[Satisfaction with technological equipment in individuals with tetraplegia following spinal cord injury]

[Technological solutions to compensate for motor disability]

There are a wide range of technological solutions now available to meet the needs of people with a motor disability. It is important to use resource centres which offer the benefit of a technological watch and are able to recommend specific solutions. They will thereby meet users' needs as closely as possible.

Comparison between joystick- and gaze-controlled electric wheelchair during narrow doorway crossing: Feasibility study and movement analysis

Due to motor deficiencies inducing low force capabilities or tremor, many persons have great difficulties to use joystick-operated wheelchairs. To alleviate such difficulties, alternative interfaces using vocal, gaze, or brain signals are now becoming available. While promising, these systems still need to be evaluated thoroughly. In this framework, the aims of this study are to analyze and evaluate the behavior of 11 able-bodied subjects during a navigation task executed with gaze or joystick-operated electric wheelchair involving a door crossing. An electric wheelchair was equipped with retroreflective markers, and their movements were recorded with an optoelectronic system. The gaze commands were detected using an eye tracking device. Apart from classical, forward, backward, stop, left and right commands, the chosen screen-based interface integrated forward-right and forward-left commands. The global success rate with the gaze-based control was 80.3%. The path optimally ratio was 0.97 and the subject adopted similar trajectories with both systems. The results for gaze control are promising and highlight the important utilization of the forward-left and forward-right commands (25% of all issued commands) that may explain the similarity between the trajectories using both interfaces.

Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia

Context/Objective: To evaluate the availability and self-declared unmet need of assistive devices to compensate for impaired hand function of individuals with tetraplegia in Switzerland.Design: Cross-sectional survey.Setting: Community.Participants: Individuals with tetraplegia, aged 16 years or older, living in Switzerland.Interventions: not applicable.Outcome Measures: The self-report availability and unmet need of 18 assistive devices for impaired hand function was analyzed descriptively. The availability of devices was further evaluated stratified by sex, age, SCI severity, independence in grooming, time since injury, living situation, working status, and income. Associations between availability of devices and person characteristics were investigated using logistic regression analysis.Results: Overall 32.7% of participants had any assistive device for impaired hand function at their disposal. The most frequent devices were adapted cutlery (14.8%), type supports (14.1%), environmental control systems (11.4%), and writing orthosis (10.6%). In the bivariate analysis several factors showed significant associations with at least one assistive device. Nevertheless, when controlling for potential confounding in multivariate analysis only independence in grooming (adapted cutlery, environmental control systems, type support, speech recognition software), SCI severity (writing orthosis, type support), and sex (adapted kitchenware) remained significantly associated with the availability of the mentioned assistive devices. The self-declared unmet need was generally low (0.7% - 4.3%), except for adapted kitchenware with a moderate unmet need (8.9%).Conclusion: This study indicates that most individuals with tetraplegia in Switzerland are adequately supplied with assistive devices to compensate for impaired hand function. The availability depends mainly on SCI severity and independence in grooming.

Taking back a little of what you have lost: the meaning of using an Environmental Control System (ECS) for people with high cervical spinal cord injury

PURPOSE

Assistive technologies have deep and personal meanings for people with disabilities. This study sought to provide an in-depth exploration of the subjective meaning of Environmental Control System (ECS) use for people with high cervical spinal cord injury.

MATERIALS AND METHOD

Interpretative Phenomenological Analysis (IPA) was used to explore the personal meaning of ECS. In-depth interviews with five participants were analyzed according to recommended IPA guidelines to produce a rich phenomenological account of lived experience.

RESULTS

This study identified two overarching themes, one of which was the subject of an earlier publication. This paper focuses on the second theme "taking back a little of what you have lost" and its two main components "reclaiming a little doing" and "feeling enabled". Doing everyday things, being less dependent on others and feeling safer and less needy all contributed to participants experience of regaining something important of what had been lost.

