Device for communication through foot movements in a patient with Locked-In Syndrome

Locked-in Syndrome (LIS) is a rare and severe condition characterised by tetraplegia, facial paralysis, and anarthria, with only vertical eye movements and blinking typically preserved. It usually results from brainstem stroke. While several devices enable communication through eye movements, no device existed that facilitated communication through foot movements when both ocular motility and eyelid function are completely impaired.

This report describes the creation, development, and adaptation of a communication device operated via foot movements in a patient affected by LIS.

A multidisciplinary team of physicians, physiotherapists, nurses, and engineers developed a device comprising acrylic parts, metal connectors, Arduino components, wiring, and speakers. Configured as foot pedals, the device was controlled by custom software capable of emitting pre-programmed phrases and allowing Morse code communication. It was installed at the patient's bedside to enable communication with family and the care team during recovery.

This case illustrates the innovative development of a novel assistive device that significantly aided the recovery process of a patient with a rare and severe LIS-like condition.