25th IEEE International Symposium on
Robot and Human Interactive Communication (RO-MAN)
August 26-31, 2016. Columbia University, NY, USA
Design of a Bath Robot System – User Definition and User
Requirements Based on International Classification of Functioning,
Disability and Health (ICF)*
Jochen Werle and Klaus Hauer, Non-Member, IEEE
Abstract — The International Classification of Functioning,
Disability and Health (ICF) provides an internationally
established conceptual framework to describe and assess
functions and disabilities of a person in several health domains.
It will guide the technical design of the system functionalities of
the I-Support bath robot system. Based on the ICF we describe
a comprehensive model of impairments, limitations and user
requirements, which are the basis for the definition of use case
scenarios from a clinical perspective. At the end, we present a
brief description of technical specifications used for the I-
Support bath robot system and also provide information on
hardware configurations and their feasibility.
I. INTRODUCTION
Health care in old age is becoming increasingly important
due to the current socio-demographic changes as well as the
development in health policy. The primary aim in health care
is to ensure that peoples’ lives are as healthy and independent
as possible while maintaining the highest possible quality of
life. Furthermore, the quality of medical and nursing care as
well as an adequate and safe home environment is of high
relevance.
Technical innovations, e.g. Ambient Assisted Living
(AAL) systems, offer increasing opportunities for an
independent and self-determined way of life for older people
living at home and in care facilities. The majority of potential
AAL users are chronically ill and frail older persons. Thus,
knowledge about their needs and medical prepositions is
crucial for the collaboration of scientists and technicians. What
is the situation of older people? How are their health
conditions? Which kind of requirements and needs does this
target group have? Which kinds of health problems limit the
use of AAL-systems in daily living?
A clinical model of user requirements for the AAL project
development will need a strong conceptual basis.
Functionalities of the I-Support bath robot system will support
impaired functions of potential users. Thus, we have chosen an
internationally well-established classification and assessment
system to describe these geriatric impairments. The
International Classification of Functioning, Disability and
Health (ICF) represents an efficient tool to assess peoples´
current functional health status (functioning) in daily life (1).
As such, the ICF constitutes a comprehensive concept for
health care planning including multiple dimensions from body
functions and body structures to personal activities, societal
* This project has received funding from the European Union‘s Horizon
2020 Research and Innovation Framework Programme, Societal Challenge 1
(DG CONNECT/H) under grant agreement No 643666, Activity PHC-19-
2014, ICT-Supported Bath Robots.
978-1-5090-3929-6/16/$31.00 ©2016 IEEE
participation and environmental factors (1). It provides the
potential framework for transition along the continuum of care
(2) and recent design studies of AAL tools, primarily based on
analysis of activities of daily living (3, 4).
The loss of function typically begins with those activities,
which are most complex and least basic. Shower and bathing
represent most complex activities of daily living (ADL), and
thus are among the first to be lost within the ageing process
and the last to be regained after acute trauma or medical
interventions such as surgery. Therefore, in the next chapter
we give a brief overview of the epidemiology of functional
loss and bathing disabilities.
II. EPIDEMIOLOGY OF BATHING DISABILITIES
A. Activities of Daily Living
Activities of daily living (ADLs) comprise people's basic
daily self-care activities (5), including mobility (ability to
walk, get in and out of bed, sit on and raise from a chair),
1
bathing and showering (washing the body) , dressing, self-
feeding, personal hygiene and grooming (including brushing/
combing/styling hair), and toilet hygiene (getting to the toilet,
cleaning oneself, and getting back up). The concept of basic
ADLs was extended to more complex activities (Instrumental
Activities of daily Living, IADLs), which require a higher
level of planning and executive functions partly also a higher
motor-functional performance (6). IADLs include among
others housework, preparing meals, taking medications as
prescribed, managing money, shopping, use of telephone, and
transportation (6).
B. Bathing Disability
In community-living older persons aged 65 years and
older, the prevalence of bathing disability, defined as help of
another person, ranges from 4.6% to 6.9% (7). In a
community-dwelling population of 5151 persons aged 70
years and older 12.7% reported bathing difficulties (8). 21%
of community-living persons aged 85 and older received help
performing bathing (9). In an institutionalized elderly
population over 90% of residents received help with bathing
(7).
