IEEE Trans Neural Syst Rehabil Eng. 2021;29:576-586. doi: 10.1109/TNSRE.2021.3056908. Epub 2021 Mar 3.
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 tested 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 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.
目前迫切需要制定策略来减缓或治疗 HIV 感染者的功能衰退。本文探讨了一种新的康复机器人方法，用于测量患有 HIV 的成年人的认知和运动障碍，包括一部分患有中风的成年人。我们进行了一项横断面研究，共有 21 名受试者表现出不同程度的认知和运动障碍。我们测试了三种基于机器人的任务——轨迹跟踪、N-back 和空间跨度，以评估这些任务得出的指标是否能敏感地反映出具有不同执行功能和上肢运动障碍程度的受试者之间的差异。我们还研究了这些指标在估计临床认知和运动评分方面的表现。结果表明，基于机器人的空间跨度任务的平均序列长度对各种认知和运动障碍水平之间的差异最敏感。我们观察到基于机器人的测量值与与 HIV 人群相关的临床认知和运动评估之间存在很强的相关性，例如颜色轨迹测试 1（rho = 0.83）、颜色轨迹测试 2（rho = 0.71）、数字符号 - 编码（rho = 0.81）、蒙特利尔认知评估-执行功能子评分（rho = 0.70）和箱和块测试（rho = 0.74）。重要的是，我们的结果表明，在评估 HIV 相关残疾时，可能会忽略粗大运动障碍。这项研究表明，康复机器人可以扩展到中风以外的新人群，即 HIV 感染者和认知障碍者。
