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A novel spelling system for locked-in syndrome patients using only eye contact.
[locked-in syndrome]
We
developed
and
evaluated
a
novel
spelling
system
for
patients
with
locked-
in
syndrome
:
patients
with
tetraplegia
,
not
able
to
talk
,
and
only
able
to
blink
their
eyes
.
A
new
communication
grid
was
compared
with
existing
non-technical
communication
methods
for
practical
daily
use
.
The
means
of
the
number
of
decision
steps
to
reach
a
full
sentence
were
compared
testing
10
sentences
relevant
in
daily
care
.
These
10
sentences
together
encompass
all
letters
of
the
alphabet
.
The
new
communication
grid
is
organised
alphabetically
in
4
columns
and
2
main
rows
,
with
each
row
subdivided
in
three
rows
.
The
first
column
contains
vowels
while
the
other
columns
contain
consonants
.
Letters
in
each
column
are
alphabetically
ordered
.
When
spelling
a
sentence
the
conversation
partner
counts
the
columns
,
until
the
patient
indicates
by
an
upward
eye
movement
that
the
column
contains
the
intended
letter
.
Hereafter
,
the
patient
indicates
by
looking
straight
ahead
or
by
looking
down
,
whether
the
intended
letter
is
in
the
upper
or
in
the
lower
main
row
,
respectively
.
The
conversation
partner
will
then
read
out
the
letters
until
the
patient
indicates
the
intended
letter
.
Compared
to
other
spelling
systems
,
this
system
requires
only
vertical
eye
movement
,
is
easier
to
memorise
,
and
faster
in
use
.
The
comparison
of
means
of
decision
steps
to
reach
the
10
full
sentences
for
different
communication
grids
shows
that
using
the
new
communication
grid
is
approximately
one
-
third
to
three
times
faster
than
the
existing
spelling
systems
(
p
=
0
.
005
)
.
This
new
grid
is
a
valuable
communication
tool
,
especially
in
situations
,
such
as
bathing
,
getting
dressed
or
out
of
house
activities
where
no
devices
are
available
.
Implications
for
Rehabilitation
Communication
with
patients
with
locked-
in
syndrome
is
a
complicated
and
strenuous
task
.
Communication
methods
,
such
as
the
alphabet
board
and
brain
-computer
interfaces
,
are
time
consuming
or
too
sophisticated
to
use
in
daily
life
tasks
.
This
communication
grid
is
fast
,
easy
to
use
and
memorise
and
requires
only
vertical
eye
movement
.
Diseases
Validation
Diseases presenting
"first column"
symptom
locked-in syndrome
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