PRE2024 3 Group9
Group members
| Group member | Student number | Study program |
|---|---|---|
| Amélie van Rossum | 1743929 | BPT |
| Annika Valkering | 1890395 | BPT |
| Koen Jaartsveld | 1855786 | BPT |
| Lisa van Nuland | 1778528 | BPT |
| Max te Brake | 1534017 | BPT |
| Carmen Knepper | 1884069 | BPT |
State-of-the-art
Problem statement and objectives
Problem statement
Globally populations are aging, making it increasingly important to help elderly people maintain physical health and emotional well-being [1]. Limited mobility in older adults impacts both their physical functioning as well as their emotional health, which often leads to decreased social interaction and reduced quality of life [2]. Traditional physical rehabilitation methods that are effective in improving physical abilities often lack the motivational and emotional engagement necessary for sustained participation [3]. One effective intervention for enhancing mobility, cognitive function, and emotional well-being in older adults is dance movement therapy [4]. However, challenges remain such as accessibility and constant participation, especially for individuals with limited mobility [5].
The field of social robotics has seen recent advancements that could present a promising solution to these challenges by offering engaging platforms for physical exercise. Specifically, humanoid robots like Pepper show the potential to be dance companions or instructors. In this way, physical activity can be promoted while also enhancing emotional well-being through social interaction and engagement with a humanoid robot, as well as maybe other older people and caregivers [6]. These robots have the ability to provide personalized, adaptable, and consistent dance-based interventions, which are crucial for users with limited ability such as older people. Research has indicated that integrating robots in dance therapy not only improves physical outcomes such as balance and mobility but also enhances psychological well-being by increasing social engagement as well as emotional satisfaction [7].
Despite these promising findings, at the moment there is limited research on how effective humanoid robots are as dance companions or instructors for older adults with mobility limitations. Specifically, it is still unclear how it could influence both physical and emotional outcomes including social connectedness, overall quality of life, and mood enhancement. Furthermore, user acceptance, long-term adherence, and engagement in robot-assisted dance programs need further investigation [6] [8].
Therefore in this study, we aim to explore the feasibility and effectiveness of using the Pepper robot as a dance companion and instructor for elderly individuals with limited mobility. We will investigate the impact of robot-assisted dance interventions on emotional well-being (mood enhancement), physical health, and social engagement. In this way, this research seeks to address the gap in literature regarding the use of humanoid robots in dance-based therapy, as well as contribute to the development of accessible and effective interventions to enhance the quality of life in older adults with limited mobility.
Objectives
The primary objective of this project is to develop and evaluate the effectiveness of the Pepper robot as a dance instructor for older adults and individuals with limited mobility. The project aims to build upon existing research on robotic-assisted dance therapy for older adults and provide insights into the feasibility, user acceptance, and impact of such interventions.
This objective involves programming Pepper to guide a music- and dance-based activity that promotes physical activity, emotional well-being, and social engagement through human-robot interaction while remaining accessible for those with limited mobility. It is essential that the robot instructs people in a way that is engaging and encourages participation, thus it is important the movements and directions the robot demonstrates are within the physical capabilities of the elderly users.
Additionally, an experiment is to be carried out to determine the effectiveness of this implementation of Pepper's capabilities. To this end, we aim to construct an experiment and interview with a select cohort of participants according to our target population criteria. Prior to the dance session the participants will engage in with Pepper, they will be interviewed to determine their expectations and current mood, and afterwards they will be interviewed once more to determine the effectiveness of the activity in improving their mood and physical well-being.
Each participant will be properly informed and sign an informed consent form, ensuring they understand the purpose of the research and their role in the experiment.
