1224 Part F Field and Service Robotics ties of daily living(ADLs).or to assist us in actually Assistive robots are generally grouped accord- doing them if we are unable to relearn.While hu- ing to whether they focus on manipulation,mobility, man therapists and attendants can indeed provide the or cognition.Manipulation aids are further classi- types of assistance required,the projected short-term fied into fixed-platform,portable-platform,and mobile demographics of China,Japan,and the Scandinavian autonomous types.Fixed-platform robots perform func- countries show a growing shortage of working-age tions in the kitchen,on the desktop,or by the bed. adults.Age-related disabilities will soon dominate the Portable types are manipulator arms attached to an elec- service sector job market,put many older and disabled tric wheelchair to hold and move objects and to interact people at risk,and increase the need for institutional- with other devices and equipment,as in opening a door. ization when there is no viable home-based solution.Mobile autonomous robots can be controlled by voice or National programs to develop personal robots,robotic other means to carry out manipulation and other errands therapy,smart prostheses,smart beds,smart homes,in the home or workplace.Mobility aids are divided and tele-rehabilitation services have accelerated in the into electric wheelchairs with navigation systems and past ten years and will need to continue apace with the mobile robots that act as smart,motorized walkers,al- ever-increasing ability of health care to allow people to lowing people with mobility impairments to lean on live longer through the repression of disease and im-them to prevent falls and provide stability.The third main provements in surgical and medication interventions. type,cognitive aids,assist people who have dementia, Rehabilitation robotics,although only a 40-year-old dis- autism or other disorders that affect communication and cipline [53.1-3],is projected to grow quickly in the physical well-being. coming decades. The fields of prosthetics and FNS are closely al- 驾 lied with rehabilitation robotics.Prostheses are artificial 53.1.1 Taxonomy of Rehabilitation Robotics hands,arms,legs,and feet that are worn by the user to replace amputated limbs.Prostheses are increasingly The field of rehabilitation robotics is generally divided incorporating robotic features.FNS systems seek to into the categories of therapy and assistance robots.In reanimate the limb movements of weak or paralyzed addition,rehabilitation robotics includes aspects of arti- people by electrically stimulating nerve and muscle. ficial limb(prosthetics)development,functional neural FNS control systems are analogous to robotic control stimulation,(FNS)and technology for the diagnosis and systems,except that the actuators being controlled are monitoring of people during ADLs. human muscles.Another related field is technology for Therapy robots generally have at least two main monitoring and diagnosing health care issues as a person users simultaneously,the person with a disability who performs ADLs. is receiving the therapy and the therapist who sets up The chapter is organized according to this taxonomy. and monitors the interaction with the robot.Types of After providing background information on world de- therapy that have benefited from robotic assistance are mographics (Sect.53.1.2)and the history (Sect.53.1.3) upper-and lower-extremity movement therapy,enabling of the field,Sect.53.2 describes physical therapy and communication for children with autism,and enabling training robots,and Sect.53.3 describes robotic aids exploration (education)for children with cerebral palsy for people with disabilities.Section 53.4 then reviews (CP)or other developmental disabilities.A robot may be recent advances in smart prostheses and orthoses that a good alternative to a physical or occupational therapist are related to rehabilitation robotics.Finally,Sect.53.5 for the actual hands-on intervention for several reasons: provides an overview of recent work in diagnosis and (1)once properly set up,an automated exercise machine monitoring for rehabilitation as well as other health care can consistently apply therapy over long periods of time issues. without tiring;(2)the robot's sensors can measure the work performed by the patient and quantify,to an extent 53.1.2 World Demographics perhaps not yet measurable by clinical scales,any re- covery of function that may have occurred,which may The various areas of rehabilitation robotics focus on be highly motivating for a person to continue with the different user populations,but a common characteris- therapy;and(3)the robot may be able to engage the tic of these populations is that they have a disability. patient in types of therapy exercises that a therapist can- Disability is defined in the Americans with Disabilities not do,such as magnifying movement errors to provoke Act as "a physical or mental impairment that substan- adaptation [53.4,5]. tially limits one or more of the major life activities."1224 Part F Field and Service Robotics