Authors (including presenting author) :
Wong SY(1), Tsoi KM(1), Chan KL(1), Yu KP(1), Ma WL(1)
Affiliation :
(1)Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital
Introduction :
Motor neurone diseases (MND) are a group of progressive neurological disorders that destroy motor neurons. Patients suffering from MND usually have limited upper and lower limb function, dysarthria and changes in respiratory function, leading to difficulties in most activities of daily living (ADL) and social participation. Studies also showed that speech and voice deficits have a strong impact on functional communication, contributing to reduced quality of life and increased risk of depression. Furthermore, non-invasive ventilation (NIV) often is needed for patients with MND, but it is difficult for them to manage NIV due to their limited physical function. This difficulty coupled with their general difficulty in seeking help due to speech deficit creates safety concerns. To overcome these challenges, adaptive switches, which are a group of input devices, are usually prescribed for them to control a tablet for communication and environmental devices. However, many commercial adaptive switches are not suitable for patients with MND due to their limited physical function to trigger the adaptive switches. Therefore, we need to find an innovative solution – being able to use very small movements to trigger the switches and control different devices.
Objectives :
This project aimed to explore and establish a new adaptive switch to facilitate more effective communication of MND patients and improve their quality of life (QOL).
Methodology :
A gyroscopic sensor was used in this project. It was modified to be an adaptive switch – hence it was called a gyro-switch. When the gyroscopic sensor detected the tiny movements of the patient, a signal would be generated and input to the target devices to control the devices. A computer program was set up to adjust the sensitivity of the sensor in terms of the frequency and velocity of movement. A 64-year-old male patient with MND was recruited to use the gyro-switch to operate a tablet and control the call bell. Feedback was collected from the patient and his family. Feedback encompassed convenience and ease of use, improvement of safety, importance of the device, improvement in QOL and overall satisfaction. An assessment was conducted using the System Usability Scale (SUS) to evaluate the effectiveness and efficiency of the gyro-switch.
Result & Outcome :
The patient was able to use the gyro-switch to control the tablet and the call bell by the tiny movement of a finger after 15 minutes of training. A cross scanning method was applied to control the tablet with the gyro-switch. The patient was able to control the basic functions of the tablet including watching videos, opening communication apps and typing. He could also trigger the call bell through the gyro-switch at night to seek help. The feedback from the patient and his family (n=2) indicated high satisfaction with the new adaptive switch in terms of ease of use (8.5/10), improvement of safety (9.5/10), improvement of QOL (8/10), importance of the device (10/10) and overall satisfaction (9/10). The SUS had a score of 80 out of 100. It indicated that the gyro-switch was a grade A- product and the patient had a good experience in using the gyro-switch. To conclude, modifying a gyroscopic sensor to be an adaptive switch is a possible solution for patients with special needs, like patients with MND. Only a tiny movement is required to generate a huge impact in the lives of our patients.
