Design and Preliminary Evaluation of a Tongue-Operated Exoskeleton System for Upper Limb Rehabilitation

Abstract

Stroke is a devastating condition that may cause upper limb paralysis. Robotic rehabilitation with self-initiated and assisted movements is a promising technology that could help restore upper limb function. Previous studies have established that the tongue motion can be used to communicate human intent and control a rehabilitation robot/assistive device. The goal of this study was to evaluate a tongue-operated exoskeleton system (TDS-KA), which we have developed for upper limb rehabilitation. We adopted a tongue-operated assistive technology, called the tongue drive system (TDS), and interfaced it with the exoskeleton KINARM. We also developed arm reaching and tracking tasks, controlled by different tongue operation modes, for training and evaluation of arm motor function. Arm reaching and tracking tasks were tested in 10 healthy participants (seven males and three females, 23–60 years) and two female stroke survivors with upper extremity impairment (32 and 58 years). All healthy and two stroke participants successfully performed the tasks. One stroke subject demonstrated a clinically significant improvement in Fugl-Meyer upper extremity score after practicing the tasks in six 3-h sessions. We conclude that the TDS-KA system can accurately translate tongue commands to exoskeleton arm movements, quantify the function of the arm, and perform rehabilitation training.

Tongue control of a five-DOF upper-limb exoskeleton rehabilitates drinking and eating for individuals with severe disabilities

“…Moreover, only one participant was recruited for the study, and the first time he tried a 3D control was five months after having the BCI implanted. Another tongue-exoskeleton interface provided control of a two-DOF ULE and controlled the hand in a horizontal plane (Zhang et al, 2021). However, the proposed system cannot be used for assisting in ADLs.…”

Eyes-Free Tongue Gesture and Tongue Joystick Control of a Five DOF Upper-Limb Exoskeleton for Severely Disabled Individuals

“…Another essential feature of our tongue-ULE interface was accommodating all five DOF controls in one mode to avoid confusion due to mode switching (Herlant et al, 2016). The other tongue-ULE interface only controlled up to two DOFs (Ostadabbas et al, 2016;Zhang et al, 2021), which is insufficient for performing ADLs, except by incorporating automation or mode switching.…”

“…An assistive robotic manipulator with seven degrees of freedom was previously interfaced with the ITCI and enabled a participant with complete tetraplegia to perform tasks with the robot (Andreasen Struijk et al, 2017b). Another tongue interface for a ULE was presented by Zhang et al (2021) that provided control over two DOFs of a rehabilitation ULE for a tracking task.…”

Assistive Technologies and Quadriplegia: A Map Point on the Development and Spread of the Tongue Barbell Piercing

“…The technological approaches have evolved and adapted from time to time into different applications for the health domain and have shown important potential for integration with Alternative and Augmentative Communication, for integration with the environment (Ambient Assisted Living), and other home automation applications [16][17][18][19][20][21].…”