User description
Old people
User requirements
1. Low-impact dance movements for elderly users
Create dance programmes that include low-impact movements specifically designed for older users. Incorporate well-controlled ballet and tap dance movements that can be performed by the robot, focusing on arm, hand and head movements that the Pepper robot can demonstrate. With such an approach, older participants can perform the activities sitting or standing, improving their physical endurance, strength and functionality in a safe way. Movement that maintains flexibility and reduces pain does not increase the risk of injury, but has been shown to encourage very high levels of adherence among participants to demonstrate effectiveness and also something worth doing [9]. Including aspects of aerobics that reduce psychological stress and possible mood enhancement would be valuable, as indicated by a study in which low-impact aerobic dance exercises significantly improved stress levels among sedentary women in Malaysia [10] .
2. Mood enhancement
Intermittent dance exercises
The robot should have intermittent aerobic dance exercises of light intensity (I-LADE) as its core activity. This exercise is considered the best to improve mood in older adults because it is very fun and engaging. According to a study published in 2021 in Frontiers in Aging Neuroscience, both forms of exercise interventions (continuous and intermittent) had a positive impact on mood and executive functions. However, the I-LADE (intermittent) intervention was particularly beneficial because it was more fun, which made it most likely to increase participation for longer. Participants reported that this intervention was clearly more pleasurable and enjoyable than continuous physical activity, allowing this intervention to be included fairly regularly in treatment programmes for older adults, especially as a morale booster [11].
Classical music
The robot should include classical music with a happy sound, specifically pieces by Mozart, to help improve the mood and cognitive functioning of elderly users. Such music would use the general inherent characteristics of classical compositions to evoke happiness and would therefore be suitable dancing programs to boost mood. Research suggests that listening to happy-sounding music, such as Mozart's, can significantly increase the level of arousal and mood in older people. This kind of music is not only good for mood but also for cognitive functions, working memory and skills needed for voluntary mental activity in older people to maintain overall mental health [12].
Personalized music
Personalised music interventions could include using favourite genres and songs to improve mood in older users, especially those with stroke or dementia. The robot will facilitate music sessions that are personalised to evoke positive emotional responses that improve mood. Teppo Särkämö's research proves that personalised music, especially well-known and favourite songs, plays a crucial role in improving the mood and emotional well-being of elderly people [13]. Such interventions take advantage of the very close emotional relationships users have with music they like, and activate positive memories and feelings that are exceptionally strong for improving mood. It emphasizes that familiar music evokes stronger emotional responses and activates reward circuits in the brain more effectively than unfamiliar music.
3. Customization of movement intensity to ensure safety and comfort for all users
The system should be able to adjust movement intensity and style so that all users, particularly older users, feel safe and comfortable. Older users may have varying levels of physical ability. Balance and type of movements should be modified to ensure the safety and comfort of the programme for older participants. This modification is due to the fact older individuals do not have comparable physical capabilities, as inscribed in the synthesis evidence from recent studies on health programmes in dance. Such customized approaches minimize injury risk in dance activities while promoting greater overall participation by making movements accessible and enjoyable for all participants, irrespective of their physical condition [14].
4. Hands-Free Controls
The robot must feature hands-free controls, such as voice commands, so that users with mobility or cognitive limitations can still use the robot. According to Zhao et al. (2023), human-robot interaction, perception-based systems and prediction-based systems design to adapt to the user's needs while ensuring safety and comfort. Dance therapy is usually defined as artistic therapy, i.e. coordinated movements and balanced use of music; hands-free control allows the user to interact with the robot without diverting their attention or requiring manual input. In addition, voice controls also enable interaction where users can start, stop or tune dance routines without the burden of physical control input that can be difficult for those with less dexterity or cognitive limitations. Another advantage is that voice guidance can provide real-time encouragement, corrections or instructions that can increase motivation and support dance sessions. Psychological safety has also been shown to greatly aid user acceptance of robotic systems [15]. Letting users control the robot with words rather than by moving their body reduces worry and increases confidence, especially among people who are not so used to technology.
5. Clear visual and audio guidance
Providing clear and straightforward visual and audio instructions is essential for elderly users, particularly those with cognitive impairments. Research indicates that older adults with cognitive decline often face challenges in comprehension and communication, which can impact their decision-making processes. Utilizing visual methods, such as infographics or pictures, has been shown to support understanding and facilitate communication in this population [16].
