Leo is 10 years old and suffers from butterfly skin syndrome, a very rare degenerative disease (only 12 children in Seville have it) for which there is no treatment or cure. This pathology, which usually appears at birth, is characterized … due to excessive fragility of the skin and mucous membranes with minimal mechanical trauma and brings infectious, nutritional or neoplastic complications that significantly limit life expectancy. The wounds Leo has don’t close (close). he closes his hands because his skin grows slower than his bones) and the daily treatments his mother has to give him are very painful. “He hates them, but he just has to get used to them,” says his guardian angel Lidia, who has cared for him since she brought him into the world and whose obsession is to make life easier for him with limited cards. was given away. And this is where Juande comes into play, a less than half-meter robot based on artificial intelligence created by the Spanish startup Inrobics.
“Juande is a friend,” says Leo, who has been “treating” him for several weeks at the early care unit of San Juan de Dios Hospital in Seville. Juande, whose name is inspired by the Order’s founder, helps Leo do exercises that improve his physical condition that he wouldn’t otherwise do with a human being, at least not in the same way he admits. Maria Jesus Elena, an occupational therapist at the health center who has worked with him for years. “He didn’t try so hard with us, he increased his demands and is progressing faster.”
Juande is a dancing and chatty robot that encourages him to move and dance, which makes Leo smile with the slow steps he takes to the beat of the music with his very thin legs completely bandaged. ON Juande His eyes glow with different types of lights and colors tailored to the patient’s reactions and he moves his neck, arms and hands. In a childish, humanized voice, he asks Leo to repeat some of the prescribed moves, which he does without question. Since there is a time for everything, Juande marks it out to Leo to do it right. Everything is recorded on the hard drive of this robot’s computer, and with all this data, therapists measure with greater precision the rehabilitation process of their patient, their strengths and weaknesses, where there is room for improvement and where not.
Upstairs, Leo is doing the prescribed exercises that Juande is giving him to improve his joints and motor skills. Below are two pictures at the Early Care Unit of Hospital San Juan de Dios in Seville. On the right with Lidia, her mother
Leo likes dancing the most and Juande She encourages him to do so by playing a song. Seconds later, the robot contorts and pretends to play an imaginary guitar, something its patient imitates almost immediately.
-Music drives me crazy. I love dancing! – shouts Juande and blinks the lights of his eyes, in which two micro-cameras are inserted.
And Leo is encouraged.
Dancing is one of the recommended exercises for improving joints and motor skills. Although Juande’s versatility is considerable (he walks, turns, crouches, moves his arms and shoulders), even with his limitations, he does not surpass Leo’s. And he still doesn’t know how to laugh like his patient. “I spend this time withnJuande is one of the best of the day« Leo acknowledges.
If the robot’s movement is very demanding and it cannot follow, it is reprogrammed. But always with the idea that he is progressing and will eventually achieve it. And make it fun and without it hurting like it does with other daily activities. “Raise your arms above your shoulders and repeat all the movements in sequence until time runs out,” the robot asks you. If he doesn’t get it right, he tells Leo how he should do it: “Look, that’s how it was,” he tells him unapologetically.
When the exercise is over, he gives Juanda a break and Leo sits down and rests. “I got a cramp,” He complains, smiles and is happy with himself despite the pain. His “friend” tells him he’s tired too and stops. “This creates self-esteem and empathy with the robot,” says Rocío. Carrascocoordinator of the San Juan de Dios Early Care Center in Seville.
“You make me do push-ups and a lot of things with my arms, hands and legs,” Leo praises him.
“You know,” replied the robot.
-I’m driving you crazy. “You’re a crack, Juand,” the boy insists.
“Leo dances better than me,” Juande replies, moving his metal hands.
Lidia says that her son’s illness, especially his injury, means he doesn’t move much and leads a relatively sedentary life, juThis is what Juande tries to avoid. Leo takes a virtual version of this robot to his tablet so he can do more exercises at home. He is the first of 200 children he “treated”. This child pioneered its use and will pave the way for the remaining 199.
