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<!DOCTYPE html> <html lang="en" dir="ltr" xmlns="http://www.w3.org/1999/xhtml" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head prefix="og: http://ogp.me/ns# article: http://ogp.me/ns/article# book: http://ogp.me/ns/book#" >  <link rel="dns-prefetch" href="//d33xdlntwy0kbs.cloudfront.net" /> <link rel="dns-prefetch" href="//cdn.jsdelivr.net" /> <link rel="dns-prefetch" href="//www.google.com" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <link rel="dns-prefetch" href="//www.googletagmanager.com" /> <link rel="dns-prefetch" href="//rum-static.pingdom.net" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://www.medrxiv.org/sites/default/files/images/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <meta name="type" content="article" /> <meta name="category" content="article" /> <meta name="HW.identifier" content="/medrxiv/early/2020/11/03/2020.10.30.20223172.atom" /> <meta name="HW.pisa" content="medrxiv;2020.10.30.20223172v1" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation" /> <meta name="DC.Identifier" content="10.1101/2020.10.30.20223172" /> <meta name="DC.Date" content="2020-11-03" /> <meta name="DC.Publisher" content="Cold Spring Harbor Laboratory Press" /> <meta name="DC.Rights" content="© 2020, Posted by Cold Spring Harbor Laboratory. This pre-print is available under a Creative Commons License (Attribution-NonCommercial-NoDerivs 4.0 International), CC BY-NC-ND 4.0, as described at http://creativecommons.org/licenses/by-nc-nd/4.0/" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="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. ### Competing Interest Statement Michelle Johnson is a co-founder of Recupero Robotics, LLC, which is commercializing the rehabilitation robot system used in the study. ### Clinical Trial Study was not a clinical trial ### Funding Statement This work was made possible through core services and support from the National Institute Of Neurological Disorders and Stroke of the National Institutes of Health (T32NS091006); the University of Pennsylvania Center for AIDS Research (P30AI 045008); the University of Pennsylvania Center for Biomedical Image Comput- ing and Analytics; and the University of Pennsylvania Departments of Bioengineering and Physical Medicine and Rehabilitation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Pennsylvania IRB Protocol #823511 All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes De-identified data is available upon request, and will be available as a repository soon." /> <meta name="DC.Contributor" content="Kevin D. Bui" /> <meta name="DC.Contributor" content="Carol A. Wamsley" /> <meta name="DC.Contributor" content="Frances S. Shofer" /> <meta name="DC.Contributor" content="Dennis L. Kolson" /> <meta name="DC.Contributor" content="Michelle J. Johnson" /> <meta name="article:published_time" content="2020-11-03" /> <meta name="citation_title" content="Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation" /> <meta name="citation_abstract" lang="en" content="<h3>Abstract</h3> <p>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.</p>" /> <meta name="citation_journal_title" content="medRxiv" /> <meta name="citation_publisher" content="Cold Spring Harbor Laboratory Press" /> <meta name="citation_publication_date" content="2020/01/01" /> <meta name="citation_mjid" content="medrxiv;2020.10.30.20223172v1" /> <meta name="citation_id" content="2020.10.30.20223172v1" /> <meta name="citation_public_url" content="https://www.medrxiv.org/content/10.1101/2020.10.30.20223172v1" /> <meta name="citation_abstract_html_url" content="https://www.medrxiv.org/content/10.1101/2020.10.30.20223172v1.abstract" /> <meta name="citation_full_html_url" content="https://www.medrxiv.org/content/10.1101/2020.10.30.20223172v1.full" /> <meta name="citation_pdf_url" content="https://www.medrxiv.org/content/medrxiv/early/2020/11/03/2020.10.30.20223172.full.pdf" /> <meta name="citation_doi" content="10.1101/2020.10.30.20223172" /> <meta name="citation_num_pages" content="10" /> <meta name="citation_article_type" content="Article" /> <meta name="citation_firstpage" content="2020.10.30.20223172" /> <meta name="citation_author" content="Kevin D. Bui" /> <meta name="citation_author_institution" content="Rehabilitation Robotics Lab and Department of Bioengineering, University of Pennsylvania" /> <meta