Additionally, sensory impairments, including vision and hearing loss, are common among the elderly and can further hinder information processing. Studies have found that visual and hearing impairments are associated with a higher risk of cognitive decline. The use of visual aids can mitigate some of these challenges by enhancing comprehension and supporting cognitive functions [17]. Incorporating clear visual and audio instructions can also improve working memory performance in older adults. Research examining the effect of auditory-visual speech stimuli on working memory found that combining auditory and visual information can enhance cognitive performance in older adults with hearing impairments [18].
By integrating clear visual and audio instructions, assistive technologies can better support elderly users, particularly those with cognitive and sensory impairments, leading to improved comprehension, communication, and overall user experience. Research on interactive robotic feedback and balance therapy demonstrates that customized movement intensity, real-time feedback, and hands-free controls significantly improve adherence, engagement, and motor functions in older people [19].
6. Encouraging feedback
The dance therapy robot should provide positive reinforcement, acknowledging the progress of the user and encouraging further effort. Physical activities require motivation, and enjoyment, and hence long-term adherence to be successful. Positive reinforcement holds such an important value in these aspects. Research also made it clear that people’s perceptions of their coach’s behaviours, like goal setting, technical guidance, and rapport-building, are the key predictors of exercise engagement over time. For a dance therapy robot, this means incorporating real-time, personalized positive feedback that will enhance the users' intrinsic motivation and enjoyment in activity. The robot should be able to:
- Recognize progress made in moving, balancing, and enduring so that it can help foster a sense of competence
- Give motivational encouragement to add to enjoyment and engagement
- Involve goal-setting mechanisms that track user achievement with reinforcement when milestones are reached
As intrinsic motivation and enjoyment are key for adherence, the feedback system has to ensure that users feel able, supported, and engaged during their dance therapy sessions [20].
7. Companion-like interactions
The interaction with the robot has to be friendly, sympathetic, and engaging so that the robot acts more like a dance partner than just an instructor. It should include social and emotional support elements, for example, active listening, personalization, and expressive communication through voice and face. The robot needs to recognize the different users' conversational requirements by providing active engagement to spur motivation and passive companionship when the user requires it. This will encourage older adults to increase motivation, enjoyment, and adherence to activities like dance therapy when done correctly [21].
Planning (approach, milestones and deliverables)
Each week, there will be a mentor meeting on Monday morning to ask questions and get feedback. Furthermore, we have two additional group meetings every week, one directly after the mentor meeting and one on Friday during the break. The Wiki will be updated every Sunday (weekly deliverable).
On a weekly basis, we will evaluate what tasks need to be done and assign the tasks according to skills and interests of the group members.
Week 1
- Introduction to the course and forming of teams - all
- Brainstorm to come up with ideas for a project and select one - all
- Communicate the idea with the course coordinater - Annika
- Conduct literature review (5 pp) - all
- Write problem statement - Lisa
- Write objectives - Max
- Write user description - Amélie
- Write user requirements - Koen
- Make planning (containing approaches, milestones, deliverables) for the project - Annika
- Select technology (Pepper, other TU/e robot) - all
Week 2
- Confirmation to use the robot lab and which robot
- Create ERB form and get approval
- Create survey about mood for pre- and post-test
- Outline of capabilities of the robot
Week 3
- Program the robot
- Make consent form
- Start finding participants
Week 4
- Final arrangements for experiment set-up (milestone 1)
- Start with user testing/experiment
Week 5
- Finalize user testing/experiment (milestone 2)
- Analyze findings
Week 6
- Write results section
- Write discussion section
- Write conclusion section
Week 7
- Finalize report (milestone 3)
- Prepare final presentation + demo
- Give final presentation (milestone 4)
- Fill in peer review
Individual effort per week
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | Intro lecture (2h), literature review (2h), group meeting (1h), user needs (4h), lecture robots tue (2h) | |
| Annika Valkering | Intro lecture (2h), literature review (2h), Wiki layout and draft planning (2h), group meeting (1h), references (1h) | |
| Koen Jaartsveld | Intro lecture (2h), literature review (2h), group meeting (1h), Reading the sources of others (3h), Draft Interview questions (0,5h) | |
| Lisa van Nuland | Intro lecture (2h), literature review (2h), draft problem definition, user needs and approach (2h), group meeting (1h), problem statement (2h) | |
| Max te Brake | Intro lecture (2h), group meeting (1h) |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Tasks |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
| Group member | Total hours | Result |
|---|---|---|
| Amélie van Rossum | ||
| Annika Valkering | ||
| Koen Jaartsveld | ||
| Lisa van Nuland | ||
| Max te Brake |
Appendix
Appendix A: Interview Questions
Before:
How happy do you feel on average?
