Interview

Introduction to Demonstration Research on Robotic Devices for Nursing Care

In today’s super-aging society, we face the challenge of a labor shortage in the nursing care field. While demand for robotic devices for nursing care is increasing, they have yet to spread widely. Among the various applications of robotic devices for nursing care, electric walkers used as mobility aids for the elderly and disabled in their daily lives can be very useful for enhancing mobility independence and expanding the range of activities. In the development and manufacturing of robotic devices for nursing care such as electric walkers, demonstration research is conducted to verify the effects of device use, with the aim of developing safer, more functional devices and putting them into use at nursing care sites.
For this article, we spoke with Yusuke Shikayama, Director and COO of RT. Works Co., Ltd., about the demonstration research on the electric walker developed by his company, including its effectiveness as well as publication and utilization of the research results.

Making use of the subsidy from the Ministry of Economy, Trade and Industry’s “Project to Promote the Development and Introduction of Robotic Devices for Nursing Care,” we conducted demonstrations at multiple nursing care facilities. With the cooperation of Aichi Medical University, other research institutions, and nursing care facilities, our demonstration project involved 54 cooperating facilities, 98 devices, and a 3-month implementation period. The purpose was to compare the effectiveness of the electric walker to conventional walkers.
While there have already been evaluations of the effectiveness of conventional devices for nursing care, these have mainly relied on subjective evaluations obtained through surveys. Although it was possible to gather opinions in specific environments, this was insufficient to evaluate a device that is widely used at various care sites and under various usage environments. Therefore, in this demonstration, we adopted a quantitative approach. Based on verification through “goal-oriented nursing care,” we quantitatively measured how the “daily life goals” and “activities” of both care recipients and caregivers changed before and after introduction of the devices, and we scientifically verified the results. We evaluated the activity range using GPS location information and acquired data on walking time and conditions using walking visualization applications. As a result, we found that use of electric walkers as a means of daily living improves quality of life for a wide range of subjects, from those requiring care levels 1 to 5. Additionally, through observation of usage scenes, we identified a need for the ability to sit and rest while outdoors, which led to improvements in the productization of RT.1 by adding a chair for resting.
In this way, conducting field demonstrations during the development phase enabled us to discover and incorporate necessary functions, which led to the utilization of such demonstration results to confirm our designs, which were based on the needs and use cases we assumed prior to market launch.

We believe that our conducting of large-scale demonstrations with a hundred units in multiple facilities across diverse regions was effective in providing reassurance for both the facilities introducing the device and for the users of the device.
These demonstrations were carried out collaboratively by three groups: the manufacturer, intermediaries such as rental service providers, and the nursing care facilities that served as demonstration sites.
As the application deadline was tight, it was challenging to assemble all three groups and form a team for entry, because this required coordination from each company. However, conducting trials together with distributors such as rental service providers led to deeper understanding and more interest in the product itself as well as practical use by said distributors.
We found this to be a good aspect of the demonstrations, as it was very effective in establishing the post-market distribution system.

In the “Project for the Development and Standardization of Robotic Devices for Nursing Care” conducted by the Japan Agency for Medical Research and Development (AMED), we conducted demonstration research from a clinical perspective by providing the device (RT.2) to Ouchi Hospital.¹
This research included measurements taken with the InbodyS10 body component analyzer (which showed a significant increase in muscle mass), measurements of QOL scores (which showed a significant improvement in the quality of social life), FIM scores (which showed that users maintained a high degree of independence in daily living after discharge), and mGES scores (which showed a rising improvement in users’ degree of confidence in their ability to walk safely in their daily living environments). In this way, we could analyze data that had not been collected in previous demonstrations, such as data on improvement in physical condition through electric walker use and associated psychological satisfaction scores.

We present the results of the demonstration research in catalogs, brochures, and product websites.
In addition, we have collaborated with Professor Takashi Yamanaka (specially appointed associate professor, Graduate School of Medicine, the University of Tokyo), who participated in “(3) Utilization of the demonstration research from a clinical perspective,” to undertake activities to increase awareness regarding our electric walker by holding seminars for care managers, explaining and introducing the targets and effects of the electric walker, and sharing points to note when using the device.

How to utilize the objective data obtained from the demonstration research depends on the phase. In the early phases of development, we provide feedback for development; after product release, we utilize the results for promotion and product improvement.
The numerical data acquired, in addition to serving as a reference for product development and improvement, also made it easier to promote the device’s usefulness.

While electric walkers will not replace all walkers, they can serve as a means to address needs that existing non-electric devices cannot fulfill.
To deliver products that meet needs and increase awareness regarding electric walkers, we believe that demonstration research is effective for promoting the differences and advantages compared to conventional walkers from both qualitative and quantitative perspectives.

We also feel that it is important to tailor how the research data is presented according to the intended audience.
For example, therapists find quantitative data useful, while presenting care managers with qualitative data, such as specific cases and episodes, makes it easier for them to imagine the effects on their clients.

1) Medical Corporation Daiwakai Oouchi Hospital
[References]

• Ministry of Economy, Trade and Industry, “Demonstration Project for the Introduction of Robotic Devices for Nursing Care from FY2013 to FY2017”
• Japan Agency for Medical Research and Development (AMED), “FY2018 Project for the Development and Introduction of Robotic Devices for Nursing Care”