Bridging stakeholder needs and technological capabilities to identify humanoid robot applications in rehabilitation: a case study in an ALS multidisciplinary care unit

Abstract

The integration of assistive service robots in healthcare has gained increasing attention for its potential to support clinical workflow and patient wellbeing. However, structured methodological approaches to identify clinically relevant applications for versatile robotic platforms before clinical implementation are still lacking. Moreover, the deployment of robots in these settings is often restricted to hyper-specialized tasks. To address these challenges, this study describes a stakeholder-driven process adopting a multidisciplinary co-design approach to adapt the Alter-Ego semi-anthropomorphic robot to the needs of a multidisciplinary neurorehabilitation unit for patients with Amyotrophic Lateral Sclerosis. We combined brainstorming, focus groups with healthcare professionals, patients and caregivers, and contextual observations to identify the real unmet needs and potential applications. The engineering team assessed the technological requirements and implementation readiness of each application. The clinical and engineering teams jointly reviewed the proposal, considering clinical, ethical, and infrastructural implications. This consensus-based process resulted in 12 use cases selected for the clinical protocol corresponding to 40 planned experimental sessions including autonomous or semi-autonomous tasks, as well as teleoperated activities for assistive and rehabilitation purposes. Furthermore, an exploratory pilot evaluated a subset of selected use cases, providing feedback to refine the platform and experimental protocol. Standardized assessments provided descriptive information on perceived workload, usability, and satisfaction. Participants generally reported a positive experience and manageable workload, while task-specific feedback identified aspects requiring further refinements. Overall, this experience offers preliminary insights into how clinical needs and technological capabilities can be jointly explored, providing a basis for subsequent clinical experimentation.