Page 19 - Mobility Management, September 2018

only to control their power wheelchair, but also various applications on their computers and smartphones.
The mTDS is currently undergoing a study at Brooks Rehabilitation in Jacksonville, Fla., under the guidance of Principal Investigator Geneva Tonuzi, M.D. The study requires participants to harness the various modalities
of the device to complete five tasks and games to test for accuracy and speed. For example, one task required participants to write an e-mail by using their head move- ment to control the mouse cursor, clicking the tongue in their cheeks to make mouse clicks and speaking into a microphone for speech-to-text typing.
“What we saw in our participants with the initial study with computer access [is] that they were able to pick
it up really fast,” said Erica Walling, MPT, ATP/SMS, a coinvestigator on the study at Brooks. “We were all really surprised how fast they were able to pick it up.”
The research team’s surprise was matched by the participants’ enthusiasm. Michelle Hoefnagel, M.S., CCC-SLP, another coinvestigator, said, “[Our partici- pants] improved their scores on the games and tasks. A lot of them said they were looking forward to returning to play the games and complete the tasks again, but wanted to do better than they did before.”
The team did encounter some challenges with the device. Hoefnagel recalled a participant who experi- enced initial difficulty completing some tasks due to a tracheostomy tube and a speaking valve that impeded breathing during head movement: “[The participant] was able to quickly figure out a way to move to complete the tasks, and he no longer had trouble breathing.” She added, “It was really awesome to see [him] adapt and overcome and be able to use this technology.”
Another participant with a new injury and a surgical collar also encountered trouble with head movement, and couldn’t complete the task without pain. Chris Fulcher, a third coinvestigator, explained that for the study, participants used the device on the same settings without personalized calibration: “For the future, we’ll be able to calibrate for a person’s head range of motion.”
For Walling, it is this ability for individual customization through its many modalities that sets this technology apart from others on the market. For example with sip-and-puff, “you’re trying to give multiple commands with a single input device,” she explained. With mTDS, “you have multiple modalities to use with different options so you can adapt it to each person with what- ever strategy works best for each individual.”
What’s Next for TDS
The team at Brooks Rehabilitation is currently only testing the TDS multi modal capabilities with computers, but they don’t want to stop there. Tonuzi hopes to combine the newer multi-modal capabilities with the power wheel- chair operation of the original version of the 2012-2013
Maysam Ghovanloo with study participant Jason DiSanto, who sustained a spinal cord injury in 2009.
studies. “We’d like to see it at least be used for things like that. I just think that it would be simpler now that it is multi-modal and you can add in head mobility and proportional control and all kinds of things.”
Ghovanloo and the Georgia Tech are working to develop a TDS that fits entirely inside the mouth; it’s called the intra-oral TDS (iTDS). This has not been without its own set of new challenges.
“There is a big difference between when you want to communicate wirelessly from inside the mouth versus from outside the body. It’s like an order of magnitude more difficult,” he explained. Not only does the device need to be able to send a wireless signal through bodily tissue, but it also has to be small enough to not inter- fere with essential tongue movement while housing an antenna, a rechargeable battery, and other electronics.
They have worked through many of these challenges, and iTDS is showing promise. Ghovanloo reports that the device is close to producing a functional prototype that can be studied on an able-bodied control group.
So far, TDS has been tested in controlled environments, and the next step is testing how the device works in the home, office and outdoors. Again, this requires funding and more collaborating partners, like those at Brooks.
Currently, the target demographic includes people with tetraplegia and other spinal cord injuries (SCI), but the hope is that it will benefit clients with other disabil- ities as well. Tonuzi, speaking for the team at Brooks Rehabilitation, said, “We want to be able to see this used not just for people who have SCI... really, there are just so many people who have been affected by anything from multiple sclerosis to Guillain-Barré to cerebral palsy.
“The sky’s the limit when it comes to who this tech- nology can benefit.” m
Editor’s Note: For more information on commercial applications, visit http://www.tonguedrive.com/ or http:// www.brooksrehab.org/. Contact mghovan@bionic- sciences.com to discuss collaborative opportunities.
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