Comparison of Manipulative Indicators of Students and Therapists Using a Robotic Arm: A Feasibility Study
Round 1
Reviewer 1 Report
This paper presents a comparison study between therapists and students in carrying out therapeutic motion therapy tasks using the SAMO robotic arm. The paper is well organized and presented and thus easy to follow. The experimental procedures are clearly explained with results well analyzed. The conclusions obtained through the comparative studies are sound and informative. Some comments to help improve the quality of the paper are as follows:
- Similar as SAMO robotic arm, many robotic/computer-based medical/surgical simulators or training systems have been used for different purposes, e.g. especially for rehabilitation. The authors may want to briefly introduce such simulators in the introduction.
- There are few expressions not very clear, e.g. the sentence "The onset of the exercise ...“ in Section 2.3 is confusing.
- For figure 3, it is suggested to use colored lines and add in legends for different lines for easier understanding. And the "black circles" and "gray triangles" are just too small to tell the different in shape and it's difficult to tell the color "black" and "gray" as well.
- Figure 4 is low in resolution and thus the lines and circles (more like dots) are vague.
Author Response
Thank you for taking time to review our manuscript and provide helpful suggestions. Our responses to your comments are presented as follows.
Reviewer #1
Comment #1 Introduction
Similar as SAMO robotic arm, many robotic/computer-based medical/surgical simulators or training systems have been used for different purposes, e.g. especially for rehabilitation. The authors may want to briefly introduce such simulators in the introduction.
Response to Comment #1
We acknowledge that we did not describe simulator robots in detail. Therefore, we added text as follows; “In the medical field, trainees can safely acquire surgical skills by using VR simulator [6]. In the field of dentistry, it is considered effective to perform simulation education and technical evaluation [7–9] using patient robots capable of autonomous tongue movement, salivation, vomiting reflex, and simple conversations. The authors report that students responded poorly to emergency; the robot patient is also useful in dental education for medical emergency training and assessment for situation management and differential diagnosis [7].” (Page 1, Line 37–43)
Comment #2
There are few expressions not very clear, e.g. the sentence "The onset of the exercise ...“ in Section 2.3 is confusing.
Response to Comment #2
We have revised sentence as follows: “The onset of the exercise was defined as the time when the angular velocity became 50 ms or more from the time of rest before the start of the task.”. (Page 4, Line 159–160)
Comment #3
For figure 3, it is suggested to use colored lines and add in legends for different lines for easier understanding. And the "black circles" and "gray triangles" are just too small to tell the different in shape and it's difficult to tell the color "black" and "gray" as well.
Response to Comment #3
We appreciate this important observation. Hence, we have revised the figure legend as follows: “The red dots represent the standard elbow joint angle rate of therapists. The blue dots represent the standard elbow joint angle rate of students. The solid red line represents the regression curve for the therapists, and the solid blue line represents the regression curve for the students.” (Figure 3, Line 214–217)
Comment #4
Figure 4 is low in resolution and thus the lines and circles (more like dots) are vague.
Response to Comment #4
We appreciate this observation. We acknowledge that Figure 4 might have a lower resolution. However, it was difficult to increase the resolution; hence, we revised the colors as well. (Figure 4, Line 272)
We have summarized our responses above. Thank you for your consideration.
Reviewer 2 Report
The work presented in this manuscript is interesting for rehabilitation training purposes. The authors have written this paper in good English.
However:
A simple hardware diagram of the SAMO therapeutic arm motion evaluation and training system could, at least, be described since the invention is already patented.
The software application developed, as seen in figure 2, could be presented with more detail, in another detailed figure. Is impossible to see the software application in figure 2.
Hence, the paper should be extended with more hardware/software details, that don't compromise the patent.
Units are missing in table 2 and table 3.
The conclusions should also be extended.
Author Response
Thank you for taking time to review our paper and provide helpful suggestions. Our responses to your comments are presented as follows.
Reviewer #2
Comment #1
A simple hardware diagram of the SAMO therapeutic arm motion evaluation and training system could, at least, be described since the invention is already patented. The software application developed, as seen in figure 2, could be presented with more detail, in another detailed figure. Is impossible to see the software application in figure 2. Hence, the paper should be extended with more hardware/software details, that don't compromise the patent.
Response to Comment #1
Thank you for to this helpful comment. We have added hardware/software details in the revised manuscript as follows: “SAMO has an arm structure section, an actuator section driving the arm, an application for controlling the actuator, and an application section for recording and analyzing the external force received by the arm from a person’s hand. The arm structure has a right humerus, radius, and ulna that are vacuum-casted from aluminum alloy, as well as a hand part made of resin. The arm frame and actuator are driven by tightening wires, which are active core wires passed through a hollow sheath. The actuator uses a hybrid stepping motor with an encoder made by Vanguard System (ST-Servo System), and voltage values obtained from the actuator can be converted into joint angles, angular velocity, and force for recording. Articular movement reproduces elbow joint flexion and extension, forearm pronation and supination, and wrist flexion and extension. Skin and subcutaneous soft tissue covering the frame are made from resin mixed with silicon and polyurethane. The application controlling the actuator uses LabVIEW (National Instruments) and records programs driving the actuator to express spasticity, rigidity, and flaccidity in patients with impaired movement. An application for analyzing arm motion information can convert the exercise therapy applied to the arm by a person into joint angles, as well as actuator voltage values into force; the application then records the conversions. In addition, it can promptly analyze the articular movement applied by a person to the arm and display it.” (Page 2, Line 54–71; Figure 1, Line 95–104)
Comment #2
Units are missing in table 2 and table 3.
Response to Comment #2
Thank you for your helpful comment. We have added the units to Tables 2 and 3.
Comment #3
The conclusions should also be extended.
Thank you for this important suggestion. We have revised the Conclusion section as follows: “The purpose of this study was to compare the therapeutic motion techniques of therapists and students by using a robot set to simulate different degrees of muscle tone pathology; we also aimed to clarify the motor elements that should be taught to students. To the best of our knowledge, this study is the first to clarify the features of the therapeutic motion techniques used by skilled therapists for various muscle tones and provide them as an index of practice for students.”. (Page 10, Line 346–351)
We have summarized our responses as described above. Thank you for your consideration.
