Publications by authors named "Michelle J Johnson"

The Hammersmith Neonatal (HNNE) and Infant (HINE) Neurological Examinations are increasingly used to evaluate developing neuromotor control in infants at risk for physical disability, but there is no global consensus on score interpretation across the first 6 months after birth. We report scores for typically developing, full-term infants aged 1 month for the HNNE and aged 2-6 months for the HINE. The median HNNE and HINE scores are consistent with previously published data.

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Objective: To determine if the use of telerehabilitation among rehabilitation therapists during the first 11 months of the COVID-19 pandemic increased, if therapists' identified plans to continue use after the pandemic, and to understand challenges that therapists face in using telerehabilitation, and to evaluate viable use-cases for telerehabilitation.

Design: A survey was conducted among clinicians containing questions about tools being used before, during, and after (planned) COVID-19. Statistical analysis was conducted to evaluate the increase in actual usage of telerehabilitation during the pandemic and planned usage after the pandemic.

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It is crucial to identify neurodevelopmental disorders in infants early on for timely intervention to improve their long-term outcomes. Combining natural play with quantitative measurements of developmental milestones can be an effective way to swiftly and efficiently detect infants who are at risk of neurodevelopmental delays. Clinical studies have established differences in toy interaction behaviors between full-term infants and pre-term infants who are at risk for cerebral palsy and other developmental disorders.

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Rehabilitation robots have the potential to alleviate the global burden of neurorehabilitation. Robot-based multiplayer gaming with virtual and haptic interaction may improve motivation, engagement, and implicit learning in robotic therapy. Over the past few years, there has been growing interest in robot mediated haptic dyads, or human-robot-robot-human interaction.

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The modern worldwide trend toward sedentary behavior comes with significant health risks. An accompanying wave of health technologies has tried to encourage physical activity, but these approaches often yield limited use and retention. Due to their unique ability to serve as both a health-promoting technology and a social peer, we propose robots as a game-changing solution for encouraging physical activity.

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Infants born pre-term are at an increased risk for developmental, behavioral, and motor delay and subsequent disability. When these problems are detected early, clinical intervention can be effective at improving functional outcomes. Current methods of early clinical assessment are resource intensive, require extensive training, and do not always capture infants' behavior in natural play environments.

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Infants at risk for developmental delays often exhibit postures and movements that may provide a window into potential impairment for cerebral palsy and other neuromotor conditions. We developed a simple 4 DOF robot pediatric simulator to help provide insight into how infant kinematic movements may affect the center of pressure (COP), a common measure thought to be sensitive to neuromotor delay when assessed from supine infants at play. We conducted two experiments: 1) we compared changes in COP caused by limb movements to a human infant and 2) we determined if we could predict COP position due to limb movements using simulator kinematic pose retrieved from video and a sensorized mat.

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There is a growing need to deliver rehabilitation care to patients remotely. Long term demographic changes, geographic shortages of care providers, and now a global pandemic contribute to this need. Telepresence provides an option for delivering this care.

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Background: Chronic upper extremity motor deficits are present in up to 65% of stroke survivors, and cognitive impairment is prevalent in 46-61% of stroke survivors even 10 years after their stroke. Robot-assisted therapy programs tend to focus on motor recovery and do not include stroke patients with cognitive impairment.

Objective: This study aims to investigate performance on the individual cognitive domains evaluated in the MoCA and their relation to upper-limb motor performance on a robotic system.

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Introduction: Stroke is the leading cause of disability worldwide. It has been well-documented that rehabilitation (rehab) therapy can aid in regaining health and function for individuals with stroke. Yet, tracking in-home rehab continues to be a challenge because of a lack of resources and population-scale demands.

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Background: Early detection of delay or impairment in motor function is important to guide clinical management and inform prognosis during a critical window for the development of motor control in children. The purpose of this study was to investigate the ability of biomechanical measures of early postural control to distinguish infants with future impairment in motor control from their typically developing peers.

Methods: We recorded postural control from infants lying in supine in several conditions.