ties of daily living (ADLs), or to assist us in actually doing them if we are unable to relearn. While hu￾man therapists and attendants can indeed provide the types of assistance required, the projected short-term demographics of China, Japan, and the Scandinavian countries show a growing shortage of working-age adults. Age-related disabilities will soon dominate the service sector job market, put many older and disabled people at risk, and increase the need for institutional￾ization when there is no viable home-based solution. National programs to develop personal robots, robotic therapy, smart prostheses, smart beds, smart homes, and tele-rehabilitation services have accelerated in the past ten years and will need to continue apace with the ever-increasing ability of health care to allow people to live longer through the repression of disease and im￾provements in surgical and medication interventions. Rehabilitation robotics, although only a 40-year-old dis￾cipline [53.1–3], is projected to grow quickly in the coming decades. 53.1.1 Taxonomy of Rehabilitation Robotics The field of rehabilitation robotics is generally divided into the categories of therapy and assistance robots. In addition, rehabilitation robotics includes aspects of arti- ficial limb (prosthetics) development, functional neural stimulation, (FNS) and technology for the diagnosis and monitoring of people during ADLs. Therapy robots generally have at least two main users simultaneously, the person with a disability who is receiving the therapy and the therapist who sets up and monitors the interaction with the robot. Types of therapy that have benefited from robotic assistance are upper- and lower-extremity movement therapy, enabling communication for children with autism, and enabling exploration (education) for children with cerebral palsy (CP) or other developmental disabilities. A robot may be a good alternative to a physical or occupational therapist for the actual hands-on intervention for several reasons: (1) once properly set up, an automated exercise machine can consistently apply therapy over long periods of time without tiring; (2) the robot’s sensors can measure the work performed by the patient and quantify, to an extent perhaps not yet measurable by clinical scales, any re￾covery of function that may have occurred, which may be highly motivating for a person to continue with the therapy; and (3) the robot may be able to engage the patient in types of therapy exercises that a therapist can￾not do, such as magnifying movement errors to provoke adaptation [53.4, 5]. Assistive robots are generally grouped accord￾ing to whether they focus on manipulation, mobility, or cognition. Manipulation aids are further classi- fied into fixed-platform, portable-platform, and mobile autonomous types. Fixed-platform robots perform func￾tions in the kitchen, on the desktop, or by the bed. Portable types are manipulator arms attached to an elec￾tric wheelchair to hold and move objects and to interact with other devices and equipment, as in opening a door. Mobile autonomous robots can be controlled by voice or other means to carry out manipulation and other errands in the home or workplace. Mobility aids are divided into electric wheelchairs with navigation systems and mobile robots that act as smart, motorized walkers, al￾lowing people with mobility impairments to lean on them to prevent falls and provide stability. The third main type, cognitive aids, assist people who have dementia, autism or other disorders that affect communication and physical well-being. The fields of prosthetics and FNS are closely al￾lied with rehabilitation robotics. Prostheses are artificial hands, arms, legs, and feet that are worn by the user to replace amputated limbs. Prostheses are increasingly incorporating robotic features. FNS systems seek to reanimate the limb movements of weak or paralyzed people by electrically stimulating nerve and muscle. FNS control systems are analogous to robotic control systems, except that the actuators being controlled are human muscles. Another related field is technology for monitoring and diagnosing health care issues as a person performs ADLs. The chapter is organized according to this taxonomy. After providing background information on world de￾mographics (Sect. 53.1.2) and the history (Sect. 53.1.3) of the field, Sect. 53.2 describes physical therapy and training robots, and Sect. 53.3 describes robotic aids for people with disabilities. Section 53.4 then reviews recent advances in smart prostheses and orthoses that are related to rehabilitation robotics. Finally, Sect. 53.5 provides an overview of recent work in diagnosis and monitoring for rehabilitation as well as other health care issues. 53.1.2 World Demographics The various areas of rehabilitation robotics focus on different user populations, but a common characteris￾tic of these populations is that they have a disability. Disability is defined in the Americans with Disabilities Act as “a physical or mental impairment that substan￾tially limits one or more of the major life activities.” Part F 53.1