;DR: This study provides valuable insights into how CD2AP contributes to LOAD susceptibility and results resulted in a significant increase in extracellular amyloid-B (Ab) levels, which did not appear to be directly related to changes in APP processing.

...read moreread less

Abstract: brain. To investigate this, we are characterising the effects of CD2AP knockdown in an in vitro model of the BBB. Methods: Endogenous CD2AP expression was knocked down in H4 and hMEC/D3 cells using siRNA. Knockdown was quantified by western blot and Image J analysis. Levels of APP, Ab, and APP metabolites were quantified using ELISAs. The rate of receptor-mediated endocytosis was measured by a transferrin uptake assay. Co-localisation of CD2AP with APP and endosomal markers was assessed using immunocytochemistry. Transcytosis in hMEC/D3 cells will be assessed using Transwell assays. Results:We observed a significant 30.2760.07 % increase in Ab40 expression (p1⁄40.0046). Expression levels of APP and APP processing metabolites was not significantly altered. Results from our experiments in progress will be made available at AAIC 2016. Conclusions:Knockdown of CD2AP expression resulted in a significant increase in extracellular amyloid-B (Ab) levels, which did not appear to be directly related to changes in APP processing. This study is ongoing and novel data will be presented at AAIC 2016. Overall, our study provides valuable insights into how CD2AP contributes to LOAD susceptibility.

...read moreread less

771 citations

Journal Article•DOI•

Socially Assistive Robots in Elderly Care: A Systematic Review into Effects and Effectiveness

[...]

Roger Bemelmans, Gert Jan Gelderblom, Pieter Jonker¹, Luc P. de Witte²•Institutions (2)

Delft University of Technology¹, Public Health Research Institute²

01 Feb 2012-Journal of the American Medical Directors Association

TL;DR: The objective of this review was to assess the published effects and effectiveness of robot interventions aiming at social assistance in elderly care, and reported positive effects of companion-type robots on (socio)psychological and physiological parameters.

...read moreread less

443 citations

Journal Article•DOI•

The psychosocial effects of a companion robot: a randomized controlled trial.

[...]

Hayley Robinson¹, Bruce A. MacDonald¹, Ngaire Kerse¹, Elizabeth Broadbent¹•Institutions (1)

University of Auckland¹

01 Sep 2013-Journal of the American Medical Directors Association

TL;DR: Paro is a positive addition to this environment and has benefits for older people in nursing home care and may be able to address some of the unmet needs of older people that a resident animal may not, particularly relating to loneliness.

...read moreread less

384 citations

Dementia UK: Update

[...]

Martin Prince, Martin Knapp, Maëlenn Guerchet, Paul McCrone, Matthew Prina, M Comas-Herrera, A wittenberg, R Adelaja, Bo Hu, Benjamin T. King, D Rehill, D Salimkumar - Show less +8 more

01 Nov 2014

TL;DR: Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version.

...read moreread less

Abstract: Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.

...read moreread less

300 citations