Human–Robot Interactions: A Pilot Study of Psychoaffective and Cognitive Factors to Boost the Acceptance and Usability of Assistive Wearable Devices

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The authors examine the psychoaffective and cognitive factors influencing the usability and acceptance of lower-limb exoskeletons for assistance. Using anxiety and cognitive reserve measures alongside usability and workload assessments, the study found significant correlations between psychological traits and perceived usability. Results suggest that anxiety and cognitive reserve play critical roles in user-device integration. Despite the contributions being significant, the authors should address major concerns as follows.

1. The study relies on a small, homogeneous sample of young, healthy volunteers, limiting its generalizability to clinical populations. The authors are suggested to validate the findings with diverse populations, particularly patients requiring robotic rehabilitation.

2. The study only examines immediate psychoaffective responses without exploring long-term device acceptance and usability. The authors should conduct longitudinal studies to assess the sustained impacts of cognitive and psycho-affective traits.

3. The manuscript does not discuss how specific device characteristics (e.g., weight, adaptability) influence the measured outcomes. Please include an analysis of how design elements impact usability and psychoaffective responses.

4. In the generalized linear models (GLMs), how does the choice of predictors (e.g., cognitive reserve) influence the adjusted r2r^2 values? The authors should highlight how alternative predictors yield higher explanatory power

5. The manuscript mentions significant correlations (e.g., r=−0.67r = -0.67, p=0.03p = 0.03). How robust are these findings in relation to potential outliers or small sample variability?

6. The NASA-TLX scores were analyzed for workload components. The authors should show how including interaction terms between anxiety and physical demand affects the GLM results.

7. The authors should notice tendencies (e.g., p=0.06p = 0.06) between motor performance and workload more carefully. It seems increasing the sample size likely pushes these findings to significance. If so, what sample size is estimated for adequate power?

8. Shapiro-Wilks test indicates normality in some measures; however, not others. The authors should tell how chosen statistical methods account for potential non-normality in small-sample datasets.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This paper investigates the influence of psychoaffective and cognitive factors on the usability and acceptance of assistive robotic exoskeletons. It reports a pilot study where ten healthy volunteers completed a walking task using an exoskeleton. The study highlights the role of state and trait anxiety, cognitive reserve, and perceived workload in shaping the human-robot interaction experience. Key findings include the predictive power of trait anxiety on perceived effort and the impact of cognitive reserve on usability perception. The results suggest tailored strategies such as user familiarization and individualized training to enhance device acceptance and rehabilitation outcomes. This paper is well-structured and well-written. Before publication, there are some questions to be solved.

1. The author mentioned “High-intensity and high-dosage training offered by robotic rehabilitation can enhance neuronal plasticity during the subacute phase following a brain injury.”, more state-of-the-art can be cited: DOI: 10.34133/cbsystems.0115; DOI: 10.34133/cbsystems.0122; DOI: 10.34133/cbsystems.0141.

2. Can the authors provide additional details on how the small sample size of ten participants impacts the generalizability of their findings? Are there plans for expanding the study to include a more diverse or clinical population, such as elderly individuals or patients with disabilities?

3. Given that the cognitive reserve index is primarily influenced by educational background in this sample, how do the authors address potential biases arising from the uniformity of participant demographics (e.g., young university students)?

4. Can the authors provide more detailed explanations of how the AttrakDiff questionnaire results (e.g., pragmatic versus hedonic quality) translate into actionable design improvements for future exoskeletons?

5. How was the 10-minute familiarization period determined, and is this duration sufficient to alleviate anxiety and establish comfort with the exoskeleton? Would a longer familiarization period yield different results?

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors have addressed all the concerns raised by the reviewer. The manuscript can now be accepted. 

Reviewer 2 Report

Comments and Suggestions for Authors

The authors have addressed comments raised by reviewers, this paper is ready for publication.