Eye-tracking computer systems for inpatients with tetraplegia: findings from a feasibility study
J J van Middendorp1,2, F Watkins1,2, C Park1
1National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire NHS Trust, Buckinghamshire, UK.
Study Design:
A longitudinal, prospective, self-controlled cohort study.
Objectives:
To determine (1) the preliminary benefits of using eye-tracking computer systems (ETCSs) among inpatients with tetraplegia and (2) the feasibility of carrying out a well-powered randomized controlled trial.
Setting:
Specialist Spinal Cord Injuries Centre, United Kingdom; 6 months during 2013-2014.
Methods:
Individuals with tetraplegia who were admitted to the center and enrolled in this study were trained and allowed to use the ETCS (Tobii Eyegaze C15 System) twice a week for a duration of 10 weeks. Standardized training modules were developed and offered to all study participants. Study feasibility indicators as well as the Appraisals of Disability: Primary and Secondary Scale, Hospital Anxiety and Depression Scale and the Assistive Technology Device Predisposition Assessment questionnaire scores were taken before and after study enrollment.
Results:
A total of 31 inpatients with tetraplegia were screened. Although 14 patients (45%) met the study eligibility criteria, 6 patients (19%) consented to be enrolled in the study. Three participants did not complete the planned training schedule because of medical, technical and logistic reasons. Although half of the participants agreed that the ETCS under study was easy to use, no substantial improvements were seen in terms of psychological outcomes, appraisals of disability or independence.
Conclusions:
The conduct of a controlled trial evaluating the benefits of using ETCSs among newly injured patients with tetraplegia comes with considerable feasibility challenges. Until substantial technical improvements of ETCSs have been implemented, future research should initially focus on those individuals with tetraplegia who are living in the community and who have expressed a need to enhance their computer access and communication skills.