name="citation_author" content="Carol A. Wamsley" /> <meta name="citation_author_institution" content="Penn Institute for Rehabilitation Medicine" /> <meta name="citation_author" content="Frances S. Shofer" /> <meta name="citation_author_institution" content="Department of Emergency Medicine, University of Pennsylvania" /> <meta name="citation_author" content="Dennis L. Kolson" /> <meta name="citation_author_institution" content="Department of Neurology, University of Pennsylvania" /> <meta name="citation_author" content="Michelle J. Johnson" /> <meta name="citation_author_institution" content="Rehabilitation Robotics Lab, Department of Physical Medicine and Rehabilitation, and Department of Bioengineering, University of Pennsylvania" /> <meta name="citation_author_email" content="johnmic@pennmedicine.upenn.edu" /> <meta name="citation_reference" content="UNAIDS, “The gap report 2014,” 2014." /> <meta name="citation_reference" content="A. J. Gill and D. L. Kolson, “Chronic inflammation and the role for cofactors (hepatitis c, drug abuse, antiretroviral drug toxicity, aging) in hand persistence,” Current HIV/AIDS Reports, vol. 11, no. 3, pp. 325–335, 2014." /> <meta name="citation_reference" content="R. K. Heaton, T. D. Marcotte, M. Rivera-Mindt, J. Sadek, D. J. Moore, H. Bentley, J. A. McCutchan, C. Reicks, I. Grant, H. Group et al., “The impact of hiv-associated neuropsychological impairment on everyday functioning,” 2004." /> <meta name="citation_reference" content="M. Rusch, S. Nixon, A. Schilder, P. Braitstein, K. Chan, and R. S. Hogg, “Impairments, activity limitations and participation restrictions: prevalence and associations among persons living with hiv/aids in british columbia,” Health and quality of life outcomes, vol. 2, no. 1, p. 46, 2004." /> <meta name="citation_reference" content="R. K. Heaton, D. R. Franklin, R. J. Ellis, J. A. McCutchan, S. L. Letendre, S. LeBlanc, S. H. Corkran, N. A. Duarte, D. B. Clifford, S. P. Woods et al., “Hiv-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors,” Journal of neurovirology, vol. 17, no. 1, pp. 3–16, 2011." /> <meta name="citation_reference" content="S. D. Pullen, N. N. Chigbo, E. C. Nwigwe, C. J. Chukwuka, C. C. Amah, and S. C. Idu, “Physiotherapy intervention as a complementary treatment for people living with hiv/aids,” Hiv/aids (Auckland, NZ), vol. 6, p. 99, 2014." /> <meta name="citation_reference" content="T. W. Wilson, E. Heinrichs-Graham, K. R. Robertson, U. Sandkovsky, J. O’neill, N. L. Knott, H. S. Fox, and S. Swindells, “Functional brain abnormalities during finger-tapping in hiv-infected older adults: a mag-netoencephalography study,” Journal of Neuroimmune Pharmacology, vol. 8, no. 4, pp. 965–974, 2013." /> <meta name="citation_reference" content="K. Lawler, K. Jeremiah, M. Mosepele, S. J. Ratcliffe, C. Cherry, E. Seloilwe, and A. P. Steenhoff, “Neurobehavioral effects in hiv-positive individuals receiving highly active antiretroviral therapy (haart) in gaborone, botswana,” PLoS One, vol. 6, no. 2, p. e17233, 2011." /> <meta name="citation_reference" content="J. Robinson-Papp, G. Gensler, A. Navis, S. Sherman, R. J. Ellis, B. B. Gelman, D. L. Kolson, S. L. Letendre, E. J. Singer, M. Valdes-Sueiras et al., “Characteristics of motor dysfunction in longstanding human immunodeficiency virus,” Clinical Infectious Diseases, 2019." /> <meta name="citation_reference" content="A. Antinori, G. Arendt, J. Becker, B. Brew, D. Byrd, M. Cherner, D. Clifford, p. Cinque, L. Epstein, K. Goodkin et al., “Updated research nosology for hiv-associated neurocognitive disorders,” Neurology, vol. 69, no. 18, pp. 1789–1799, 2007." /> <meta name="citation_reference" content="S. I. Kronemer, J. A. Mandel, N. C. Sacktor, and C. L. Marvel, “Impairments of motor function while multitasking in hiv,” Frontiers in human neuroscience, vol. 11, p. 212, 2017." /> <meta name="citation_reference" content="J. C. Scott, S. P. Woods, O. Vigil, R. K. Heaton, B. C. Schweinsburg, R. J. Ellis, I. Grant, and T. D. Marcotte, “A neuropsychological in-vestigation of multitasking in hiv infection: Implications for everyday functioning.” Neuropsychology, vol. 25, no. 4, p. 511, 2011." /> <meta name="citation_reference" content="F. C. Chow, S. Regan, S. Feske, J. B. Meigs, S. K. Grinspoon, and V. A. Triant, “Comparison of ischemic stroke incidence in hiv-infected and non-hiv-infected patients in a us health care system,” Journal