Seal Robot, PARO
as Neurological Therapeutic
Medical Device
for Dementia Patients
Takanori Shibata
National Institute of Advanced Industrial
Science and Technology (AIST), Japan &Tokyo Institute of Technology &Massachusetts Institute of Technology

Therapeutic Seal Robot: PARO

Contentsz Seal Robot, PAROz Robot Therapyz Results of Clinical Testsz PARO in Disaster Areas in Japan

Animal Assisted Therapy/Activity
z Psychological Merits
y Cheery Motivationz Physiological Merits
y Stress Reductiony Rehabilitationz Social Merits
y Encourage Communication

Problems of Owning Animals
z Allergies
z Bitesz Infectionz House regulationDifficult to introduce!

Model: Baby of Harp Seal

Seal Robot, Paro,for Therapy 8th Generation
CPU
32bit RISC
Voice Recognition
Learning Functions:•New Name•Change Behavior

Audition
Microphone×3

Size:

Vision

L:550 x W:290x H:180 mm
Weight: 2.7 kg

Light Sensors
×2Touch・Ubiquitous Surface Tactile Sensor ×12
・Whisker Tactile Sensor
・Artificial Fur(Anti-biotic)

Posture Sensor

Actuator×7neck(2), each front fin(1), rear fins(1),each eyelid(1)PARO’s Inside (X-ray in NY, 2006)

Safety and Dependability
CE, RoHS, and other regulationsz Anti-bacterial, Hair-Loss Prevention, and Soil
Resistant Finish in Artificial Furz Electromagnetic Shieldz Coping with Strong Force by Humansz Easy Usage and Maintenancey One Switch and Pacifier Type Battery Chargerz Tough Structurez Drop Testz Stroking Test (100,000 times)z Anti-Electrostatic Voltage Test (20,000 Volt)

Technical Points

Ubiquitous Surface Tactile Sensor

Automatic Chip Mounter

Six Layered Print Circuit

Aesthetic Pointsz Kansei (Sensibility)
y Touch: Texture and Softness
y Holding: Wight, its Balance, and Warmnessz Designy Appearancey Sound sampled by a real baby harp seal inCanadaz Handmade for its Quality
y Eyelashy Trimming: Each Paro has its own Face

Paro Factory

Toyama, Japan

Japanese Alps in Toyama

Japanese Alps from Ocean

Mountains

UNESCO World Heritage
Michelin ★ ★ ★

Integration of Art and Technology 1in Nanto, Toyama, Japan
Japanese Paper
1200 years oldGokayama, a World Heritage
Shosoin(Emperor's Treasure
Warehouse)in Nara和紙
１２００年以上の歴史
奈良・正倉院にも保管されている
日本に和紙が伝わった直後には五箇山での生産が始まっているIntegration of Art and Technology 2
in Toyama, Japan

Karakuri DollFestival of Decorated Floatswith Gold, Silk, Woodcraft, etc.
300 years oldIntegration of Art and Technology 3in Toyama, Japan
Woodcraft
260 years

Aesthetic Points
Handmade for Quality

EyelashesTrimming

Musee des arts Decratifs, Louvre
Paris, France (Dec., 2008)

Museum of Modern Art (MoMA) NYFeb. 21st and 22nd, 2009

Japan EXPO in Paris, France
July 7-8, 2012

Expectation to PARO by Questionnaires
to 2000 people in 7 Countries
PetJapan
Korea

USBrunei

SwedenItaly
UKTherapy

Paro on the World Map(in about 30 countries)

Place where Paro has been used

About 3000 PAROs in Practical Usez 2000+ PAROs in Japan since 2005
y 60% are individuals, and 30% are institutionsz About 300 PAROs in Denmark since 2009
y 70%+ municipalities adopted PAROs

z NL, SE, DE, CH & other European countries
y 100% are institutionsy Seminar and Certificationy Health Insurance of Niedersachsen, Germanyz In the US, since Dec. 2009y Medical Device by FDA

Robot Therapy at Karolinska Hospitalin Stockholm, Sweden (Oct. 2003 - )Astrid Lindgrens Pediatric Hospital

LIVABoston Higashi School for Childrenwith Autism (Feb. 26, 2009)

Cancer PatientsChemotherapy with PARO

20 Women with Ovarian Cancer (49-71: ave. 67)
Chemotherapy for 3 – 5 hours
Interaction with PARO reduce・Pain (P = .04), Fatigue (P = .034), Anxiety (P = .036)
・9 factors of Quality of Life on Health (P = .03)
UC Irvine and Long Beach Memorial Hospital, CA, USA(Society of Gynecologic Oncologists (SGO) 44th Annual Meeting on Women's Cancer, 351, 2013)

Aging Societies

Aging Society
7%Dementia
10%
10%
50%
30%

In Japan
4.6 M People with Dementia
4.0M Mild Cognitive Impairment

アルツハイマー型認知症
血管性認知症
レビー小体型認知症その他33

Observed Effects for Elderly with Dementia
z Improved Communicationz Improved Sociabilityz Reduced Aggression
z Reduced WanderingAlzheimer Patient with Anxiety(Italy, since Feb. 2005)

Wandering Person by Dementia(Italy, since Feb. 2005)

Sundown Syndrome(Alzheimer's Disease, 97y Female)PARO for Sundown Syndrome

高齢者の履歴・行動を分析：
・最初はパロを嫌がった
・過去に犬を飼っていた
・「さぶろう」という名前の犬・パロに「さぶろう」の名前
・「さぶろう」のお世話を依頼
・定期的なふれあいを開始

