Designing robot-assisted neurorehabilitation strategies for people with both HIV and stroke
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Designing robot-assisted neurorehabilitation strategies for people with both HIV and stroke Kevin D. Bui1,2 and Michelle J. Johnson1,2,3* Abstract 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. Keywords: HIV, Stroke, Neurorehabilitation, Robotics, Developing countries
Background Stroke is a leading cause of death and disability in high income countries while both stroke and human immunodeficiency virus (HIV) are leading causes of death and disability in lower income countries [1, 2]. 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 in both high and low resource areas [3–9]. Little research has been conducted on this population, particularly from a neurorehabilitation standpoint. It is important to consider the HIV-stroke population from this viewpoint because both are chronic diseases associated with lasting neurologic injury and require extensive amounts of monitoring, assessment, and treatment. While dealing with one is *Correspondence: [email protected] Department of Bioengineering, University of Pennsylvania, Philadelphia, USA 2 Rehabilitation Robotics Lab (a GRASP Lab), University of Pennsylvania, 1800 Lombard Street, 19146 Philadelphia, USA Full list of author information is available at the end of the article 1
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