title: Assistive device with conventional, alternative, and brain-computer interface inputs to enhance interaction with the environment for people with amyotrophic lateral sclerosis: a feasibility and usability study.
abstract: OBJECTIVE
  To evaluate the feasibility and usability of an assistive technology (AT) prototype designed to be operated with conventional/alternative input channels and a P300-based brain-computer interface (BCI) in order to provide users who have different degrees of muscular impairment resulting from amyotrophic lateral sclerosis (ALS) with communication and environmental control applications.
  
  
  METHODS
  Proof-of-principle study with a convenience sample.
  
  
  METHODS
  An apartment-like space designed to be fully accessible by people with motor disabilities for occupational therapy, placed in a neurologic rehabilitation hospital.
  
  
  METHODS
  End-users with ALS (N=8; 5 men, 3 women; mean age ± SD, 60 ± 12 y) recruited by a clinical team from an ALS center.
  
  
  METHODS
  Three experimental conditions based on (1) a widely validated P300-based BCI alone; (2) the AT prototype operated by a conventional/alternative input device tailored to the specific end-user's residual motor abilities; and (3) the AT prototype accessed by a P300-based BCI. These 3 conditions were presented to all participants in 3 different sessions.
  
  
  METHODS
  System usability was evaluated in terms of effectiveness (accuracy), efficiency (written symbol rate, time for correct selection, workload), and end-user satisfaction (overall satisfaction) domains. A comparison of the data collected in the 3 conditions was performed.
  
  
  RESULTS
  Effectiveness and end-user satisfaction did not significantly differ among the 3 experimental conditions. Condition III was less efficient than condition II as expressed by the longer time for correct selection.
  
  
  CONCLUSIONS
  A BCI can be used as an input channel to access an AT by persons with ALS, with no significant reduction of usability.
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy. Electronic address: f.schettini@hsantalucia.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Schettini
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Riccio
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Simione
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Institute of Neuroscience, Université Catholique de Louvain, Louvain-la-Neuve, Belgium.
authors.forename: Giulia
authors.initials: G
authors.lastname: Liberati
authors.affiliation: Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Caruso
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Frasca
authors.affiliation: Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Calabrese
authors.affiliation: Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mecella
authors.affiliation: Crossing Dialogues Association, Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Pizzimenti
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Inghilleri
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Mattia
authors.affiliation: Neuroelectrical Imaging and BCI Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Computer, Control, and Management Engineering Antonio Ruberti, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Febo
authors.initials: F
authors.lastname: Cincotti
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000534:rehabilitation*; D062207:Brain-Computer Interfaces; D003143:Communication Devices for People with Disabilities; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004569:Electroencephalography; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012656:Self-Help Devices; D014584:User-Computer Interface
keywords: Amyotrophic lateral sclerosis; Assistive technology; Brain-computer interfaces; Event-related potentials; P300; Rehabilitation