How physically fit do you feel on average?
How mentally fit do you feel on average?
Do you think you exercise/move enough?
What kind of movement/exercises do you do weekly?
Would you like to move more? Why or why not?
What kind of music do you like to listen to?
Which song always makes you happy?
What kind of music do you particularly dislike?
- ↑ Carta, M. G., Cossu, G., Pintus, E., Zaccheddu, R., Callia, O., Conti, G., Pintus, M., Aviles Gonzalez, C. I., Massidda, M. V., Mura, G., Sardu, C., Contu, P., Minerba, L., Demontis, R., Pau, M., Finco, G., Cocco, E., Penna, M. P., Orr, G., Kalcev, G., … Preti, A. (2021). Moderate exercise improves cognitive function in healthy elderly people: Results of a randomized controlled trial. Clinical Practice and Epidemiology in Mental Health, 17, 75–80. https://doi.org/10.2174/1745017902117010075
- ↑ Lu, J., Abd Rahman, N. A., Wyon, M., & Shaharudin, S. (2024). The effects of dance interventions on physical function and quality of life among middle-aged and older adults: A systematic review. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0301236
- ↑ Swaine, B., Poncet, F., Lachance, B., Proulx-Goulet, C., Bergeron, V., Brousse, É., Lamoureux, J., & McKinley, P. (2020). The effectiveness of dance therapy as an adjunct to rehabilitation of adults with a physical disability. Frontiers in Psychology, 11, 1963. https://doi.org/10.3389/fpsyg.2020.01963
- ↑ Ho, R. T. H., Fong, T. C. T., Chan, W. C., Kwan, J. S. K., Chiu, P. K. C., Yau, J. C. Y., & Lam, L. C. W. (2020). Psychophysiological effects of dance movement therapy and physical exercise on older adults with mild dementia: A randomized controlled trial. The Journals of Gerontology: Series B, 75(3), 560–570. https://doi.org/10.1093/geronb/gby145
- ↑ Bevilacqua, R., Maranesi, E., Benadduci, M., Cortellessa, G., Umbrico, A., Fracasso, F., Melone, G., Margaritini, A., La Forgia, A., Di Bitonto, P., Potenza, A., Fiorini, L., & La Viola, C. (2025). Exploring dance as a therapeutic approach for Parkinson disease through the Social Robotics for Active and Healthy Ageing (SI-Robotics): Results from a technical feasibility study. JMIR Aging, 8, e62930. https://doi.org/10.2196/62930
- ↑ 6.0 6.1 Chen, T. L., Bhattacharjee, T., Beer, J. M., Ting, L. H., Hackney, M. E., Rogers, W. A., & Kemp, C. C. (2017). Older adults’ acceptance of a robot for partner dance-based exercise. PLOS ONE, 12(10), e0182736. https://doi.org/10.1371/journal.pone.0182736
- ↑ Gianluca, B., Francesco, M., & Barbara, L. (2023). Dances with social robots: A pilot study at long-term care. Robotics, 11(5), 96. https://doi.org/10.3390/robotics11050096
- ↑ Gormley, M., Scassellati, B., & Pivoto, L. (2016). Lessons learned from the deployment of a long-term autonomous robot as companion in physical therapy for older adults with dementia: A mixed methods study. IEEE Xplore. https://doi.org/10.1109/ROBIO.2015.7451730
- ↑ Kimberly Lazo Green, Yang Yang, Ukachukwu Abaraogu, Claire H Eastaugh, Fiona R Beyer, Gill Norman, Chris Todd, Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis, Age and Ageing, Volume 53, Issue 5, May 2024, afae104, https://doi.org/10.1093/ageing/afae104