Gill et al. (10) analyzed data of a prospective cohort study
with community-living older persons aged 70 years and older
(N=754) and published incidence rates of bathing disability.
Within 6 years 58.4% of the participants (N=440) had at least
1
The ADL item „bathing“ includes the use of a bath tub or a shower as
well as taking a complete sponge bath. In the literature, there is no
differentiation between bathing and showering activities.
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one episode of bathing disability, and 34.0% (N=266) had
multiple episodes, with the duration of each episode averaging
about 6 months. The prevalence of bathing disability is higher
in women than in men and increases with age and physical
frailty. The occurrence of bathing disability was strongly
associated with the risk of long-term nursing home admission
(11) and the receipt of home care services (12).
Several studies have assessed the extent to which loss of
function across ADLs progresses hierarchically. The hierarchy
within ADLs was first identified in studies of illness in the
aged. The Index of ADL (5) was developed based on
observations of a large number of activities performed by a
group of patients (N = 1001) with hip fracture. The authors
developed a hierarchy for the observed functions: bathing,
dressing, toileting (going to the toilet), transferring,
maintaining continence, and feeding. Bathing represents the
first ADL to be lost and the first function requiring assistance.
In the following years a number of cross-sectional studies have
evaluated and confirmed the Katz hierarchy. This hierarchy is
representative for older adults in the community, in acute care
settings and in the inpatient rehabilitation setting (8,13,14,15).
Dunlop et al. (16) referred to data from the Longitudinal
Study of Aging (LSOA). The LSOA is a prospective survey of
5151 community-dwelling persons aged 70 years and older
who were initially interviewed in the 1984 National Health
Interview Survey, Supplement on Aging and re-interviewed
every two years ending in 1990. The main result of this
longitudinal study was to define the incidence of disability of
ADL (see Table I).
TABLE I. INCIDENCE OF DISABILITIES OF ADL (16)
Total incidence of disability (in %)
Function Women Men
(N = 1837) (N = 3255)
Walking 38.2 33.5
Bathing 29.9 25.0
Transferring 23.0 18.8
Dressing 14.1 12.7
Toileting 11.5 9.1
Feeding 8.2 6.3
a. Change in disability over six years (1984 to 1990) among elderly without
baseline (1984) disabilities in ADL (n = 2777)
Women consistently experienced higher disability
incidence rates than men for all six activities. For example,
over the 6-year period, the incidence rate for bathing disability
was 29.9% for women and 25.0% for men. The higher
incidence rate, compared to other cross-sectional studies was
esxplained with methodological issues. In the LSOA study,
disability for a specific activity was defined as having
difficulty performing that function. Other studies have used
different definitions of disability, such as inability to perform
an ADL or requiring assistance in order to perform an ADL.
Njegovan et al. (17) studied the hierarchy of functional loss
associated with cognitive decline in older persons (N=5874
community-dwelling persons aged 65 years and older from the
Canadian Study of Health and Aging I and II). This is the first
prospective study using a large representative cohort of elderly
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persons to demonstrate that progressive cognitive decline is
associated with a specific pattern of loss of functional tasks.
Dependency in IADLs occured at higher cognitive scores
compared to basic ADLs with an overlap. Bathing as basic
ADL is comparable to more complex IADL, e.g. shopping,
transportation or meal preparation (17).
For the I-Support project this is a remarkable result.
Bathing, especially with an ICT-supported bath robot system,
is as complex as other IADLs with a high impact of cognitive
functions. In future times, ICT-supported bathing may be part
of the IADL.
III. USER DEFINITION
The user definition for the design of the I-Support bath
robot system will be based on internationally established, valid
and reliable clinical assessment strategies with focus on ADL
deficits and cognitive impairment with established cut-off
values available for the staging of impairment levels.
A. Bathing disability
Dependency in the comprehensive bathing activities
represents the first inclusion criterion for the definition of the
I-Support user group. According to the Index of ADL (5) we
use the Barthel definition of scoring for the item “bathing” to
give a clear dichotomous decision between “independent” and
“dependent”. The BADL item “bathing” of the Barthel Index
(18) will be used as a clear defining criterion for the user group
in the I-Support project.
