Purpose The aim of this study was to conduct a systematic review of the literature relating to the feasibility, utility, and safety of augmentative and alternative communication (AAC) interventions...

The Feasibility, Utility, and Safety of Communication Interventions With Mechanically Ventilated Intensive Care Unit Patients: A Systematic Review.

This paper reviews management strategies for patients undergoing prolonged mechanical ventilation (PMV). Topics covered include how to identify and correct barriers to weaning, the systematic approach to weaning trials, when to cease weaning trials and proceed with life-long support, managing the tracheostomy tube during PMV, and, finally, how to select a suitable mechanical ventilator for PMV.

http://rc.rcjournal.com/content/respcare/57/6/889.full.pdf

Long-Term Mechanical Ventilation: Management Strategies

Virtual keyboard applications and alternative communication devices provide new means of communication to assist disabled people. To date, virtual keyboard optimization schemes based on script-specific information, along with multimodal input access facility, are limited. In this paper, we propose a novel method for optimizing the position of the displayed items for gaze-controlled tree-based menu selection systems by considering a combination of letter frequency and command selection time. The optimized graphical user interface layout has been designed for a Hindi language virtual keyboard based on a menu wherein 10 commands provide access to type 88 different characters, along with additional text editing commands. The system can be controlled in two different modes: eye-tracking alone and eye-tracking with an access soft-switch. Five different keyboard layouts have been presented and evaluated with ten healthy participants. Furthermore, the two best performing keyboard layouts have been evaluated with eye-tracking alone on ten stroke patients. The overall performance analysis demonstrated significantly superior typing performance, high usability (87% SUS score), and low workload (NASA TLX with 17 scores) for the letter frequency and time-based organization with script specific arrangement design. This paper represents the first optimized gaze-controlled Hindi virtual keyboard, which can be extended to other languages.

/pdf/toward-optimization-of-gaze-controlled-human-computer-drpv4diaut.pdf

Toward Optimization of Gaze-Controlled Human–Computer Interaction: Application to Hindi Virtual Keyboard for Stroke Patients

Families in the Intensive Care Unit: A Guide to Understanding, Engaging, and Supporting at the Bedside

Eye-typing is an important tool for people with physical disabilities and, for some, it is their main form of communication. By observing expert typists using physical keyboards, we notice that visual throughput is considerably reduced in current eye-typing solutions. We propose AugKey to improve throughput by augmenting keys with a prefix, to allow continuous text inspection, and suffixes to speed up typing with word prediction. AugKey limits the visual information to the foveal region to minimize eye movements (i.e., reduce eye work). We have applied AugKey to a dwell-time keyboard and compared its performance with two conditions with no augmented feedback: a keyboard with and one without word prediction. Results show that AugKey can be about 28% faster than no word prediction and 20% faster than traditional word prediction, with a smaller workload index.

AugKey: Increasing Foveal Throughput in Eye Typing with Augmented Keys

Many patients with respiratory failure related to neuromuscular disease receive chronic invasive ventilation through a tracheostomy. Improving quality of life, of which speech is an important component, is a major goal in these patients. We compared the effects on breathing and speech of low-level positive end-expiratory pressure (PEEP, 5 cmH2O) and of a Passy-Muir speaking valve (PMV) during assist-control ventilation. We studied ten patients with neuromuscular disorders, between December 2008 and April 2009. Flow was measured using a pneumotachograph. Microphone speech recordings were subjected to both quantitative measurements and qualitative assessments; the latter consisted of both an intelligibility score (using a French adaptation of the Frenchay Dysarthria Assessment) and a perceptual score determined by two speech therapists. Text reading time, perceptive score, intelligibility score, speech comfort, and respiratory comfort were similar with PEEP and PMV. During speech with 5 cmH2O PEEP, six of the ten patients had no return of expiratory gas to the expiratory line and, therefore, had the entire insufflated volume available for speech, a condition met during PMV use in all patients. During speech, the respiratory rate increased by at least 3 cycles/min above the backup rate in seven patients with PEEP and in none of the patients with PMV. Low-level PEEP is as effective as PMV in ensuring good speech quality, which might be explained by sealed expiratory line with low-level PEEP and/or respiratory rate increase during speech with PEEP observed in most of the patients.

/pdf/speech-effects-of-a-speaking-valve-versus-external-peep-in-296r68oycm.pdf

Speech effects of a speaking valve versus external PEEP in tracheostomized ventilator-dependent neuromuscular patients.