“Robotics used with patients in the healthcare field have traditionally been medical, i.e. those that achieved improvement in the patient through physical contact. We are talking, for example, about exoskeletons. However, Juande is a social care robot, i.e. a technology with the concept of care, but which involves social interaction that until now has not been maintained by a machine with a patient. Juande calls patients by name and can have a close conversation with them, tailored to each child’s circumstances, and that humanizes it,” explains José Carlos Pulido, CEO of Inrobics, a digital health company focused on the rehabilitation sector and supporting people’s quality of life.
Rocío says that since 2019 they have been looking for an electronic device that would allow them to better measure the movement progress of their pediatric patients. “We looked at Curro, a playful robot from Virgen del Rocío Children’s Oncology, who danced and entertained the admitted children, but we needed to go a step further, something beyond playfulness. lWe have been designing this project since last year. and our intention is that based on recreational activities for children led by this robot, it will be possible to perform a series of functional physical exercises that improve the quality of life of our patients. All these movements are perfectly programmed to improve functionality or avoid or in any case slow down the deterioration caused by a degenerative disease like Leo. Thanks to artificial intelligence, the device will measure all the progress, success or failure of any activity and draw attention to shortcomings, and we can improve the level of the program for each session,” explains the therapist.
He explains that in the early care unit «Our patient is very young, which means special conditions in therapy: we do not always get adequate cooperation from them, they do not tolerate external measurement mechanisms, the attention span and task implementation is very short.
Therapists needed technology that could measure progress in mobility, so they needed other software that would allow them to dynamic measurement, through exercises or choreography with the little ones. The acquisition of the robot and the first steps were taken thanks to the contribution of the company, Cuatrogasa Group, at the social work of San Juan de Dios in Seville. Rocío Carrasco discovered that the San José Institute Foundation was working on projects for brain-damaged patients and for adults at its day center with Inrobics And that’s when the Juande project began to take shape.
“For several years now Saint John of God and Inrobic “We worked closely together to translate the specific requirements of these therapies with children into the software,” explains José Carlos Pulido.
Leo would like to take his “friend” to school one day, and the therapists at San Juan de Dios agree to take him out of the hospital if he completes the exercises well. Leo studies at school Paul VI, from Amate and his mother is happy with his integration into the center.
Juande has already been tested with more than 200 children in five Andalusian hospitals of San Juan de Dios. Children with disabilities, attention deficit disorders or autism spectrum disorders (ASD). “Autistic children love Juande and so do others with cerebral palsy. NIt will help you a lot to work on the functionality and it imitates, for example, the movements of brushing the teeth or the face. It’s just another therapeutic tool, but it turns out to be super motivating for the kids because they see it as a game,” explains María Jesús Elena.
If one of Leo’s best moments of the day is dancing with Juande, the worst is undoubtedly the treatment and the bath afterwards. “When I do them, he tells me that it hurts a lot and that he is sufferingsays his ecstatic mother, who says she would change for him with her eyes closed. “Bath time is also very bad because the water hurts. When he was younger, he heard the word bathroom and his face changed.’
His body has open wounds that won’t close and are very itchy. “We’ve tried everything, but nothing works. This is perhaps the worst thing about this disease because there is nothing that can make it go away. And when he scratches himself, he gets blood and a wound,” says Lidia.
Leo has the worst version of epidermolysis bullosa, ( “recessive dystrophic”) and his mother knows it won’t get better. “They’re losing their hands, they’re shutting down. And the wounds keep getting bigger and bigger when new ones don’t appear. “That’s why the time he spends with the robot is so important to him, in which he has so much fun and looks so happy, in addition to helping him improve his joint movement.”
Lidia confirms that her son is thinking Juande a friend with whom you can play and have fun. “That’s why we’re very pleased with this new therapy,” he says.
The human component never disappears, as these are guided sessions with an expert who determines therapeutic goals and prescribes treatment based on these results. «It is a three-way interaction: the child, the therapist and Juande. Professionals have an undeniable role in humanizing these sessions; “They are the ones who know the patients and guide Juande to achieve the best results,” explains Rocío Carrasco.
I’m just getting started
Juande is just getting started in the world of early care. The digital version, which was first tested with Leo’s tablet, will allow children to continue their rehabilitation at home. “There is also a catalog of cognitive activities that can be used, like memory exercises, language comprehension or psychological and emotional exercises,” says Rocío Carrasco.