• Independent: Patient may use a bath tub, a shower, or
take a complete sponge bath. He must be able to do all
the steps involved in whichever method is employed
without another person being involved.
• Dependent: Patient may use a bath tub, a shower, or
take a complete sponge bath only with help of another
person.
B. Cognitive status
For screening of cognitive functions we chose the Mini
Mental State Examination (MMSE) (19), an internationally
well-established screening test for cognitive impairment that
allows comparability to other studies including cognitive
criteria. The test has proven high validity, reliability,
feasibility to be used as a screening instrument (19,20). The
time to administer is about 10-15 minutes requesting only
limited personell resources for assessment. For a screening
tool, the MMSE allows a rather comprehensive documentation
of cognitive sub-performances including memory (early-late
recall, working memory), executive- and semantic
performances, orientation in time and locus.
For the I-Support user definition we will use established
cut-offs (19) with 24-30 scores to define persons without
cognitive impairment and scores ranging from 18-23 to define
persons with moderate impairment.
As we start with the development of a new service robot
we suggest not including persons with advanced or severe
cognitive impairment levels (MMSE <18), as those will be
overtaxed by managing the assistance of the I-Support bath
robot system or may need a far more complex handling
support.
 For the I-Support validation studies we will include people
with a dependency in bathing and showering activities. Within
this population persons with severe cognitive impairments
(MMSE < 18) are excluded.
IV. MODELING OF USER REQUIREMENTS AND USE CASE
SCENARIOS
The World Health Organization (WHO) has developed
two reference classification systems to describe the health
status of a person at a particular point in time. Diseases and
other health-related concerns are recorded with the
International Classification of Diseases (ICD-10). ICD-10 is
the standard diagnostic tool for epidemiology, health
management and clinical purposes. It is used to monitor the
incidence and prevalence of diseases and other health-related
problems (21). Medical therapies in acute events such as
stroke, heart attack or fractures, request strictly disease-related
therapy pathways.
A. International Classification of Functioning, Disability
and Health (ICF) as framework for modeling user needs
In contrast, the International Classification of Function,
Disability and Health (ICF) comprises health domains and
contemplates individual health conditions with its effects on
daily life. The ICF represents a holistic, integrated bio-psycho-
social model of human functioning and disability (1).
In terms of ICF a person is (functionally) healthy, if her/his
entire background (concept of context factors)
• her/his body functions and body structures correspond
to generally accepted (statistical) standards (concept
of body functions and body structures),
• she/he is able to do all the things, which are expected
from people without health problems (concept of
activities), and
• she/he can unfold her/his entity in all areas of life in a
way it is expected from non-disabled people (concept
of participation in areas of life).
Within the ICF, the term “disability” denotes the negative
aspects of the interaction between a person’s health
condition(s) and the individual’s contextual factors. Thus,
disability is used as an umbrella term for body impairments,
activity limitations and participation restrictions (1).
Diseases as well as changes due to the ageing process are
associated with disabilities resulting in persisting or temporary
somatic changes of body functions and structures (concept of
impairments) as well as psycho-social changes affecting
activities (concept of limitations) or societal participation
(concept of restrictions). Contextual factors may affect
functional health/disability in a positive (facilitators) or
negative way (barriers).
The ICF model of disability and the relationships of its
health domains are represented in Figure 1.
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Figure 1. The ICF model of disability (according to WHO, 2002)
In summary, functional health/disability of a person
represents the result of the interaction between the persons´
health conditions (ICD) and her/his perceived contextual
factors. Contextual factors represent the complete background
of an individual’s life and living. They include two
components: environmental factors and personal factors.
Environmental factors comprise the physical, social and
attitudinal environment in which people live and conduct their
lives. Personal factors include, among others, gender, race,
age, other health conditions, fitness, lifestyle, habits, coping
styles, social background, education, profession, past and
current experience (past life events and concurrent events),
overall behavior pattern and character style, individual
psychological assets and other characteristics (1).
