Pointing device usage guidelines for people with quadriplegia: a simulation and validation study utilizing an integrated pointing device apparatus.

This study undertakes a simulation and validation experiment to provide guidelines regarding pointing device usage for quadriplegic individuals assisted by a newly developed integrated pointing device apparatus (IPDA). The simulation experiment involving 30 normal subjects whose upper limb movement was restricted by splints. Another 15 subjects with high level cervical spinal cord injury (SCI) were recruited for the validation study. All normal subjects employed six control modes for target-acquisition and drag-and-drop tasks using an IPDA to integrate common pointing devices. A previously designed software was used to evaluate the operational efficiency (OE), expressed as "able performance" (%AP), of the subjects. The experimental results indicated that the OE of normal subjects for controlling the pointing devices were dominated first by using the unilateral hand (69-100 %AP), then by using the wrist/hand (65-73 %AP), and finally by using either bilateral body parts or the combination of limb and chin (45-53 %AP). The OE for operating an orientation-rotated mouse using the dominant wrist/hand via IPDA in both tasks was equivalent to that for operating a trackball using the dominant hand. The experimental results obtained by subjects with SCI also demonstrated similar findings, although the OEs in each control mode were lower than in normal subjects. Results of this study provide valuable guidelines for selecting and integrating common pointing devices using IPDA for quadriplegic individuals. The priority for selecting which body part should control the pointing devices was as follows: unilateral hands, unilateral wrist/hands, and either bilateral body parts or a limb and chin/head/neck in combination.