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

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.

We will collaborate with over 40 partners drawn from across FMCG and Food; Creative Industries; Health and Wellbeing; Smart Mobility; Finance; Enabling technologies; and Policy, Law and Society. These will benefit from engagement with our CDT through the following established mechanisms:

- Training multi-disciplinary leaders. Our partners will benefit from being able to recruit highly skilled individuals who are able to work across technologies, methods and sectors and in multi-disciplinary teams. We will deliver at least 65 skilled PhD graduates into the Digital Economy.

- Internships. Each Horizon student undertakes at least one industry internship or exchange at an external partner. These internships have a benefit to the student in developing their appreciation of the relevance of their PhD to the external societal and industrial context, and have a benefit to the external partner through engagement with our students and their multidisciplinary skill sets combined with an ability to help innovate new ideas and approaches with minimal long-term risk. Internships are a compulsory part of our programme, taking place in the summer of the first year. We will deliver at least 65 internships with partners.

- Industry-led challenge projects. Each student participates in an industry-led group project in their second year. Our partners benefit from being able to commission focused research projects to help them answer a challenge that they could not normally fund from their core resources. We will deliver at least 15 such projects (3 a year) throughout the lifetime of the CDT.

- Industry-relevant PhD projects. Each student delivers a PhD thesis project in collaboration with at least one external partner who benefits from being able to engage in longer-term and deeper research that they would not normally be able to undertake, especially for those who do not have their own dedicated R&D labs. We will deliver at least 65 such PhDs over the lifetime of this CDT renewal.

- Public engagement. All students receive training in public engagement and learn to communicate their findings through press releases, media coverage.

This proposal introduces two new impact channels in order to further the impact of our students' work and help widen our network of partners.

- The Horizon Impact Fund. Final year students can apply for support to undertake short impact projects. This benefits industry partners, public and third sector partners, academic partners and the wider public benefit from targeted activities that deepen the impact of individual students' PhD work. This will support activities such as developing plans for spin-outs and commercialization; establishing an IP position; preparing and documenting open-source software or datasets; and developing tourable public experiences.

- ORBIT as an impact partner for RRI. Students will embed findings and methods for Responsible Research Innovation into the national training programme that is delivered by ORBIT, the Observatory for Responsible Research and Innovation in ICT (www.orbit-rri.org). Through our direct partnership with ORBIT all Horizon CDT students will be encouraged to write up their experience of RRI as contributions to ORBIT so as to ensure that their PhD research will not only gain visibility but also inform future RRI training and education. PhD projects that are predominantly in the area of RRI are expected to contribute to new training modules, online tools or other ORBIT services.