It is the changes of body functions and structures
(impairments), which are specifically targeted in a
rehabilitation process and it is these changes that trigger the
design of the I-Support bath robot system. Therefore, in the
next section we give a short overview of the ICF strategies to
assess functions and disabilities.
B. Assessment of functions and disabilities – ICF Core Sets
The ICF provides the comprehensive framework to
describe and assess functions and disabilities of a person in
several health domains. ICF codes utilize an alphanumeric
system to describe health and health-related domains, with the
following letter codes: b=body functions, s=body structures,
d=activities and participation, e=environmental factors.
The letters are followed by a numeric code that starts with
a one digit chapter number followed by a second level denoted
by two-digits, and third and fourth levels represented by one
digit each. (1).
Comprising over 1400 second-level categories, the entire
volume of the ICF cannot be applied by the clinicians to all
their patients. In order to enhance the applicability of the ICF
in clinical practice and research as well as to overcome
practical concerns relating to the high number of categories
provided within the ICF, the development of ICF Core Sets
was recently initiated by the ICF Core Set projects (22). Those
comprehensive ICF Core Sets were created to provide
standards for a multi-professional comprehensive patient
assessment, and to include the typical spectrum of problems in
functioning encountered in different patient populations (23).
 The ICF Core Set development involved a formal decision- As displayed in Figure 2, we identified six main categories
making and consensus process, integrating evidence gathered of functional impairments that affect bathing/showering:
from preliminary studies including focus groups of health mental functions, sensory functions/pain, movement-related
professionals, a systematic review of the literature and empiric functions, skin functions, and urination/defecation functions.
data collection from patients (2). The brief ICF Core Set for
geriatric patients in early-post-acute rehabilitation represents a D. Modeling of user requirements and use case scenarios
practical alternative to the lengthy comprehensive sets for our The technical requirements for an innovative bath robot
target group. It provides a minimal standard for measuring and system are very complex. From a clinical perspective, we
communicating patients’ functioning in a therapeutic context focus on needs of potential users, based on frequent
(24). impairments of body functions and associated limitations of
activities. The bathing/showering process consists of many
For the design of the I-Support bath robot system the ICF different activities which users have to perform, starting from
Core Sets have to be adapted to define user requirements and entering the shower until leaving it again. The shower process
describe use case scenarios from a clinical perspective. itself is the core process, but transfer and transition process are
Therefore, in the next chapter we give a description of of similar importance.
frequent geriatric impairments, which have to be considered
in the design process of the I-Support bath robot system.
C. Description of frequent geriatric impairments
In a geriatric population, using the ICF Core Set, most
prevalent disabilities were found in the health domain
“Activities”, primarily moving around (80%), walking (79%),
washing oneself (75%), caring for body parts (74%) or
dressing (73%). They are closely linked with frequent
impairments in associated categories of “body functions”, such
as gait pattern functions (73%), muscle power functions
(73%), mobility of joint functions (59%) and sensation of pain
(57%) (23).
As mentioned above, bathing/showering disability may
have different causes, cognitive as well as motor and sensorial
impairments. Therefore, we selected the most relevant second-
level categories concerning bathing/showering limitations
from the comprehensive ICF Core Set for geriatric patients.

Figure 3. I-Support: Model of impairments, limitations and user

requirements

In the previous section, we described frequent geriatric

impairments which are clinically relevant for the overall
bathing/showering process. In figure 3, these impairments are
listed as second-level codes in the left column. Those
impairments are often followed by limitations of activities. As
listed in the middle column of figure 3, limitations concerning
Figure 2. Potential impairments of body functions affecting
bathing/showering activities
bathing/showering activities are more complex than expected.
For the design of an innovative bath robot system it is not
sufficient to focus on self-care functions alone. It is also

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essential to provide functionalities for limitations, concerning
transfer and transition to the shower room as well as
communication with the system. In our model, user
requirements can directly be derived from specific
impairments and limitations. In the right column of figure 3,
impairment-related user requirements for the I-Support bath
robot system are shown.
The following paragraph gives detailed information on the
user requirements defined in figure 3 (right column). This will
be the basis for the use case scenarios which are based on
clinical expertise.