of acquired immune deficiency syndromes (1999), vol. 60, no. 4, p. 351, 2012." /> <meta name="citation_reference" content="M. J. Vinikoor, S. Napravnik, M. Floris-Moore, S. Wilson, D. Y. Huang, and J. J. Eron, “Incidence and clinical features of cerebrovascular disease among hiv-infected adults in the southeastern united states,” AIDS research and human retroviruses, vol. 29, no. 7, pp. 1068–1074, 2013." /> <meta name="citation_reference" content="H. Augustyn, p. de Witt, and D. Franzsen, “The effect of hiv status on post-stroke outcomes in personal activities of daily living,” British Journal of Occupational Therapy, p. 0308022620902683, 2020." /> <meta name="citation_reference" content="E. Weber, K. Blackstone, and S. P. Woods, “Cognitive neurorehabilitation of hiv-associated neurocognitive disorders: a qualitative review and call to action,” Neuropsychology review, vol. 23, no. 1, pp. 81–98, 2013." /> <meta name="citation_reference" content="H. deBoer, M. Andrews, S. Cudd, E. Leung, A. Petrie, S. Chan Carusone, and K. K. O’Brien, “Where and how does physical therapy fit? integrating physical therapy into interprofessional hiv care,” Disability and rehabilitation, vol. 41, no. 15, pp. 1768–1777, 2019." /> <meta name="citation_reference" content="K. D. Bui and M. J. Johnson, “Designing robot-assisted neurorehabilitation strategies for people with both hiv and stroke,” Journal of neuroengineering and rehabilitation, vol. 15, no. 1, p. 75, 2018." /> <meta name="citation_reference" content="A. C. Lo, p. D. Guarino, L. G. Richards, J. K. Haselkorn, G. F. Wittenberg, D. G. Federman,R. J. Ringer, T. H. Wagner, H. I. Krebs, B. T. Volpe et al., “Robot-assisted therapy for long-term upper-limb impairment after stroke,” New England Journal of Medicine, vol. 362, no. 19, pp. 1772–1783, 2010." /> <meta name="citation_reference" content="V. Do Tran, p. Dario, and S. Mazzoleni, “Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: a review,” Medical engineering & physics, vol. 53, pp. 13–31, 2018." /> <meta name="citation_reference" content="T. C. Bourke, C. R. Lowrey, S. P. Dukelow, S. D. Bagg, K. E. Norman, and S. H. Scott, “A robot-based behavioural task to quantify impairments in rapid motor decisions and actions after stroke,” Journal of neuroengineering and rehabilitation, vol. 13, no. 1, p. 91, 2016." /> <meta name="citation_reference" content="L. M. Logan, J. A. Semrau, C. T. Debert, J. M. Kenzie, S. H. Scott, and S. P. Dukelow, “Using robotics to quantify impairments in sensorimotor ability, visuospatial attention, working memory, and executive function after traumatic brain injury,” The Journal of head trauma rehabilitation, vol. 33, no. 4, pp. E61–E73, 2018." /> <meta name="citation_reference" content="C. Bosecker, L. Dipietro, B. Volpe, and H. Igo Krebs, “Kinematic robot-based evaluation scales and clinical counterparts to measure upper limb motor performance in patients with chronic stroke,” Neurorehabilitation and neural repair, vol. 24, no. 1, pp. 62–69, 2010." /> <meta name="citation_reference" content="H. I. Krebs, M. Krams, D. K. Agrafiotis, A. DiBernardo, J. C. Chavez, G. S. Littman, E. Yang, G. Byttebier, L. Dipietro, A. Rykman et al., “Robotic measurement of arm movements after stroke establishes biomarkers of motor recovery,” Stroke, vol. 45, no. 1, pp. 200–204, 2014." /> <meta name="citation_reference" content="M. J. Johnson, R. Rai, S. Barathi, R. Mendonca, and K. Bustamante-Valles, “Affordable stroke therapy in high-, low-and middle-income countries: From theradrive to rehab cares, a compact robot gym,” Journal of rehabilitation and assistive technologies engineering, vol. 4, p. 2055668317708732, 2017." /> <meta name="citation_reference" content="A. Beck, R. Steer, and G. Brown, “Manual for the beck depression inventory-fast screen for medical patients,” San Antonio, TX: Psychological Corporation, 2000." /> <meta name="citation_reference" content="L. D’Elia, p. Satz, C. L. Uchiyama, and T. White, “Color trails test,” 1996." /> <meta name="citation_reference" content="D. Wechsler, “Wechsler adult intelligence scale-revised (wais-r),” 1981." /> <meta name="citation_reference" content="Z. S. Nasreddine, N. A. Phillips, V. Bédirian, S. Charbonneau, V. White-head, I. Collin, J. L. Cummings, and H. Chertkow, “The montreal cognitive assessment, moca: a brief screening tool for mild cognitive impairment,” Journal of the American