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Purpose: For children with mobility impairments, without cognitive delays, who want to participate in outdoor activities, existing assistive technology (AT) to support their needs is limited. In this review, we investigate the control and design of a selection of robotic walkers while exploring a selection of legged robots to develop solutions that address this gap in robotic AT.

Method: We performed a comprehensive literature search from four main databases: PubMed, Google Scholar, Scopus, and IEEE Xplore.

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The World Health Organization estimates that 15 million infants are born preterm every year [1]. This is of concern because these infants have a significant chance of having neuromotor or cognitive developmental delays due to cerebral palsy or other developmental issues [2]. Our long-term goal is to determine the roles emotion and movement play in the diagnosis of atypical infants.

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Introduction: We present Lil'Flo, a socially assistive robotic telerehabilitation system for deployment in the community. As shortages in rehabilitation professionals increase, especially in rural areas, there is a growing need to deliver care in the communities where patients live, work, learn, and play. Traditional telepresence, while useful, fails to deliver the rich interactions and data needed for motor rehabilitation and assessment.

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With the shortage of rehabilitation clinicians in rural areas and the ongoing COVID-19 pandemic, remote rehabilitation (telerehab) fills an important gap in access to rehabilitation, especially for the treatment of adults and children experiencing upper arm disability due to stroke and cerebral palsy. We propose the use of a socially assistive robot with arms, a torso, and a face to play games with and guide patients, coupled with a telepresence platform, to maintain the patient-clinician interaction, and a computer vision system, to aid in automated objective assessments, as a tool for achieving more effective telerehab. In this paper, we outline the design of such a system, Lil'Flo, and present a uniquely large perceived usefulness evaluation of the Lil'Flo platform with 351 practicing therapists in the United States.

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Background: The negative discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms.

Objective: Albeit the LNU phenomenon is generally accepted to exist, currently, no transdisciplinary definition exists. Furthermore, although therapeutic approaches are implemented in clinical practice targeting LNU, no standardized diagnostic routine is described in the available literature.

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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.

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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.

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An infant's risk of developing neuromotor impairment is primarily assessed through visual examination by specialized clinicians. Therefore, many infants at risk for impairment go undetected, particularly in under-resourced environments. There is thus a need to develop automated, clinical assessments based on quantitative measures from widely-available sources, such as videos recorded on a mobile device.

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Background: The worldwide population of older adults will soon exceed the capacity of assisted living facilities. Accordingly, we aim to understand whether appropriately designed robots could help older adults stay active at home.

Methods: Building on related literature as well as guidance from experts in game design, rehabilitation, and physical and occupational therapy, we developed eight human-robot exercise games for the Baxter Research Robot, six of which involve physical human-robot contact.

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Early detection of neurodevelopmental disorders in infants is critical for early intervention to improve their long-term function. Integrating natural play with quantitative measurements of developmental milestones may help to quickly and efficiently identify infants at-risk for developmental delays. Ailu is a sensorized toy designed to elicit and measure natural infant play interactions.

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We introduce Lil'Flo, an affordable robot for pediatric upper extremity rehabilitation. We present the design and fabrication methodology of the head and face of the robot, the central design element for emotional expression. Through a guided interview with 10 subjects, a number of faces which have a clear sentiment associated with them are identified.

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Robot-based neurorehabilitation strategies often ignore cognitive performance during treatment, but this is a need in populations dealing with a wide variety of cognitive and motor impairments, such as the stroke and HIV populations, for which an association between the two have been established. In this study, we concurrently measure cognitive and motor performance on a robotic cognitive-motor task and quantify cognitive-motor interference. We apply this method to a pilot group of healthy, stroke, and HIV-stroke subjects, and we demonstrate the potential of smoothness and correct response rate as metrics to capture motor and cognitive-related dual-task effects.

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Task-oriented therapy consists of three stages: demonstration, observation and assistance. While demonstration using robots has been extensively studied, the other two stages rarely involve robots. This paper focuses on the transition between observation and assistance.

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