Cognitive assistance
As mentioned before, bathing represents a complex
ADL/IADL with a high impact of cognitive functions,
especially in the context of an ICT-supported, sophisticated
bath robot system. Therefore, cognitive status was identified
as main inclusion criterion for the I-Support user definition.
Persons with advanced impairment levels (MMSE <18) will
be excluded from the project.
People with no or moderate cognitive impairment might have
limitations using communication and technical devices
(d360) properly, particularly when they are lacking technical
experience which is associated with a feeling of helplessness
and fear avoidance strategies. Within the I-Support
development process, this issue has to be considered in the
design of all system functionalities. Ease of use, safety, and
automation are requested standards for the complete sequence
of the I-Support shower process. Furthermore, the I-Support
bath robot system may have to provide strategies and
functionalities
• to adjust base settings,
• to provide clear and safe operating instructions,
• to navigate older persons through the transfer and
shower process, for example with verbal instructions
to avoid fears and a feeling of helplessness,
• to support subsequent modifications of base settings,
• to provide emergency strategies (e.g. fall detection),
• to include gesture/speech recognition.
Shower assistance
Showering represents the core process of the I-Support bath
robot system. The entire shower process consists of pouring
water, soaping, scrubbing, wiping, and drying with a towel)
specific body parts. From a clinical perspective, it is essential
to maintain the user´s independence in parts of her/his
activities as long as possible. The I-Support system will
provide as much technical support as needed, depending on
the user´s abilities and preferences, leaving remaining
abilities to be still trained and used in the showering process.
For this reason, we defined four use case scenarios, based on
user abilities and impairments: Core region, distal region,
back region and posterior region.
The core region includes body parts, where the user is able to
wash herself/himself in a seated position, with low risk
exposure or little effort. The core region includes abdomen,
chest, arms, front of thighs and genitals. Performing intimate
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hygiene independently is very important for the elderly. For
washing this sensitive body part, the soft arms of the I-
Support system may only have assistive functions - as passive
water hose and as robotic arm - to give the user washing tools
or drying towels.
The distal region comprises the lower thighs from knee joints
on downwards to the feet. For washing these body parts, the
user has to bend forward with a high risk of losing postural
control. The I-Support bath robot system has to perform the
distal region shower process automatically.
The back region is expanding from the cervical spine to the
tailbone. Due to limitations in reaching this body part, the I-
Support bath robot system may has to provide a functionality
for a fully automatic back region shower process.
The posterior region includes the back of the thighs and the
backside (buttock). Urinary and/or fecal incontinence (see
figure 3) are serious problems for many older persons, and
intimate care is indispensable. It is not possible to wash the
back of thighs and the backside comprehensively while
seated. For this reason, a use case scenario “Posterior region
shower process” may have to provide functionalities for sit-
to-stand and stand-to-sit transfer as well as postural control
while standing.
The development of such technical assistive technologies for
bathing procedures has a long tradition on which the I-
Support project may draw from. At the 1970 World Expo in
Osaka, a Japanese Electronics Group, introduced a first
concept of a washing machine for humans, officially named
Ultrasonic Bath, which found no access to the market. Due to
lack of demand, the production of a descendant of the
Ultrasonic Bath concept (2004) called the HIRB ("Human In
Roll-lo Bathing") system was also stopped. More recent
design studies deal with mechatronic systems for bathing
assistance of bedridden elderly people (25,26) and the
development of a head care robot (27). In addition, some
rehabilitation robots have functionalities to support activities
of daily living, including grooming, shaving and bathing (28,
29).
Motion control of the soft arm
Bathing/showering with an ICT-supported bath robot
system is not only cognitively demanding. It also requires
well-trained motor control capabilities. For older persons the
fine hand use as well as the hand and arm use is limited.
Modeling the user´s intention and movements in complex
motions of the soft arms is a prior challenge in the design
process of the I-Support bath robot system. The I-Support
bath robot system may have to provide functionalities to assist
the user in showering (based on learned motion primitives),
and to control the soft arm motions.
