Schmalfuß L, Rupp R, Tuga M R, Kogut A, Hewitt M, Meincke J, Klinker F, Duttenhoefer W, Eck U, Mikut R, Reischl M, Liebetanz D
Heidelberg University Hospital, Spinal Cord Injury Center, Heidelberg, Germany.
Karlsruhe Institute of Technology, Institute for Applied Computer Science/Automation Technology, Karlsruhe, Germany.
Restor Neurol Neurosci. 2016;34(1):79-95. doi: 10.3233/RNN-150579.
Providing mobility solutions for individuals with tetraplegia remains challenging. Existing control devices have shortcomings such as varying or poor signal quality or interference with communication. To overcome these limitations, we present a novel myoelectric auricular control system (ACS) based on bilateral activation of the posterior auricular muscles (PAMs).
Ten able-bodied subjects and two individuals with tetraplegia practiced PAM activation over 4 days using visual feedback and software-based training for 1 h/day. Initially, half of these subjects were not able to voluntarily activate their PAMs. This ability was tested with regard to 8 parameters such as contraction rate, lateralized activation, wheelchair speed and path length in a virtual obstacle course. In session 5, all subjects steered an electric wheelchair with the ACS.
Performance of all subjects in controlling their PAMs improved steadily over the training period. By day 5, all subjects successfully generated basic steering commands using the ACS in a powered wheelchair, and subjects with tetraplegia completed a complex real-world obstacle course. This study demonstrates that the ability to activate PAM on both sides together or unilaterally can be learned and used intuitively to steer a wheelchair.
With the ACS we can exploit the untapped potential of the PAMs by assigning them a new, complex function. The inherent advantages of the ACS, such as not interfering with oral communication, robustness, stability over time and proportional and continuous signal generation, meet the specific needs of wheelchair users and render it a realistic alternative to currently available assistive technologies.
为四肢瘫痪者提供移动解决方案仍然具有挑战性。现有的控制设备存在诸如信号质量变化或不佳、干扰通信等缺点。为了克服这些限制，我们提出了一种基于耳后肌（PAM）双侧激活的新型肌电耳廓控制系统（ACS）。
10名健全受试者和2名四肢瘫痪者在4天内通过视觉反馈和基于软件的训练（每天1小时）练习PAM激活。最初，这些受试者中有一半无法自主激活其PAM。在虚拟障碍课程中，针对收缩率、侧向激活、轮椅速度和路径长度等8个参数对这种能力进行了测试。在第5次训练中，所有受试者使用ACS驾驶电动轮椅。
在训练期间，所有受试者控制其PAM的表现稳步提高。到第5天，所有受试者都使用ACS在电动轮椅上成功生成了基本转向命令，四肢瘫痪的受试者完成了复杂的现实世界障碍课程。这项研究表明，双侧或单侧激活PAM的能力可以被学习并直观地用于驾驶轮椅。
通过ACS，我们可以通过赋予耳后肌新的复杂功能来挖掘其未被利用的潜力。ACS的固有优势，如不干扰口头交流、坚固性、随时间的稳定性以及成比例和连续的信号生成，满足了轮椅使用者的特定需求，并使其成为当前可用辅助技术的现实替代方案。