Geriatrics Society, vol. 53, no. 4, pp. 695–699, 2005." /> <meta name="citation_reference" content="N. C. Sacktor, M. Wong, N. Nakasujja, R. L. Skolasky, O. A. Selnes, S. Musisi, K. Robertson, J. C. McArthur, A. Ronald, and E. Katabira, “The international hiv dementia scale: a new rapid screening test for hiv dementia,” Aids, vol. 19, no. 13, pp. 1367–1374, 2005." /> <meta name="citation_reference" content="M. Maj, L. D’Elia, p. Satz, R. Janssen, M. Zaudig, C. Uchiyama, F. Starace, S. Galderisi, and A. Chervinsky, “Evaluation of two new neuropsychological tests designed to minimize cultural bias in the assessment of hiv-1 seropositive persons: a who study,” Archives of Clinical Neuropsychology, vol. 8, no. 2, pp. 123–135, 1993." /> <meta name="citation_reference" content="M. L. Ettenhofer, C. H. Hinkin, S. A. Castellon, R. Durvasula, J. Ullman, M. Lam, H. Myers, M. J. Wright, and J. Foley, “Aging, neurocognition, and medication adherence in hiv infection,” The American Journal of Geriatric Psychiatry, vol. 17, no. 4, pp. 281–290, 2009." /> <meta name="citation_reference" content="P. Fazeli, K. Casaletto, E. Paolillo, R. Moore, D. Moore, H. Group et al., “Screening for neurocognitive impairment in hiv-positive adults aged 50 years and older: Montreal cognitive assessment relates to self-reported and clinician-rated everyday functioning,” Journal of clinical and experimental neuropsychology, vol. 39, no. 9, pp. 842–853, 2017." /> <meta name="citation_reference" content="B. Lam, L. E. Middleton, M. Masellis, D. T. Stuss, R. D. Harry, A. Kiss, and S. E. Black, “Criterion and convergent validity of the montreal cognitive assessment with screening and standardized neuropsychological testing,” Journal of the American Geriatrics Society, vol. 61, no. 12, pp. 2181–2185, 2013." /> <meta name="citation_reference" content="V. Mathiowetz, G. Volland, N. Kashman, and K. Weber, “Adult norms for the box and block test of manual dexterity,” American Journal of Occupational Therapy, vol. 39, no. 6, pp. 386–391, 1985." /> <meta name="citation_reference" content="R. M. Ruff and S. B. Parker, “Gender-and age-specific changes in motor speed and eye-hand coordination in adults: normative values for the finger tapping and grooved pegboard tests,” Perceptual and motor skills, vol. 76, no. 3 suppl, pp. 1219–1230, 1993." /> <meta name="citation_reference" content="J. A. Schrack, L. P. Jacobson, K. N. Althoff, K. M. Erlandson, B. D. Jamieson, S. L. Koletar, J. Phair, T. T. Brown, and J. B. Margolick, “Effect of hiv-infection and cumulative viral load on age-related decline in grip strength,” AIDS (London, England), vol. 30, no. 17, p. 2645, 2016." /> <meta name="citation_reference" content="K. D. Bui, R. Rai, and M. J. Johnson, “Using upper limb kinematics to assess cognitive deficits in people living with both hiv and stroke,” in 2017 International Conference on Rehabilitation Robotics (ICORR). IEEE, 2017, pp. 907–912." /> <meta name="citation_reference" content="S. Balasubramanian, A. Melendez-Calderon, A. Roby-Brami, and E. Burdet, “On the analysis of movement smoothness,” Journal of neuroengineering and rehabilitation, vol. 12, no. 1, p. 112, 2015." /> <meta name="citation_reference" content="A. M. Owen, K. M. McMillan, A. R. Laird, and E. Bullmore, “N-back working memory paradigm: A meta-analysis of normative functional neuroimaging studies,” Human brain mapping, vol. 25, no. 1, pp. 46–59, 2005." /> <meta name="citation_reference" content="R. P. Kessels, M. J. Van Zandvoort, A. Postma, L. J. Kappelle, and E. H. De Haan, “The corsi block-tapping task: standardization and normative data,” Applied neuropsychology, vol. 7, no. 4, pp. 252–258, 2000." /> <meta name="citation_reference" content="R. Brunetti, C. Del Gatto, and F. Delogu, “ecorsi: implementation and testing of the corsi block-tapping task for digital tablets,” Frontiers in psychology, vol. 5, p. 939, 2014." /> <meta name="citation_reference" content="R. P. Fellows, D. A. Byrd, and S. Morgello, “Effects of information processing speed on learning, memory, and executive functioning in people living with hiv/aids,” Journal of clinical and experimental neuropsychology, vol. 36, no. 8, pp. 806–817, 2014." /> <meta name="citation_reference" content="I. M. Elicer, D. Byrd, U. S. Clark, S. Morgello, and J. Robinson-Papp, “Motor function declines over time in human immunodeficiency virus and is associated with cerebrovascular disease, while hiv-associated neurocognitive disorder remains stable,” Journal of neurovirology, vol. 24, no. 4, pp. 514–522, 2018." /> <meta name="citation_reference" content="R. A. Cohen, S. Siegel, J. Gullett, E. Porges, A. Woods, H. Huang, Y. Zhu, K. Tashima, and M.