![]() ![]() ![]() The number of actuated joints of a ULE varies from a single degree-of-freedom (DOF) (Tang et al., 2014 Crea et al., 2017 Hosseini et al., 2017) to seven DOFs including shoulder, elbow and wrist joints (Barsotti et al., 2015 Cui et al., 2016 Kim and Deshpande, 2017). These technologies can improve the users' quality of life by facilitating more independence and autonomy in the ADLs. Therefore, restoration of the arm functionality remains critical and highly prioritized to improve the quality of life and independence.Īssistive upper-limb exoskeletons (ULEs) are robotic devices that augment human muscles or substitute for the lost functionality or weakness in the arm in individuals having suffered a stroke or SCI. Individuals with tetraplegia usually require full-time assistance with the activities of daily living (ADLs) and desire to increase the level of dependence (Manns and Chad, 2001). SCI in the cervical levels of the spine affects both the upper and lower body (so-called tetraplegia) and leads to partial or complete loss of voluntary control of both arms and legs, which accounts for approximately one-third of SCI cases (Wyndaele and Wyndaele, 2006). The highest incidence rate is found within young adults (20–29 years for males 15–19 years for females) (Bickenbach et al., 2013) with a median survival time of 38 years after the injury (McColl et al., 1997). The estimated incidence of spinal cord injury (SCI) is between 250 000 and 500 000 worldwide (Bickenbach et al., 2013). The interface was used both with and without visual feedback. This study demonstrated the first single-modal control interface that can enable individuals with complete tetraplegia to fully and continuously control a five-DOF upper limb exoskeleton and perform a drinking task after only 2 h of training. In a clinical case study, an individual with tetraplegia further succeeded to fully control the exoskeleton and perform the drinking task only 5.6% slower than the able-bodied group. The results showed that it was possible to control the exoskeleton with the tongue even without visual feedback and to perform the drinking task at 65.1% of the speed of the gamepad. As a baseline, the participants performed the drinking task with a standard gamepad. ![]() Ten able-bodied participants tongue controlled the exoskeleton for a drinking task with and without visual feedback on a screen in three experimental sessions. Furthermore, we evaluated eyes-free use of the ITCI for the first time and compared two tongue-operated control methods, one based on tongue gestures and the other based on dynamic virtual buttons and a joystick-like control. In this study, a control interface for an assistive upper-limb exoskeleton with five DOFs based on an intraoral tongue-computer interface (ITCI) for individuals with tetraplegia was proposed. Providing an efficient user interface that can provide full continuous control of such a device-safely and intuitively-with multiple degrees of freedom (DOFs) still remains a challenge. Assistive upper-limb exoskeletons are one of the solutions that can enable an individual with tetraplegia (paralysis in both arms and legs) to perform simple activities of daily living by mobilizing the arm. Spinal cord injury can leave the affected individual severely disabled with a low level of independence and quality of life. ![]()
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