Information technology plays a very important role in society. People with disabilities are often limited by slow text input speed despite the use of assistive devices. This study aimed to evaluate the effect of a dynamic on-screen keyboard (Custom Virtual Keyboard) and a word-prediction system (Sibylle) on text input speed in participants with functional tetraplegia. Ten participants tested four modes at home (static on-screen keyboard with and without word prediction and dynamic on-screen keyboard with and without word prediction) for 1 mo before choosing one mode and then using it for another month. Initial mean text input speed was around 23 characters per minute with the static keyboard and 12 characters per minute with the dynamic keyboard. The results showed that the dynamic keyboard reduced text input speed by 37% compared with the standard keyboard and that the addition of word prediction had no effect on text input speed. We suggest that current forms of dynamic keyboards and word prediction may not be suitable for increasing text input speed, particularly for subjects who use pointing devices. Future studies should evaluate the optimal ergonomic design of dynamic keyboards and the number and position of words that should be predicted.

/pdf/effect-of-dynamic-keyboard-and-word-prediction-systems-on-102axvb6mh.pdf

Effect of dynamic keyboard and word-prediction systems on text input speed in persons with functional tetraplegia.

La chirurgie de transferts musculaires des membres superieurs, eventuellement completee par la pose d’un dispositif de stimulation electrique fonctionnelle implante, a fait la preuve de son interet pour ameliorer les capacites fonctionnelles des patients tetraplegiques. Les solutions technologiques de compensation constituent a la fois une alternative et un complement a cette chirurgie. Les dispositifs existants sont de plus en plus nombreux et performants. Ils se developpent tres rapidement a la faveur des avancees technologiques dans le domaine de l’informatique, de l’automatique, de l’electronique et de la robotique. Les principaux obstacles a leur diffusion sont leur cout et les difficultes d’acces a l’information pour les utilisateurs potentiels. L’acces a un poste informatique et son utilisation doivent pouvoir etre proposes a tous les tetraplegiques, quel que soit leur niveau neurologique. De meme, toutes ces personnes devraient pouvoir beneficier d’un controle d’environnement pour piloter au minimum leur materiel audiovisuel et eventuellement une domotisation d’interieur. Les systemes de stimulation electrique fonctionnelle externe, bien qu’existants, sont peu diffuses parce que peu fonctionnels. La robotique de compensation devrait se developper dans les annees qui viennent, grâce aux progres des interfaces homme-machine (IHM) et de la robotique industrielle ou grand public. Les fauteuils roulants ont considerablement evolue depuis une dizaine d’annees, mais des progres restent a faire sur leur poids, leur encombrement et leur prix. La conduite d’un vehicule automobile est devenue possible pour certains tetraplegiques et c’est probablement des progres du domaine « grand public » que viendront les ameliorations qui permettront a un plus grand nombre de patients de reprendre la conduite. Le denominateur commun a toutes ces technologies est la necessite de mettre au point des IHM performantes. La multiplication des capteurs utilisables ainsi que le caractere de plus en plus interactif des dispositifs innovants laissent entrevoir des perspectives prometteuses. Les interfaces cerebrales ne sont plus un reve, et leur diffusion, dans le domaine du jeu video par exemple, ne saurait tarder. L’avenir pour les personnes tetraplegiques est probablement a des interfaces hybrides combinant plusieurs modes de commande, discretes, d’apprentissage facile et intelligentes parce qu’auto-adaptables et evolutives.

Tétraplégie: solutions technologiques de compensation des incapacités découlant de l’atteinte des membres supérieurs

Dans la litterature, il existe de nombreux articles etudiant les differents aspects des aides techniques nouvelles technologies sur le lieu de vie des usagers. Il en ressort, entre autres, un consensus fort entre professionnels et utilisateurs, sur l'utilite indeniable du pret de ces aides-techniques. Pourtant, les donnees de la litterature etablissant cette preuve sont quasi inexistantes. Nous avons donc realise une etude sur l'interet de notre dispositif de pret d'aides techniques nouvelles technologies au domicile des personnes en situation de handicap: ADAPTECH IDF. L'impact du pret a ete mis en evidence dans l'aide au choix de l'aide technique meme si des donnees quantitatives manquent afin de nous conforter dans cette optique.

Évaluation d'un dispositif de prêt d' aides techniques nouvelles technologies: ADAPTECH IDF

Intégration et évaluation d’un moteur de prédiction lexicale dans un clavier virtuel d’aide à la saisie de texte pour personnes présentant un handicap moteur

Justine Bouteille

Papers

Speech effects of a speaking valve versus external PEEP in tracheostomized ventilator-dependent neuromuscular patients.

Effect of dynamic keyboard and word-prediction systems on text input speed in persons with functional tetraplegia.

Tétraplégie: solutions technologiques de compensation des incapacités découlant de l’atteinte des membres supérieurs

Évaluation d'un dispositif de prêt d' aides techniques nouvelles technologies: ADAPTECH IDF

Intégration et évaluation d’un moteur de prédiction lexicale dans un clavier virtuel d’aide à la saisie de texte pour personnes présentant un handicap moteur