Transfer, transition and posture assistance
A loss of muscle strength, postural control and gait
abnormalities caused by an age-related loss of muscle mass
and a decline of vestibular and proprioceptive functions
represent intrinsic risk factors for falling. Due to the high
prevalence of falls in the bathing environment (30), it is
essential to give the potential user a secure feeling, in
particular while entering and leaving the shower cabin, during
stand-to-sit and sit-to-stand transfers and maintaining a secure TABLE II. PRELIMINARY USE CASE SCENARIOS AND SYSTEM
FUNCTIONALITIES FROM A CLINICAL PERSPECTIVE
sitting position during the shower procedure. The hardware of
the I-Support bath robot system may have to provide System Use case
User requirements
functionalities scenarios
functionalities for stand-to-sit/ sit-to-stand transfer, transition
Cognitive assistance To adjust base Operation and
into/out of the shower area, and postural control. settings control of system
Sensorial Assistance functionalities
To provide clear and
Perceptual impairments did not seem to impact older adults’ safe g instructions
ability to perform ADLs and IADLs as much as motor To navigate persons
impairments (31). However, for the design and operation of through the transfer
an assistive bath robot system, perceptual impairments and shower process
represent a serious problem. When using the shower, persons To support Subsequent
usually do not wear eye glasses or hearing aids. subsequent modification of
modifications of base settings
It is essential that people with poor vision are able to operate base settings
the I-Support bath robot system correctly. High safety
To provide Emergency
standards should ensure that operator errors do not result in emergency procedures
increased numbers of accidents and injury due to sensory strategies
deficits, e.g. the adjustment of water temperature. Hearing Shower assistance To assist the user to Core region
impairment in older persons requires additional system shower shower process
adaptations for the human-robot-communication tools of the To assist the user to Distal region
I-Support system. It has to be considered, that the I-Support dry herself/himself shower process
bath robot system provides sufficient font sizes and brightness To control the Back region
motion of the soft shower process
as well as voice control functions for persons with visual
arm(s)
impairments. In addition, it is important to adjust signals or
Posterior region
alerts with respect to persons with hearing impairments. It has shower process
to be considered that annoying signals and alarms promote Transfer, transition To provide physical Stand-to-sit/Sit-to-
confusion in older and/or cognitively impaired persons. and posture assistance assistance during stand transfer
stand-to-sit/sit-to-
Base settings and system adjustment stand transfer
Older persons have a reduced thermal sensitivity, especially To assist the user Transition into/out
during cooling and a decreased thermogenesis (32). For this during transition of the shower area
into/out of the
reason, they start freezing very quickly. In addition, heat shower area
exposure may extend cardiac sensations. These issues may
To provide postural
have to be considered in the adjustment of the base settings, control
e.g. air and water temperature, pressure of the water jet, and To provide Emergency
length of the shower process. Deviations may cause short- emergency procedures
term risks for the health of old and frail users. The recognition strategies
of the user´s behavior during the shower process is essential. Sensorial assistance To support user with Visual control
Appropriate functionalities of the I-Support bath robot system visual impairment
are user perception, gesture and voice recognition, and To provide adequate Human-Robot
interpretation. communication communication
tools for user with
Transition to potential use case scenarios hearing impairment

In the comprehensive model above (Figure 3), we described

user requirements, based on frequent geriatric impairments
and associated limitations of activities. These user
requirements serve as a basis for the definition of use case
scenarios from a clinical perspective. In the following table
(see Table II) we summarize impairments and associated
potential use case scenarios for the I-Support project.
The preliminary use case scenarios will be amended by the
identification of user behaviors and attitudes from a
qualitative perspective as identified by qualitative interviews
and quantitative data collection (Frankfurt University of
Applied Sciences). Final use cases will be described in
cooperation with technical partners including their technical
perspective and identification of functionalities.
V. DESCRIPTION OF THE TECHNICAL SET-UP OF THE I-
SUPPORT BATH ROBOT SYSTEM
The I-Support bath robot system consists of two main
hardware components:
• A motorized shower chair mounted on the wall
with three degrees of freedom (vertical,
horizontal, rotational) providing support for stand-
to-sit and sit-to-stand transfer and for the transition
from dry areas outside into the shower space and
back.
