Co-Design of Assistive Robotic Systems for Monitoring and Management of Chronic Pain

疼痛是一种不愉快的感觉，我们在整个生命过程中都会经历，但它有助于进化的目的，提醒我们注意危险，让我们保护自己的身体。然而，慢性疼痛并不能达到这个目的，并且可以在没有损伤或组织损伤的情况下持续存在。慢性疼痛是持续时间超过3个月的任何疼痛的总称，包括各种疾病，如骨关节炎和类风湿性关节炎、纤维肌痛、复杂性局部疼痛综合征（CRPS）、头痛和偏头痛以及慢性背痛[1]。在英国，62%的75岁以上的人患有某种形式的慢性疼痛，至少有10%的人这种疼痛是中度到重度致残[2]。在世界范围内，长期疼痛影响超过30%的成年人[3]，然而，尽管这种患病率，对其神经机制知之甚少。由于对阿片类药物使用缺点的认识不断提高，最近NICE治疗慢性疼痛的指南强调在患者和临床医生之间建立合作治疗计划[4]。该项目旨在利用机器人、传感和机器学习等新兴技术来帮助检测和管理慢性疼痛。慢性疼痛很难检测和诊断，因为疼痛水平每天都在波动，因此家中的传感器可能适合在比临床咨询更长的时间内监测疼痛的影响。这也可以帮助检测随着时间的推移而变化的健康或移动水平[5]。然而，如果我们要在家中放置传感器，我们需要了解它们如何收集足以告知用户和临床医生健康状况的数据，同时仍然可以被最终用户接受[6]。如果疼痛可以被感知和理解，那么可能有机会开发辅助技术，然后可以做出适当的反应并与疼痛管理计划相结合。辅助机器人可以通过提供分心（通过疼痛门控）[7]或使用舒缓的触摸来帮助疼痛管理，释放催产素以减轻疼痛[8]。使用这些机制的机器人疼痛管理干预已经显示出前景，但很少有研究来了解经历疼痛的老年人的愿望，尽管这是最大的疼痛人口[9]。因此，与行业合作伙伴ExtraCare慈善信托基金一起，该项目将包括一系列与ExtraCare退休村的老年人一起共同设计的活动。通过调查、访谈、焦点小组和其他设计研讨会，我们希望了解这一人群的需求，以开发用于疼痛管理的辅助技术，特别关注可接受性、可用性和可访问性。

Pain is an unpleasant sensation which we all experience throughout the course of life, but it serves the useful evolutionary purpose of alerting us to danger and allowing us to protect our bodies. However, chronic pain does not serve this purpose and can persist in the absence of injury or tissue damage. Chronic pain is an umbrella term for any pain that persists for longer than 3 months, and includes a wide range of conditions such as osteo and rheumatoid arthritis, fibromyalgia, complex regional pain syndrome (CRPS), headaches and migraines, and chronic back pain [1]. In the UK 62% of people over 75 live with some form of chronic pain, and in at least 10% this pain is moderately to severely disabling [2]. Worldwide, long-term pain effects over 30% of the adult population [3], however despite this prevalence, little is understood about its neurological mechanisms. Due to increased awareness of the drawbacks of opioid use, recent NICE guidelines for treating chronic pain emphasise building a collaborative treatment plan between patients and clinicians [4]. This project aims to use emerging technologies from robotics, sensing, and machine learning to aid in the detection and management of chronic pain.Chronic pain can be difficult to detect and diagnose, as pain levels fluctuate for an individual daily, so sensors in the home may be suitable for monitoring the effects of pain over a period much longer than a clinical consultation. This could also help with detection in changing levels of health or mobility over time [5]. However, if we are to place sensors within the home, we need to understand how they can collect data which is sufficient to inform the user and clinician about health status, whilst still being acceptable to that end user [6].If pain can be sensed and understood, there may be the opportunity to develop assistive technology that can then respond appropriately and be integrated with pain management plans. Assistive robots may be able to aid in pain management by providing distraction (through pain gating) [7] or using soothing touch, which release oxytocin to reduce pain [8]. Robotic pain management interventions using these mechanisms have shown promise, but little research has been conducted to understand the desires of older adults experiencing pain, despite this being the largest pain demographic [9].Therefore, alongside the industry partner, ExtraCare Charitable trust, this project will include a series of co-design activities alongside older adults living with pain at ExtraCare retirement villages. Using surveys, interviews, focus groups, and other design workshops, we hope to understand the needs of this demographic to develop assistive technologies for pain management, with a particular focus on acceptability, usability and accessibility.