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People with spinal cord injury or neurological disorders frequently require aid in performing daily tasks. Utilizing hand-free assistive technologies (ATs), particularly tongue-controlled ATs, may offer a feasible solution as the tongue is controlled by a cranial nerve and remains functional in the presence of spinal cord injury. However, existing intra-oral ATs require a significant level of training to accurately issuing these commands. To minimize the training process, we have designed intuitive tongue commands for our Multifunctional intraORal Assistive technology (MORA). Our prior works demonstrated that electrotactile feedback outperformed visual feedback in tasks involving tongue motor learning. In this study, we implement electrical stimulation (E-stim) as electrotactile feedback on the tongue to teach new tongue commands of MORA, and quantitatively analyze the efficacy of the electrotactile feedback in command accuracy and precision. The random command task was adopted to evaluate tongue command accuracy with 14 healthy participants. The average sensors contacted per trial dropped significantly from 1.57 ± 0.15 to 1.16 ± 0.05 with electrotactile feedback. After training with electrotactile feedback, 83% of the trials were completed with only one command having been activated. These results suggest that E-stim enhanced both the accuracy and precision of subjects' tongue command training. The results of this study pave the way for the implementation of electrotactile feedback as an accurate and precise command training technique for MORA.

Neurotraumas and neurological diseases often result in compromised proprioceptive feedback, which plays a critical role in motor control by delivering real-time position information. Electro-prosthetic proprioception (EPP) using frequency-modulated electrotactile feedback is a promising solution, as it can deliver proprioceptive information such as a joint angle via tactile channel. Prior works demonstrated that EPP successfully delivered distance information between the end effector and the target object. In this study, we implemented the electronic skin (E-skin) monitoring the elbow joint angle and delivering it to the nervous system via tactile channel. We also demonstrated that EPP improved both accuracy and precision of the elbow joint angle control. The gyroscope measuring the elbow joint angle and electrodes delivering electrotactile feedback were integrated together as a skin using thin silicon coating and polyurethane film. We call this novel E-skin, monitoring and delivering joint angle information, as an electro-prosthetic E-skin. Elbow joint angle matching test with two healthy human subjects showed that the EPP, via electro-prosthetic E-skin, enhanced 101.7% accuracy and 63.8% precision in elbow joint angle control. Clinical Relevance-Presented electro-prosthetic E-skin will address the compromised proprioceptive feedback by delivering joint angle information by electro-prosthetic proprioception (EPP) via tactile channel. This novel E-skin will open up a new path to assist and rehabilitative motor control problems after neurotraumas and neurological diseases.

Electronic skin (E-skin) is an emerging wearable device typically used to mimic the function of the human skin, mainly by replicating the role of tactile sensory receptors in the skin. This study showed an interesting modification of the E-skin, called an electro-prosthetic E-skin, which adds the functionality of distance sensing and stimulation of the palmar digital nerve. The electro-prosthetic E-skin operates as a closed loop to deliver the finger aperture distance information to the nervous system. This E-skin was implemented as an additional layer mounted to the original human skin, to be worn on the fingertip with a thin silicone substrate. The E-skin was designed to be mounted onto the index fingertip, to deliver the distance information between the fingertips and to enhance the finger aperture distance control. In this study, we demonstrated that electro-prosthetic proprioception (EPP), implemented with the electro-prosthetic E-skin, successfully delivered the distance information between the fingertips and enhanced the finger aperture distance control accuracy. Clinical Relevance- Presented electro-prosthetic E-skin delivering finger aperture distance via electro-prosthetic proprioception (EPP) will enhance accuracy of the finger aperture distance control. This technology can be applied to the neurosurgery to minimize unforced errors caused by the limited human control accuracy over the fingertip.

There is an increasing demand for real-time neural signal monitoring from a large number of electrode contacts to provide adequate spatial and temporal resolution for brain mapping and high-resolution neural interface. This paper proposes a novel multi-channel neural recording system that records neural signals from a large number of electrodes with a smaller number of recording channels. The system utilizes an adaptive electrode selection technique to automatically scan the electrode arrays and record from selected electrodes where neural spikes are detected. The proposed neural recording IC was fabricated in CMOS 180 nm process and tested with in vitro environments. Experiment results with pre-recorded neural data indicate that neural spikes can be separated and amplified with the proposed system and counted in real-time.

The aging process, as well as neurological disorders, causes a decline in sensorimotor functions, which can often bring degraded motor output. As a means of compensation for such sensorimotor deficiencies, sensorimotor augmentation has been actively investigated. Consequently, exoskeleton devices or functional electrical stimulation could augment the muscle activity, while textured surfaces or electrical nerve stimulations could augment the sensory feedback. However, it is not easy to precisely anticipate the effects of specific augmentation because sensory feedback and motor output interact with each other as a closed-loop operation via the central and peripheral nervous systems. A computational internal model can play a crucial role in anticipating such an effect of augmentation therapy on the motor outcome. Still, no existing internal sensorimotor loop model has been represented in a complete computational form facilitating the anticipation. This paper presents such a computational internal model, including numerical values representing the effect of sensorimotor augmentation. With the existing experimental results, the model performance was evaluated indirectly. The change of sensory gain affects motor output inversely, while the change of motor gain did not change or minimally affects the motor output.Clinical Relevance- The presented computational internal model will provide a simple and easy tool for clinicians to design therapeutic intervention using sensorimotor augmentation.

Tongue Drive System (TDS) is a wireless and wearable assistive technology (AT) that enables people with severe disabilities to control their computers, wheelchairs, and electronic gadgets using their tongue motion. We developed the TDS to control smartphone's (iPhone/iPod Touch) built-in and downloadable apps with a customized Bluetooth mouse module by emulating finger taps on the touchscreen. The TDS-iPhone Bluetooth mouse interface was evaluated by four able-bodied subjects to complete a scenario consisting of seven tasks, which were randomly ordered by using touch on the iPhone screen with index finger, a computer mouse on iPhone, and TDS-iPhone Bluetooth mouse interface with tongue motion. Preliminary results show that the average completion times of a scenario with touch, mouse, and TDS are 165.6 ± 14.50 s, 186.1 ± 15.37 s, and 651.6 ± 113.4 s, respectively, showing that the TDS is 84.37% and 81.16% slower than touch and mouse for speed of typing with negligible errors. Overall, considering the limited number of commands and unfamiliarity of the subjects with the TDS, we achieved acceptable results for hands-free functionality.

Tongue Drive System (TDS) is a wireless tongue-operated assistive technology (AT), developed for people with severe physical impediments to control their environments using their tongue motion. We have developed a new intraoral TDS (iTDS) in a form of a dental retainer, which can tightly clasp onto the upper teeth, completely hidden inside the mouth, using commercial off-the-shelf components (COTS). The iTDS retainer was tested by two healthy subjects and their performance was compared with that of an external TDS (eTDS) implemented in the form of a headset. The iTDS retainer showed comparable performance with the eTDS headset. The iTDS is expected to improve the stability and robustness of the TDS, while giving users a certain degree of privacy.

Tongue Drive System (TDS) is a wireless tongue-operated assistive technology (AT), developed for people with severe physical disabilities to control their environment using their tongue motion. We have developed a new ergonomic headset for the TDS with a user-friendly smartphone interface, through which users will be able to wirelessly control various devices, access computers, and drive wheelchairs. This headset design is expected to act as a flexible and multifunctional communication interface for the TDS and improve its usability, accessibility, aesthetics, and convenience for the end users.