Therapist-Robot-Patient Physical Interaction is Worth a Thousand Words: Enabling Intuitive Therapist Guidance via Remote Haptic Control

Robotic systems can enhance the amount and repeatability of physically guided motor training. Yet their real-world adoption is limited, partly due to non-intuitive trainer/therapist-trainee/patient interactions. To address this gap, we present a haptic teleoperation system for trainers to remotely guide and monitor the movements of a trainee wearing an arm exoskeleton. The trainer can physically interact with the exoskeleton through a commercial handheld haptic device via virtual contact points at the exoskeleton's elbow and wrist, allowing intuitive guidance. Thirty-two participants tested the system in a trainer-trainee paradigm, comparing our haptic demonstration system with conventional visual demonstration in guiding trainees in executing arm poses. Quantitative analyses showed that haptic demonstration significantly reduced movement completion time and improved smoothness, while speech analysis using large language models for automated transcription and categorization of verbal commands revealed fewer verbal instructions. The haptic demonstration did not result in higher reported mental and physical effort by trainers compared to the visual demonstration, while trainers reported greater competence and trainees lower physical demand. These findings support the feasibility of our proposed interface for effective remote human-robot physical interaction. Future work should assess its usability and efficacy for clinical populations in restoring clinicians' sense of agency during robot-assisted therapy.