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

疼痛是一种令人不快的感觉，我们在整个生命过程中都会经历这种感觉，但它服务于有益的进化目的，即提醒我们注意危险，并允许我们保护自己的身体。然而，慢性疼痛并不能达到这个目的，而且可以在没有损伤或组织损伤的情况下持续存在。慢性疼痛是任何持续超过3个月的疼痛的总称，包括各种情况，如骨性关节炎和类风湿性关节炎、纤维肌痛、复杂的区域疼痛综合征(CRPS)、头痛和偏头痛以及慢性背痛[1]。在英国，62%的75岁以上的人生活在某种形式的慢性疼痛中，至少有10%的人这种疼痛是中度到严重的致残[2]。在世界范围内，超过30%的成年人口会受到长期疼痛的影响[3]，然而，尽管患病率很高，人们对其神经机制却知之甚少。由于越来越多的人意识到阿片类药物使用的缺点，最近的NICE治疗慢性疼痛指南强调在患者和临床医生之间建立协作治疗计划[4]。该项目旨在利用机器人学、传感和机器学习的新兴技术来帮助检测和管理慢性疼痛。慢性疼痛可能很难检测和诊断，因为个人的疼痛水平每天都会波动，所以家里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。这也有助于检测随时间变化的健康或机动性水平[5]。然而，如果我们要在家里放置传感器，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，同时仍为最终用户所接受[6]。如果可以感知和理解疼痛，可能就有机会开发出能够做出适当反应并与疼痛管理计划相结合的辅助技术。辅助机器人可能能够通过分散注意力(通过疼痛门控)或使用舒缓的触摸来帮助疼痛管理[8]，后者可以释放催产素来减轻疼痛。使用这些机制的机器人疼痛管理干预已经显示出希望，但很少有人进行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退休村里患有疼痛的老年人一起设计的活动。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开发疼痛管理辅助技术的需求，特别是可接受性、可用性和可获得性。

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.