CONCLUSIONS

A nuanced range of meanings, demonstrating how "a little can mean a lot" emerged from this study. For those with high cervical spinal cord injury, "reclaiming a little doing" resulted in subtle, but subjectively significant, improvements in identity, relationships and well-being, while "feeling enabled" was both enjoyable and empowering and led to an increased sense of safety and reduced neediness. The potentially powerful impact on individuals with life-altering injuries of reclaiming a little of what they had lost, supports the value of more widespread access to and provision of ECS. Implications for rehabilitation While ECS use produces only a "little" objective change in activity levels, it subjectively means "a lot" to people with high level injuries. ECS enable people to "do" everyday things as well help in supporting them to "feel" less dependent and needy. Using ECS facilitates much more than functional tasks and a sense of security. It helps promote positive self-perception and continuity of being. It is important for those with high cervical spinal cord injuries to have access to ECS to ensure they can enjoy both psychological and physical benefits.

ANSO study: evaluation in an indoor environment of a mobile assistance robotic grasping arm

OBJECTIVE

To evaluate the reliability and functional acceptability of the ‘‘Synthetic Autonomous Majordomo’’ (SAM) robotic aid system (a mobile Neobotix base equipped with a semi-automatic vision interface and a Manus robotic arm).

MATERIALS AND METHODS

An open, multicentre, controlled study. We included 29 tetraplegic patients (23 patients with spinal cord injuries, 3 with locked-in syndrome and 4 with other disorders; mean SD age: 37.83 13.3) and 34 control participants (mean SD age: 32.44 11.2). The reliability of the user interface was evaluated in three multi-step scenarios: selection of the room in which the object to be retrieved was located (in the presence or absence of visual control by the user), selection of the object to be retrieved, the grasping of the object itself and the robot’s return to the user with the object. A questionnaire was used to assess the robot’s user acceptability.

RESULTS

The SAM system was stable and reliable: both patients and control participants experienced few failures when completing the various stages of the scenarios. The graphic interface was effective for selecting and grasping the object – even in the absence of visual control. Users and carers were generally satisfied with SAM, although only a quarter of patients said that they would consider using the robot in their activities of daily living.

Evaluation of a graphic interface to control a robotic grasping arm: a multicenter study

Laffont I, Biard N, Chalubert G, Delahoche L, Marhic B, Boyer FC, Leroux C. Evaluation of a graphic interface to control a robotic grasping arm: a multicenter study.

OBJECTIVE

Grasping robots are still difficult to use for persons with disabilities because of inadequate human-machine interfaces (HMIs). Our purpose was to evaluate the efficacy of a graphic interface enhanced by a panoramic camera to detect out-of-view objects and control a commercialized robotic grasping arm.

DESIGN

Multicenter, open-label trial.

SETTING

Four French departments of physical and rehabilitation medicine.

PARTICIPANTS

Control subjects (N=24; mean age, 33y) and 20 severely impaired patients (mean age, 44y; 5 with muscular dystrophies, 13 with traumatic tetraplegia, and 2 others) completed the study. None of these patients was able to grasp a 50-cL bottle without the robot.

INTERVENTIONS

Participants were asked to grasp 6 objects scattered around their wheelchair using the robotic arm. They were able to select the desired object through the graphic interface available on their computer screen.

MAIN OUTCOME MEASURES

Global success rate, time needed to select the object on the screen of the computer, number of clicks on the HMI, and satisfaction among users.

RESULTS

We found a significantly lower success rate in patients (81.1% vs 88.7%; chi(2)P=.017). The duration of the task was significantly higher in patients (71.6s vs 39.1s; P<.001). We set a cut-off for the maximum duration at 79 seconds, representing twice the amount of time needed by the control subjects to complete the task. In these conditions, the success rate for the impaired participants was 65% versus 85.4% for control subjects. The mean number of clicks necessary to select the object with the HMI was very close in both groups: patients used (mean +/- SD) 7.99+/-6.07 clicks, whereas controls used 7.04+/-2.87 clicks. Considering the severity of patients' impairment, all these differences were considered tiny. Furthermore, a high satisfaction rate was reported for this population concerning the use of the graphic interface.

CONCLUSIONS

The graphic interface is of interest in controlling robotic arms for disabled people, with numerous potential applications in daily life.