帰宅願望時
・パロとのふれあい・不安の軽減・精神的安定・介護者の負担を軽減
・他の利用者へも目配りSuppression of BPSD
(Behavioral and Psychological Symptoms of Dementia)

Dementia Behavior
Disturbance Scale:(DBD)
・ＢＰＳＤがひどく家族が介護困難に・ＧＨへ、家族は面会拒否
・パロによりＢＰＳＤを抑制
・家族の面会が再開したRobot Therapy for Demented Elderly

DIMENTION:
EEG Method for Estimating Neuronal Impairment

Procedure of Experiment

EEG recording(3 min)Robot Therapy(about 20 min)

EEG recording(3 min)Dementia

non-uniform neuronal impairment

unstable distortion of the scalp potential
distortion parameter=D; instability parameter=D

normalnormalAlzheimer

Dσ: SD of smoothness fluctuation

Experimental Results(IEEE EMB Magazine)(14 subjects)

Impaired

7 patients were improved!
Sub-normalNormal
Dα: smoothness of scalp electrical potential distribution

Relationship between Impression of Paroand its Efficacy on 11 PatientsStudy designParticipants：
10 healthy participants (8 males and 2 females)
Aged 21-33

MethodzSet up the NIRS probes on theparticipants’ head mainly frontal
lobe areazExamined brain activity of 35
channel areas by fNIRS(OMM2001, Shimazu Corporation)

Study design2zStress task: Word association
It was conducted to balance the participants’brain activityzExperimental tasks: Paro ON/OFFParticipants were instructed to interact withParo physically and verballyzEach task had one minute and there wereone minute rests conditions before and afterthe tasks

Brain activity during Paro ON
compared with before the task

channel 5, 11, and 12 were significantly activated (p<0.05) in PARO ONtask compared with before the task

Recovery of Speech by Biofeedback
through interaction with PARO
An immigrant from the eastern EU who lost speech in Danish by dementia

Patient talks to PARO in Danish

She can talk with others in Danish

Dementia Center,Copenhagen, Denmark

From 2006 to 2008, PARO was tested.
70 out of 98 municipalities have been using PARO

PARO in DenmarkJun 2011 (NHK Today’s Close Up)Seminar for Therapists andCare Givers by DTI

Users Meeting in Denmark

Collection of Data
DTIAIST

Other Area (in Denmark)

Down Syndrome & Dementia

Brain Injured Patient

The Usage of PARO for Elderly who need Help at Home•

In the beginning of 2012, 12 PARO’s were introduced in the home careservice.

•Procedure of introducing PARO in the home of elderly people who needhelp:• Identification of elderly citizens who may benefit from PARO
• Inform and seek permission from relatives before introducing PARO
• Bring PARO to the home of the elderly when visiting to provide a
specific service related to personal or practical help

Source: Danish Technological InstituteGroup Home in Amsterdam, Netherlands
Since July 2007

Distribution of PARO since 2011
100 Paros at about 70 institutions

Clinical Testby ZUYD Univ.

Nursing Homes in Germany
since Nov. 2006
Christinen-Stift, Baden-Baden

Pflege- und Therapiezentrum,
Lehre-Wendhausen

Press Release in GermanyHealthcare Insurance Covers Mobile
Service with PARO in Land Niedersachsenz Wolfsburg AG, asubsidiary of Volkswagen,started to provide mobileservice with PARO forelderly with dementia athome since May 2012

Donation of Paro from BBVA toQueen of Spain, Sep. 21, 2009

Certification of Medical Device
by FDA in the US in Sep. 2009Vinson Hall, McLean, VA, US

Greenwich Woods Health Care
Center, CT

Pictures by “Greenwich Time”
On July 18th, 2011
Others: Greenwich Post

Cases in the US

VCS Elderly Institution
In Pittsburgh

VA Medical Center
In Washington DC

Document SystemNews Video (Dec. 23, 2010)
Marian Manor, Pittsburg, PA

TOTAL RESIDENTS WHO TRIGGERED(from Marian Manor and Vincentian Home)

2015DEPRESSION
BEHAVIOR

1050
1st Qtr - 2010

2nd Qtr- 2010

VA Palo Alto Health Care System
PARO Study・Clinical Test at Four Locations
・Development of Protocol of UsageResults at VA (presented APA 2012)
Negative Behaviors and PRNs
Neg. Behaviors

newpreimproved

PRNs
14 male residents
VA PAHCS in Menlo Park
47 Observation for 10 months
usedavoidednotconsideredVisitation Therapy by Passage Hospicesin Illinois and Michigan
Visitation Therapy: 400+ nursing homes
Elderly: about 6,000
Records: cases

Tower Hill Health Center
South Elgin, IL(by Daily Herald)

Atrium Health Care andRehabilitation Center
Cahokia, IL

RCT by Auckland Univ., NZ
N=40

PARO is capable of improving loneliness in older people

JAMDA: Journal of the American
Medical Directors Association

PARO should be considered in future care plan

Griffith Univ., Brisbane, AUz RCT (Randomized Controlled Trials)
z N=18, QOL-AD and Pleasure are improvedz Large Scale RCTCover Page of Australian Journalof Dementia Care (Oct./Nov., 2013)
Prof. Wendy Moyle
Board Member of
ICD-11
Classification of Behavioural andPsychosocial Symptoms ofDementiaWHOLancet Neurology
Sep. 2013

Shatin Hospital, CUHKz Therapy for Out-patient Dementia by OTs
z Evaluation of Therapeutic Effectsz Developing Protocol

PARO as a Staff of
Day Care Service Center, ELCHK

9th Generation of PAROs arecoming soon

The Endparo.jp