-Z. Ding, “Neural response to working memory demand predicts neurocognitive deficits in hiv,” Journal of neurovirology, vol. 24, no. 3, pp. 291–304, 2018." /> <meta name="citation_reference" content="G. B. Fogel, S. L. Lamers, A. J. Levine, M. Valdes-Sueiras, M. S. McGrath, p. Shapshak, and E. J. Singer, “Factors related to hiv-associated neurocognitive impairment differ with age,” Journal of neurovirology, vol. 21, no. 1, pp. 56–65, 2015." /> <meta name="citation_reference" content="K. K. O’Brien, F. Ibáñez-Carrasco, p. Solomon, R. Harding, J. Cattaneo, W. Chegwidden, J. Gahagan, L. Baxter, C. Worthington, p. Gayle et al., “Advancing research and practice in hiv and rehabilitation: a framework of research priorities in hiv, disability and rehabilitation,” BMC infectious diseases, vol. 14, no. 1, p. 724, 2014." /> <meta name="citation_reference" content="D. A. Piggott, K. M. Erlandson, and K. E. Yarasheski, “Frailty in hiv: epidemiology, biology, measurement, interventions, and research needs,” Current HIV/AIDS Reports, vol. 13, no. 6, pp. 340–348, 2016." /> <meta name="citation_reference" content="N. A. Johs, K. Wu, K. Tassiopoulos, S. L. Koletar, R. C. Kalayjian, R. J. Ellis, B. Taiwo, F. J. Palella Jr, and K. M. Erlandson, “Disability among middle-aged and older persons with human immunodeficiency virus infection,” Clinical Infectious Diseases, vol. 65, no. 1, pp. 83–91, 2017." /> <meta name="twitter:title" content="Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation" /> <meta name="twitter:site" content="@medrxivpreprint" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:image" content="https://www.medrxiv.org/sites/default/files/images/medrxiv_logo_homepage7-5-small-test-up.png" /> <meta name="twitter:description" content="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. ### Competing Interest Statement Michelle Johnson is a co-founder of Recupero Robotics, LLC, which is commercializing the rehabilitation robot system used in the study. ### Clinical Trial Study was not a clinical trial ### Funding Statement This work was made possible through core services and support from the National Institute Of Neurological Disorders and Stroke of the National Institutes of Health (T32NS091006); the University of Pennsylvania Center for AIDS Research (P30AI 045008); the University of Pennsylvania Center for Biomedical Image Comput- ing and Analytics; and the University of Pennsylvania Departments of Bioengineering and Physical Medicine and Rehabilitation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Pennsylvania IRB Protocol #823511 All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes De-identified data is available upon request, and will be available as a repository soon." /> <meta name="og-title" property="og:title" content="Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation" /> <meta name="og-url" property="og:url" content="https://www.medrxiv.org/content/10.1101/2020.10.30.20223172v1" /> <meta name="og-site-name" property="og:site_name" content="medRxiv" /> <meta name="og-description" property="og:description" content="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. ### Competing Interest Statement Michelle Johnson is a co-founder of Recupero Robotics, LLC, which is commercializing the rehabilitation robot system used in the study. ### Clinical Trial Study was not a clinical trial ### Funding Statement This work was made possible through core services and support from the National Institute Of Neurological Disorders and Stroke of the National Institutes of Health (T32NS091006); the University of Pennsylvania Center for AIDS Research (P30AI 045008); the University of Pennsylvania Center for Biomedical Image Comput- ing and Analytics; and the University of Pennsylvania Departments of Bioengineering and Physical Medicine and Rehabilitation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: University of Pennsylvania IRB Protocol #823511 All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. 