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

Abstract

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.

Overview of the role of robots in upper limb disabilities rehabilitation: a scoping review

“…Most of the studies were done in Italy (n = 19, 34.55%) [ 26 – 28 , 31 , 33 , 36 , 37 , 43 , 46 – 49 , 57 , 62 , 63 , 68 , 76 , 79 ]. After Italy, 14.24% and 8.9% of the studies were conducted in the USA (n = 8) [ 29 , 42 , 50 , 51 , 56 , 60 , 61 , 72 ] and China (n = 5) [ 32 , 54 , 59 , 65 , 73 ], respectively. (More details in Table 1 ).…”

“…As shown in Fig. 2 , most articles on robots for upper limb rehabilitation were published in 2017 (n = 9) [ 33 – 35 , 60 , 61 , 67 , 72 , 79 , 80 ], 2020 (n = 7) [ 46 – 50 , 63 , 64 , 69 ], and 2021 (n = 7) [ 51 – 55 , 65 , 73 ]. (More details in Table 1 )…”

“…60.52% of the studies used games and virtual reality to rehabilitate the upper extremities in robots [ 26 , 30 – 32 , 36 , 38 , 40 , 42 – 51 , 54 , 55 , 57 , 59 – 62 , 64 , 66 – 73 , 75 ](n = 34). Moreover, 3.56% of studies had used telerehabilitation in their robots (n = 2) [ 32 , 35 ].…”

“…According to Tables 3 , 89% of the studies used both males and females in the robot evaluation process(n = 49) [ 26 – 29 , 31 – 42 , 44 , 45 , 47 – 58 , 60 – 63 , 65 – 76 , 78 – 80 ]. Most of the participants were over 18 years old (n = 47, 85%) [ 26 – 29 , 31 , 33 – 51 , 53 – 60 , 62 , 63 , 65 – 68 , 70 – 73 , 75 , 78 – 80 ]. Moreover, in some studies, the age of the participants was less than or equal to 18 years (n = 4, 7%) [ 30 , 67 , 69 , 76 ].…”

The Impact of Cognitive Impairment on Robot-Based Upper-Limb Motor Assessment in Chronic Stroke

“…Our group has developed such an approach, expanding the robot-assisted technologies to the assessment of cognitive and motor impairments in the HIV and HIV-stroke populations. 25 Consideration should be given as to how to measure these domains in isolation as well as when motor demands are jointly present. Addressing these barriers will allow for broader populations to benefit from robotic therapy systems.…”