Using upper limb kinematics to assess cognitive deficits in people living with both HIV and stroke

Wamsley²,

Shofer

et al. 2020

Preprint

Self Cite

There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a cross-sectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We developed three robot-based tasks - trajectory tracking, N-back, and spatial span - to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined if these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between subjects' cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol - Coding (rho = 0.81), Montreal Cognitive Assessment - Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.

“…The Haptic Theradrive, a one degree-of-freedom rehabilitation robot system used in this study. Image used with permission from [38]. …”

Section: Methodsmentioning

confidence: 99%

Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation

Wamsley²,

Shofer

et al. 2020

Preprint

Self Cite

“…The Haptic Theradrive, a one degree-of-freedom rehabilitation robot system used in this study. Image used with permission from [38].…”

Section: Robot Assessment 1) Rehabilitation Robot Systemmentioning

confidence: 99%

Robot-Based Assessment of HIV-Related Motor and Cognitive Impairment for Neurorehabilitation

IEEE Trans. Neural Syst. Rehabil. Eng.

Wamsley

Shofer

et al. 2021

Self Cite

There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a crosssectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We tested three robot-based taskstrajectory tracking, N-back, and spatial span -to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined how well these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between various cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol -Coding (rho = 0.81), Montreal Cognitive Assessment -Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.

“…One approach we have tried is assessing unilateral upper limb kinematics in both the impaired and less impaired limb sides using a variety of tasks that engage both motor and cognitive domains. Our hypothesis is that metrics exploring the relationship between the impaired and less impaired side could potentially be used to assess both cognitive and motor deficits across the stroke, HIV, and HIV-stroke populations [ 142 ]. This approach is supported by other recent work in stroke subjects [ 127 ].…”

Section: A Potential Approach For Hiv-stroke Neurorehabilitationmentioning

confidence: 99%

Designing robot-assisted neurorehabilitation strategies for people with both HIV and stroke

J NeuroEngineering Rehabil

Johnson

2018

Self Cite

There is increasing evidence that HIV is an independent risk factor for stroke, resulting in an emerging population of people living with both HIV and stroke all over the world. However, neurorehabilitation strategies for the HIV-stroke population are distinctly lacking, which poses an enormous global health challenge. In order to address this gap, a better understanding of the HIV-stroke population is needed, as well as potential approaches to design effective neurorehabilitation strategies for this population. This review goes into the mechanisms, manifestations, and treatment options of neurologic injury in stroke and HIV, the additional challenges posed by the HIV-stroke population, and rehabilitation engineering approaches for both high and low resource areas. The aim of this review is to connect the underlying neurologic properties in both HIV and stroke to rehabilitation engineering. It reviews what is currently known about the association between HIV and stroke and gaps in current treatment strategies for the HIV-stroke population. We highlight relevant current areas of research that can help advance neurorehabilitation strategies specifically for the HIV-stroke population. We then explore how robot-assisted rehabilitation combined with community-based rehabilitation could be used as a potential approach to meet the challenges posed by the HIV-stroke population. We include some of our own work exploring a community-based robotic rehabilitation exercise system. The most relevant strategies will be ones that not only take into account the individual status of the patient but also the cultural and economic considerations of their respective environment.