Different levels of freedom

Various lesions and diseases of the body may result in different levels of motor activity loss. Powerful muscles may retain partial activity in some cases, for example in the fingers and legs. Some people may lose their ability to talk coherently, but they are still able to produce various sounds. Full paralysis means eye movement is retained in most situations.

A combination of EyeComTec assistive complex programs can be created for each specific case or situation. Our experts work hard to provide those with significant physical limitations a way of communication.

Different levels of freedom could include:

Partially retained motor activity. A person is able to perform one of the following actions:
- Press a button with the fingers
- Press a pedal or another alternative input device with one or two feet
- Use a special “tongue joystick”
- Use any other physical device for data input
Visually distinguishable actions. A person may retain some kind of motor activity, but they are not able to use any kind of physical device - for example, when the fingers are too weak to press a button, but they can make slight movements. Visually distinguishable actions are:
- Opening and closing of the eyes
- Changing of gaze direction
- Mimics –eyebrow, lip, tongue movements and other actions.
Various sounds actions. Patients with a total loss of powerful motor activity can sometimes produce a wide range of sounds:
- moaning, wheezing, and any other distinguishable sound
- audible breathing.
Total loss of motor activity. In some situations patients are not able to make or perform any visually distinguishable actions (even eye blinking) or make sounds.

Let’s look at each of the levels of freedom closer.

1. Partially retained motor activity

When a patient suffers from various forms of partial paralysis or muscle dystrophy, they usually retain some kind of motor activity, which means they are generally able to perform various physical actions. The following situations can result in a partial paralysis:

a recent heart attack or a stroke;
amyotrophic lateral sclerosis (motor neuron disease, Lou Gehrig's disease, Charcot disease)
multiple sclerosis
spinal cord compression.

The general level of motor activity can be decreased in various diseases, which results in the loss of sensitivity of the extremities such as the face, hands and feet.

However, patients are usually able to use their powerful muscles for communication. They can control ECTkeyboard. - a virtual keyboard - by using various devices (buttons, pedals or joysticks). This virtual keyboard is very easy to use and allows the user to type messages using only one button, which involves a scanning method. This approach makes it useful for those who suffer from a wide range of diseases and whom have limited motor activity. In other words, ECTkeyboard makes it possible to type and communicate with others, even in situations when the user is able to press only one button. Another product we develop is ECTmouse. This allows users to control the mouse cursor by sending special controlling commands from the keyboard.

2. Visually distinguishable actions

Total loss of motor skills makes it impossible to use any physical device for communication. Patients with these issues are not able to press even a single button or use any other manipulator for data input. Often this means the sufferer can only retain mobility of the eyes or single mimic muscles.

Total loss of gross motor skills can usually be caused by:

tumors and lesions of the brain and the spinal cord
spinal cord ruptures and spinal fractures
hereditary illnesses and congenital defects of the central neural system
Guillain-Barré syndrome and other diseases.

In all mentioned cases the only visually distinguishable activity any one person can carry out is blinking. These movements are used by assistants and medical staff to establish a connection with fully paralyzed patients.

Assistive technologies from EyeComTec can replace a live assistant and successfully track the state of the patient’s eyes (open, closed, or only one eye open). A combination of ECTcamera, ECTtracker and ECTkeyboard software is required.ECTcamera acquires images from a computer installed with a camera, while ECTtracker analyzes the image and identifies the state of the user’s eyes. Furthermore, ECTtracker can also be used to track eyebrow or lip position, the direction of a gaze, or any other visually-distinguishable movement in the image. After analyzing the acquired information, the software emulates a key in ECTkeyboard, which is then pressed in relation to a button of the virtual keyboard. This process provides the possibility for those with limited motor activity to “type” by blinking the eyes, moving the eyebrows or lips, opening the mouth, or even changing the size of the eye’s pupil by focusing on close or distant objects.

3. Various sound actions

As a result of stroke, blood circulation problems, neuropsychiatric diseases, brain tumors, and various traumas, patients often lose their ability to talk coherently. They can produce only incoherent sounds, which means verbal communication simply becomes impossible.

Speech disorders can be caused by the following:

ataxiophemia – disorders of the larynx and the vocal cords, weakening of the vocal muscles.
aphasia – inability to speak coherently, with distortion and misrepresentation of pronounced words.
degenerative diseases, which cause speech disorders.

However, people who lose their ability to speak coherently can still produce sounds, for example sniffing, moaning, wheezing, and so on. Any correctly-controlled sound is more than enough to operate ECTlistener

The program analyzes the volume and duration of sounds captured by a microphone. By using this information, ECTlistener emulates pressing or releasing of a required button in ECTkeyboard. This means that by breathing loudly, moaning, or making any other distinguishable sound, keystrokes are able to be emulated. This makes it possible to select different symbols on the virtual keyboard and type successively by making throat sounds or slightly blowing on the microphone.

4. Total loss of motor activity

The most difficult situation is when there is total loss of the ability to perform visually distinguishable actions while a person is conscious. This is a fully paralyzed state called the locked-in syndrome. All traditional methods of communication with personnel of medical institutions are severely limited.

Despite full immobility, brain activity is usually retained.ECTkeyboard can be adjusted to work in conjunction with electroencephalographic equipment (EEG). This provides those who are fully paralyzed the possibility to communicate with “the power of their mind” (by choosing letters on the virtual keyboard).