1. Human Machine Interfacing for
Communication Access in Severe
Paralysis
Amrita Nishtala
Partner: Saniya Shah
Advisor: Cara Stepp
December 14, 2015

2. The Big Problem
http://www.rightdiagnosis.com/g/guillain_barre_syndrome/stats.htm
http://www.seattlechildrens.org/kids-health/teens/diseases-and-conditions/bones-muscles-and-joints/guillain-barr_syndrome/
 1 in 100,000 people in the US are annually affected by
Guillain-Barre Syndrome
 In 2010 5,200 people in the US were affected by the
syndrome
 Neuromuscular degeneration causing neuromuscular
paralysis
 Voice and speech impairment
 Respiration and swallowing affected
 Unique and rare but has drastic complications
 Lack ability to communicate

3. Our Problem
 Our client’s condition:
 Limited head, neck, and shoulder movement
 Brain and facial muscles are responsive
 Preserved sensation
 Dry eyes
 Ventilator
 Current form of communication:
 Day: AccuPoint head tracking system
 Night: letter board
 Efficient communication at night
 Computer usage and/or speech capability

4. Our Solution
A communication device for nighttime usage with the
following features:
 Easy to set up, use, and, troubleshoot
 Inexpensive ($300 budget)
 Does not require an external light source
 Little equipment; equipment composed of
commercially available parts
 Little specialized training

5. Objectives Slide
1. Designing and selecting device concept
 Current solutions research and assessment
 Identification of solution
 Risk and cost analysis
2. Creating, implementing, and, testing device
 Prototyping
 Testing
 Evaluating
 Improving

6. Our Approach
Device Selection Process
• Background
Information/Prelim studies
• Feasibility – easy to use
• Constraints & needs
• Cost – meets budget
• Selection, evaluation, and
improvement
• Pass/Fail process
Creation
• Commercial parts or programs
• Data collections
• Pattern observation
• Hardware and software
components
• Require alternate approach

7. Approach
Prototyping, Testing, Evaluating
• Several prototypes
• Testing:
• ourselves & test subjects
• Environment
• Data analysis continues
• Accuracy, and communication goals met
• Room for improvement Final design
• Training instructions
• Video directions
• Ready for use!

8. Preliminary Studies
1. Communication device evaluation
 Dr. Susan Fager
 74% intelligibility
 2 months post onset: letter board used, no speech
abilities
 1 year post onset: scanning speech generating
device, regained some speech capabilities & head
movement
 1.5 year post onset: AccuPoint Head tracker,
speech and head control regained

9. Preliminary Studies
2. Onsite visit by Prof. Stepp and Meredith
 Videos of him using AccuPoint
 Speech samples
 EMG device made in Stepp Lab tested on him
 Found it difficult to use  emphasizes
personalization

10. Preliminary Studies
Technique Current Solutions Advantages Disadvantages
Laser
Laser, computer, webcam,
MATLAB
Low cost Might not be accurate enough
Laser, computer, Optical
mouse
Low cost Need to point laser at a smaller
target which could be painstaking;
accuracy issues
Laser, Computer, Image
sensor, MATLAB
Obvious accuracy in solution
Image sensor is crucial to the
usability and accuracy of the
system. This sensor is hard to
acquire
Accelerometer
Controlling a mouse cursor
using an accelerometer;
Accelerometer (iPhone) -->
Wifi Transmitter -->
Computer
Solution is basic and can be
easily tailored to fit needs Papers only tests basic hand
movements such as tilting phone
left and right. This needs to be
tailored to account for his head
movement. The signal processing
will also have to be done to
account for all possible gestures.
PIC microcontroller -->
Accelerometer -->
Wireless ---> Computer
With the use of the
microcontroller, the recognition of
gestures will be better and the
signal output will be smoother
Uses hand gestures so it must be
tailored to detect head movement
EOG Eye tracking with
electrodes
Low cost as parts are
commercially available
Will require electrodes to be
placed on his face everyday
EMG Muscle tracking with
electrodes
Low cost as parts are
commercially available; utilizes
many of his available motor
functions
Will require heavy electrodes on
his face

11. Device Requirements
Our Device
Easy to use
Commercially available parts
Easy to set up and troubleshoot
Require limited lighting to use
and no external light source
Limited training
Inexpensive
Utilize head, shoulder, and/or neck
movement
Easy assimilation to new device
Present focus on client, however we
could expand our device in the future
to help others with similar needs

12. Timeline Slide
Process/Time
Period
Sept- Nov
2015
Nov – Dec
2015
Jan – Mar
2016
Mar- Apr 2016
Preliminary
Studies
Solutions
Research
Technology
research and
feasibility
Selection of Idea We are here!
Prototype *Failure
Data Analysis
Finalize
Send/Install
Product

13. Summary
 Patients with Guillain Barre syndrome lack the ability
to communicate and express themselves due to
severe paralysis
 Our client has a head tracking system to use in the
day, he lacks easy communication access at night
 We are creating a communication device that he can
also use at night
Thank you!

14. Questionnaire sent to Dr. Fager and client
Client: Better understanding of needs and constraints
no response
Dr. Fager: understanding living conditions including the
ventilator system he uses