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class="highwire-article-citation highwire-citation-type-highwire-article node126136" data-node-nid="126136" id="node-126136--21353447632" data-pisa="medrxiv;2020.10.30.20223172v1" data-pisa-master="medrxiv;2020.10.30.20223172" data-apath="/medrxiv/early/2020/11/03/2020.10.30.20223172.atom" data-hw-author-tooltip-instance=""><div class="highwire-cite highwire-cite-highwire-article highwire-citation-medrxiv-article-top clearfix has-author-tooltip" > <h1 class="highwire-cite-title" id="page-title">Robot-based assessment of HIV-related motor and cognitive impairment for neurorehabilitation</h1> <div class="highwire-cite-authors" ><span class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Kevin D.</span> <span class="nlm-surname">Bui</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Carol A.</span> <span class="nlm-surname">Wamsley</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Frances S.</span> <span class="nlm-surname">Shofer</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Dennis L.</span> <span class="nlm-surname">Kolson</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Michelle J.</span> <span class="nlm-surname">Johnson</span></span></span></div> <div class="highwire-cite-metadata" ><span class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">doi:</span> https://doi.org/10.1101/2020.10.30.20223172 </span></div> </div> <div id="hw-article-author-popups-node-126136--21353447632" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Kevin D. Bui </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span><span class='nlm-institution'>Rehabilitation Robotics Lab and Department of Bioengineering, University of Pennsylvania</span>, Philadelphia, PA 19104 <span class='nlm-country'>USA</span></div>Ph.D.</span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Kevin%2BD.%2BBui%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bui%20KD&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AKevin%2BD.%2BBui%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Carol A. Wamsley </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>2</span><span class='nlm-institution'>Penn Institute for Rehabilitation Medicine</span>, Philadelphia, PA 19146 <span class='nlm-country'>USA</span></div>PT, DPT</span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Carol%2BA.%2BWamsley%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wamsley%20CA&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ACarol%2BA.%2BWamsley%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Frances S. Shofer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>3</span><span class='nlm-institution'>Department of Emergency Medicine, University of Pennsylvania</span>, Philadelphia, PA 19104 <span class='nlm-country'>USA</span></div>Ph.D.</span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Frances%2BS.%2BShofer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shofer%20FS&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AFrances%2BS.%2BShofer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Dennis L. Kolson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>4</span><span class='nlm-institution'>Department of Neurology, University of Pennsylvania</span>, Philadelphia, PA 19104 <span class='nlm-country'>USA</span></div>M.D., Ph.D.</span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Dennis%2BL.%2BKolson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kolson%20DL&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ADennis%2BL.%2BKolson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Michelle J. Johnson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>5</span><span class='nlm-institution'>Rehabilitation Robotics Lab, Department of Physical Medicine and Rehabilitation, and Department of Bioengineering, University of Pennsylvania</span>, Philadelphia, PA 19104 <span class='nlm-country'>USA</span> (e-mail: )</div>Ph.D.</span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Michelle%2BJ.%2BJohnson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Johnson%20MJ&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AMichelle%2BJ.