Influence of the Number of Predicted Words on Text Input Speed in Participants With Cervical Spinal Cord Injury.

OBJECTIVES: To determine whether the number of words displayed in the word prediction software (WPS) list affects text input speed (TIS) in people with cervical spinal cord injury (SCI), and whether any influence is dependent on the level of the lesion. DESIGN: A cross-sectional trial. SETTING: A rehabilitation center. PARTICIPANTS: Persons with cervical SCI (N=45). Lesion level was high (C4 and C5, American Spinal Injury Association [ASIA] grade A or B) for 15 participants (high-lesion group) and low (between C6 and C8, ASIA grade A or B) for 30 participants (low-lesion group). INTERVENTION: TIS was evaluated during four 10-minute copying tasks: (1) without WPS (Without); (2) with a display of 3 predicted words (3Words); (3) with a display of 6 predicted words (6Words); and (4) with a display of 8 predicted words (8Words). MAIN OUTCOME MEASURES: During the 4 copying tasks, TIS was measured objectively (characters per minute, number of errors) and subjectively through subject report (fatigue, perception of speed, cognitive load, satisfaction). RESULTS: For participants with low-cervical SCI, TIS without WPS was faster than with WPS, regardless of the number of words displayed (P<.001). For participants with high-cervical SCI, the use of WPS did not influence TIS (P=.99). There was no influence of the number of words displayed in a word prediction list on TIS; however, perception of TIS differed according to lesion level. CONCLUSIONS: For persons with low-cervical SCI, a small number of words should be displayed, or WPS should not be used at all. For persons with high-cervical SCI, a larger number of words displayed increases the comfort of use of WPS.

Evaluation of 3 pushrim-activated power-assisted wheelchairs in patients with spinal cord injury.

OBJECTIVE: To assess differences between manual wheelchairs and 3 pushrim-activated power-assisted wheelchairs (PAPAWs): Servomatic A and B and E-motion. DESIGN: Repeated measures. SETTING: Rehabilitation hospital. PARTICIPANTS: Volunteers with spinal cord injuries (N=52). INTERVENTIONS: Ten subjects propelled the wheelchairs on a dynamometer, 46 evaluated each wheelchair on indoor and outdoor courses, and 10 evaluated their ability to transfer themselves and their wheelchairs into and out of their car. MAIN OUTCOME MEASURES: Oxygen consumption per unit time (V˙o2) and heart rate were measured during propulsion on the dynamometer. Wheelchair efficiency on the indoor and outdoor courses was evaluated on the basis of heart rate, completion time, handrim push frequency, and patient satisfaction. RESULTS: On the dynamometer, decreases in V˙o2 and heart rate were similar with the 3 PAPAWs compared with manual wheelchairs. On the outdoor course, heart rate was significantly decreased by PAPAWs compared with manual wheelchairs and patient satisfaction was better with Servomatic devices than with the E-motion device. Indoors, the course completion time was longer with the E-motion wheelchair than with other wheelchairs in the overall population, and handrim push frequency was higher with the E-motion wheelchair than with other wheelchairs in the subgroup with T12 to L1 injuries. Car transfer ability was lower with PAPAWs than with manual wheelchairs. CONCLUSIONS: Differences exist across PAPAWs. Compared with E-motion, the 2 Servomatic PAPAWs were easier to use outdoors, and difficulty transferring into/out of the car was similarly increased with all 3 PAPAWs.

The effect of word prediction settings (frequency of use) on text input speed in persons with cervical spinal cord injury: a prospective study.

PURPOSE: To determine whether activation of the frequency of use and automatic learning parameters of word prediction software has an impact on text input speed. METHODS: Forty-five participants with cervical spinal cord injury between C4 and C8 Asia A or B accepted to participate to this study. Participants were separated in two groups: a high lesion group for participants with lesion level is at or above C5 Asia AIS A or B and a low lesion group for participants with lesion is between C6 and C8 Asia AIS A or B. A single evaluation session was carried out for each participant. Text input speed was evaluated during three copying tasks: • without word prediction software (WITHOUT condition) • with automatic learning of words and frequency of use deactivated (NOT_ACTIV condition) • with automatic learning of words and frequency of use activated (ACTIV condition) Results: Text input speed was significantly higher in the WITHOUT than the NOT_ACTIV (p< 0.001) or ACTIV conditions (p = 0.02) for participants with low lesions. Text input speed was significantly higher in the ACTIV than in the NOT_ACTIV (p = 0.002) or WITHOUT (p < 0.001) conditions for participants with high lesions. CONCLUSIONS: Use of word prediction software with the activation of frequency of use and automatic learning increased text input speed in participants with high-level tetraplegia. For participants with low-level tetraplegia, the use of word prediction software with frequency of use and automatic learning activated only decreased the number of errors. Implications in rehabilitation Access to technology can be difficult for persons with disabilities such as cervical spinal cord injury (SCI). Several methods have been developed to increase text input speed such as word prediction software.This study show that parameter of word prediction software (frequency of use) affected text input speed in persons with cervical SCI and differed according to the level of the lesion. • For persons with high-level lesion, our results suggest that this parameter must be activated so that text input speed is increased. • For persons with low lesion group, this parameter must be activated so that the numbers of errors are decreased. • In all cases, the activation of the parameter of frequency of use is essential in order to improve the efficiency of the word prediction software. • Health-related professionals should use these results in their clinical practice for better results and therefore better patients 'satisfaction.

Effect of a tracheostomy speaking valve on breathing-swallowing interaction.

PURPOSE: Expiratory flow towards the upper airway after swallowing serves to expel liquid or food particles misdirected towards the trachea during swallowing. However, expiration may not occur consistently after swallowing in tracheostomised patients with an open tracheostomy tube. We investigated the effect of a speaking valve (SV) on breathing-swallowing interactions and on the volume expelled through the upper airway after swallowing. METHODS: Eight tracheostomised neuromuscular patients who were able to breathe spontaneously were studied with and without an SV. Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, and nasal and tracheal flow recording. Three water-bolus sizes (5, 10, and 15 mL) were tested in random order. RESULTS: Swallowing characteristics and breathing-swallowing synchronisation were not influenced by SV use. However, expiratory flow towards the upper airway after swallowing was negligible without the SV and was restored by adding the SV. CONCLUSION: In tracheostomised patients, protective expiration towards the upper airway after swallowing is restored by the use of an SV.

Comparative evaluation of electric wheelchair manoeuvrability.

OBJECTIVE: The aim of this study was to determine whether manoeuvrability varied between electric wheelchairs. DESIGN: Randomized, prospective, repeated measures design. SUBJECTS: Twelve wheelchair users. METHODS: Three different electric powered indoor/outdoor wheelchairs (Invacare Storm 3, Ottobock B500, and Meyra Champ) intended for use by patients with severe impairments were tested over an indoor and an outdoor circuit. Points were assigned when the users touched the circuit boundaries or failed to pass obstacles. The users completed the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire (QUEST). RESULTS: Performance was significantly worse with Ottobock B500 compared with the other 2 wheelchairs on the indoor test (Wilcoxon, p < 0.05 for both comparisons) and compared with Invacare Storm on the outdoor test (Wilcoxon, p < 0.05). The mean 6-item QUEST score, effectiveness, and simplicity of use were significantly worse for Ottobock B500 than for the other 2 wheelchairs (Wilcoxon, p < 0.05). CONCLUSION: Differences in manoeuvrability exist between commercially available electric wheelchairs belonging to the same category. Driving tests and QUEST provide complementary and concordant information.