- ↑ Johar, M., Omar-fauzee, M. S., Abu Samah, B., & Abd Rashid, S. (2012). Effect of low-impact aerobic dance exercise on psychological health (stress) among sedentary women in Malaysia. Biology of Sport, 29(1). Effect_of_low-impact_aerobic_dance_exercise_on_psy.pdf
- ↑ Frontiers in Aging Neuroscience. (2021). Comparison between the effects of continuous and intermittent light-intensity aerobic dance exercise on mood and executive functions in older adults. Retrieved from https://www.frontiersin.org/articles/10.3389/fnagi.2021.723243/full
- ↑ Vincenzi, M., Borella, E., Sella, E., Lima, C. F., De Beni, R., & Schellenberg, E. G. (2022). Music Listening, Emotion, and Cognition in Older Adults. Brain Sciences, 12(11), 1567. https://doi.org/10.3390/brainsci12111567
- ↑ Särkämö, T. (Year). Music for the ageing brain: Cognitive, emotional, social, and neural benefits of musical leisure activities in stroke and dementia. Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki. content
- ↑ Waugh, M., Youdan Jr., G., Casale, C., Balaban, R., Cross, E. S., & Merom, D. (2024). The use of dance to improve the health and wellbeing of older adults: A global scoping review of research trials. PLoS ONE, 19(10), e0311889. https://doi.org/10.1371/journal.pone.0311889
- ↑ Zhao, D., Sun, X., Shan, B., Yang, Z., Yang, J., Liu, H., Jiang, Y., & Hiroshi, Y. (2023). Research status of elderly-care robots and safe human-robot interaction methods. Frontiers in Neuroscience, 17, 1291682. https://doi.org/10.3389/fnins.2023.1291682
- ↑ Chen, A. T., Teng, A. K., Zhao, J., Asirot, M. G., & Turner, A. M. (2022). The use of visual methods to support communication with older adults with cognitive impairment: A scoping review. Geriatric Nursing, 46, 52–60. https://doi.org/10.1016/j.gerinurse.2022.04.027
- ↑ Kwan, R. Y. C., Kwan, C. W., Kor, P. P. K., & Chi, I. (2022). Cognitive decline, sensory impairment, and the use of audio-visual aids by long-term care facility residents. BMC Geriatrics, 22, 216. https://doi.org/10.1186/s12877-022-02895-x
- ↑ Frtusova, J. B., & Phillips, N. A. (2016). The auditory-visual speech benefit on working memory in older adults with hearing impairment. Frontiers in Psychology, 7, 490. https://doi.org/10.3389/fpsyg.2016.00490
- ↑ Segal, A. D., Adamczyk, P. G., Petruska, A. J., & Silverman, A. K. (2022). Hands-free balance therapy using robotic mobile feedback for home-based training for aging adults. IEEE Transactions on Neural Systems and Rehabilitation Engineering. https://doi.org/10.1109/TNSRE.2022.3205850
- ↑ Braga-Pereira, R., Furtado, G. E., Campos, F., Sampaio, A. R., & Teques, P. (2024). Impact of fitness coach behavior on exercise motivation, commitment, and enjoyment: A longitudinal study. PLOS ONE, 19(12), e0310931. https://doi.org/10.1371/journal.pone.0310931
- ↑ Irfan, B., Kuoppamäki, S., & Skantze, G. (2024). Recommendations for designing conversational companion robots with older adults through foundation models. Frontiers in Robotics and AI, 11. https://doi.org/10.3389/frobt.2024.1363713