%2BJohnson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-corresp-email-link last"><span>For correspondence: <a href="mailto:johnmic@pennmedicine.upenn.edu" class="" data-icon-position="" data-hide-link-title="0">johnmic@pennmedicine.upenn.edu</a> <a href="mailto:johnmic@pennmedicine.upenn.edu" class="" data-icon-position="" data-hide-link-title="0">johnmic@pennmedicine.upenn.edu</a></span></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs" > <div class="pane-content"> <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="first"><a href="/content/10.1101/2020.10.30.20223172v1" class="panels-ajax-tab-tab" data-panel-name="biorxiv_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:126136" data-trigger="" 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data-entity-context="node:126136" data-trigger="full.pdf+html" data-url-enabled="1"><i class="icon-file-alt"></i> Preview PDF</a><a href="/panels_ajax_tab/biorxiv_tab_pdf/node:126136/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="biorxiv_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://www.medrxiv.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-biorxiv_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2 class="">Abstract</h2><p id="p-2">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.</p></div><h3>Competing Interest Statement</h3><p id="p-3">Michelle Johnson is a co-founder of Recupero Robotics, LLC, which is commercializing the rehabilitation robot system used in the study.</p><h3>Clinical Trial</h3><p id="p-4">Study was not a clinical trial</p><h3>Funding Statement</h3><p id="p-5">This work was made possible through core services and support from the National Institute Of Neurological Disorders and Stroke of the National Institutes of Health (T32NS091006); the University of Pennsylvania Center for AIDS Research (P30AI 045008); the University of Pennsylvania Center for Biomedical Image Comput- ing and Analytics; and the University of Pennsylvania Departments of Bioengineering and Physical Medicine and Rehabilitation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</p><h3>Author Declarations</h3><p id="p-6">I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.</p><p id="p-7">Yes</p><p id="p-8">The details of the IRB/oversight body that provided approval or exemption for the research described are given below:</p><p id="p-9">University of Pennsylvania IRB Protocol #823511</p><p id="p-10">All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.</p><p id="p-11">Yes</p><p id="p-12">I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).</p><p id="p-13">Yes</p><p id="p-14"> I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.</p><p id="p-15">Yes</p><div class="section data-availability" id="sec-38"><h2 class="">Data Availability</h2><p id="p-98">De-identified data is available upon request, and will be available as a repository soon.</p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-biorxiv-copyright" > <div class="pane-content"> <div 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HIV-related motor and cognitive impairment for neurorehabilitation</div> </div> <div class="highwire-cite-authors" ><span class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Kevin D.</span> <span class="nlm-surname">Bui</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Carol A.</span> <span class="nlm-surname">Wamsley</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Frances S.</span> <span class="nlm-surname">Shofer</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Dennis L.</span> <span class="nlm-surname">Kolson</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Michelle J.</span> <span class="nlm-surname">Johnson</span></span></span></div> <div class="highwire-cite-metadata" ><span class="highwire-cite-metadata-journal highwire-cite-metadata">medRxiv </span><span class="highwire-cite-metadata-pages highwire-cite-metadata">2020.10.30.20223172; </span><span class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="doi_label">doi:</span> https://doi.org/10.1101/2020.10.30.20223172 </span></div> </div> </div> </div> <div class="highwire-citation-formats"> <h2>Citation Manager Formats</h2> <div class="highwire-citation-formats-links"> <span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.spage&rft.epage&rft.atitle=Robot-based%20assessment%20of%20HIV-related%20motor%20and%20cognitive%20impairment%20for%20neurorehabilitation&rft.volume&rft.issue&rft.date=2020-01-01%2000%3A00%3A00&rft.stitle&rft.jtitle=medRxiv&rft.au=Bui%2C+Kevin+D.&rft.au=Wamsley%2C+Carol+A.&rft.au=Shofer%2C+Frances+S.&rft.au=Kolson%2C+Dennis+L.&rft.au=Johnson%2C+Michelle+J."></span><ul class="hw-citation-links inline button button-alt button-grid clearfix"><li class="bibtext 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