The Three Laws of Neurorobotics: A Review on What Neurorehabilitation Robots Should Do for Patients and Clinicians

Abstract

Most studies and reviews on robots for neurorehabilitation focus on their effectiveness. These studies often report inconsistent results. This and many other reasons limit the credit given to these robots by therapists and patients. Further, neurorehabilitation is often still based on therapists’ expertise, with competition among different schools of thought, generating substantial uncertainty about what exactly a neurorehabilitation robot should do. Little attention has been given to ethics. This review adopts a new approach, inspired by Asimov’s three laws of robotics and based on the most recent studies in neurorobotics, for proposing new guidelines for designing and using robots for neurorehabilitation. We propose three laws of neurorobotics based on the ethical need for safe and effective robots, the redefinition of their role as therapist helpers, and the need for clear and transparent human–machine interfaces. These laws may allow engineers and clinicians to work closely together on a new generation of neurorobots.

The 3Ts of the new millennium neurorehabilitation gym: therapy, technology, translationality

“…absence of rehabilitation) has been considered unethical; second, the need of a standardized treatment for designing a randomized controlled trial contrasts with the concept of adaptability of the therapy, customized, and tailored on patient' s conditions. This is also known as 'the effectiveness paradox' [8,9]. Potential economic pressure may increase confusion in this already complex scenario, with implications on ethical issues and threatening the scientific value of newly proposed interventions.…”

“…All technological devices utilized for neurorehabilitation should take into account the so-called laws of neurorobotics [8]: (i) high benefit/risk ratio, (ii) involvement of the therapist into the patient-technological device loop (the device should be a tool in the hands of therapist), and (iii) transparent human-machine interface (technological devices should be an artificial intelligence as a support for human intelligence).…”

“…Also, technological devices should undergo the same evaluation road map before their commercialization [8,14].…”

Brain-machine Interface in Robot-assisted Neurorehabilitation for Patients with Stroke and Upper Extremity Weakness – the Therapeutic Turning Point

“…External force can make further injury to the body parts, which warrants these points to be considered [30]. The bony integrity, bone density, tenderness of the body parts and limitation of range of motion should be carefully checked.…”

“…If the mechanism of the robot is not understandable in clinical spectrum, application of the robot to the patient could be ineffective and potentially harmful [30]. Monitoring/measuring function of robots should be always considered for patients and clinicians.…”