• A robotic shower with two identical soft-arm,
lightweight, robotic manipulators mounted on the
wall and aimed at the provision of pouring water,

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 soaping, scrubbing, wiping and drying. Different
tools for wiping and scrubbing can be
automatically attached/de-attached in a quick and
secure way, based on small magnets.
The consortium has selected the Pressalit commercially
available motorized chair. Currently the Pressalit chair has
one motorized DOF (along the vertical axis). The adaptations
done by partner ROBOTNIK will add two additional DOFs:
one translational (along the horizontal axis) and one rotational
(about the vertical axis), in order to position the user in an
optimal way with respect to the two soft-robot arms. Hence,
during the validation studies the motorized chair will have
overall three DOFs.
The two arms are identical: one soft arm will serve the
lower extremities; the other arm will serve the back, the torso
and the upper extremities, offering the following
functionalities:
• Pouring water, soaping and rinsing. These tasks do
not involve human interaction. The robotic arm
will act as a robotic hose which pours water and/or
soap. The control unit will provide the possibility
to select only water, only soap or water/soap Figure 5. Overall system showing the configuration of the I-Support bath
robot system (Source: Robotnik Automation, Spain)
simultaneously.
• Scrubbing, wiping and drying. These tasks involve The RGB-D vision system is responsible for human pose
human interaction. The end-effector for estimation, robot pose estimation and gesture recognition.
performing these contact-tasks is removable and The final design of the vision system was done by INRIA and
equipped with quick release mechanism so that comprises three KINECT V2 sensors. Their position/
orientation in the shower space has been finalized and has
been validated by conducting calibration experiments and
data collection experiments at KIT premises.
Audio sensors enable the verbal human-robot-interaction.
The proposed audio sensing setup is designed to provide
sufficient spatio-temporal sampling of the targeted acoustic
scenes in the I-SUPPORT bathroom environment and consists
of eight condenser omni-directional microphones distributed
on the walls and ceiling of the room.
The force sensor measures the forces imparted by the soft-
arm end-effector on the user and provide feedback for force
control. Partner SSSA has selected an ATI force sensor
(model: Nano17). As context awareness sensors SSSA
proposes the CubeSensors and/or Amphiro.
Figure 4. Latest version of soft robot arm with end effectors and their
quick release mechanism (Source: The BioRobotics Institute - Scuola A hand-held motion tracker is used as an intuitive soft-arm
Superiore Sant' Anna, Italy) tele-manipulator. The elderly will tele-manipulate the soft-
arm end-effector motion. OMEGA is currently developing
Additionally, a set of force, shape, motion-tracking and the custom made motion tracker for telemanipulation, and
context awareness sensors are installed in the shower will evaluate its functionality and compare its performance
environment in order to enable audio/gestural and prior to the validation studies.
telemanipulation human-robot interaction, context awareness
of the shower environment and sensing of the robot state. At the moment, data collection experiments take place in
Figure 5 depicts the complete I-Support system in CAD order to adapt the hardware configuration to the specific
design. requirements of the I-Support bath robot system. Technical
data are not yet available.

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 VI. CONCLUSION
Based on the International Classification of Functioning,
Disability and Health (ICF) as an internationally established
conceptual framework we described a comprehensive model
of impairments, limitations and user requirements, which may
represent the basis for the definition of use case scenarios
from a clinical perspective.
ACKNOWLEDGMENT
This project has received funding from the European
Union‘s Horizon 2020 Research and Innovation Framework
Program, Societal Challenge 1 (DG CONNECT/H) under
grant agreement No 643666, Activity PHC-19-2014, ICT-
Supported Bath Robots. The I-Support Consortium:
Karlsruhe Institute of Technology (KIT), Germany; Robotnik
Automation, Spain; Institute of Communication and
Computer Systems (ICCS), Greece; Scuola Superiore
Sant´Anna – The BioRobotics Institute (SSSA), Italy; Institut
Nationale de Recherche en Informatique et en Automatique
(INRIA), France; T. Alexandridis & CO Omega Technology
(Omega), Greece; Fondazione Santa Lucia (FSL), Italy;
Frankfurt University of Applied Sciences (FRA-UAS),
Germany; Agaplesion Bethanien Hospital/Geriatric Centre at
Heidelberg University (Bethanien), Germany.
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