Title: Hands free-control of upper arm prostheses using The Earswitch, and translation to functional, active, assistive support (The Earswitch FAAS-brace) for upper-limb weakness post-stroke, cervical spinal cord injury and neuropathies.
Funder: Department of Health and Social Care

Abstract: This project provides: handsfree control of upper limb prosthetics (robotic arms for people with amputations or poor arm growth from birth) from earphones using &quot;The Earswitch&quot; development of a new solution for people with neurological (nerve or brain related) upper limb (arm & hand) weakness (e.g. stroke, spinal cord injuries at the neck and nerve damage; neuropathies). 1) The Earswitch is an earpiece which detects eardrum movement, controlled by intentionally squeezing a middle-ear muscle. NIHR i4i Connect funded work with University of Bath, indicates this to be controllable by a majority of people. The Earswitch may provide unobtrusive control of upper limb prostheses, unlike current prosthetics which use a physical switch operated by the other hand to alter grip pattern. We will develop this control using an existing and marketed robotic prosthetic Open Bionics &ldquo;Hero Arm&rdquo;. This will allow the user to use both hands at the same time in activities of daily living. We will use the learning from developing this new control interface to develop the software control for the following Earswitch FAAS-brace in Stage 2. 2) The Earswitch FAAS-brace will be developed as a new device to improve hand movement after a stroke or other neurological disability. The brace is worn as a waist-band (similar to a lumbar support) with an attached forearm support. Hand movements are driven by cables passing from the waist-band, via the elbow, to a cable-driven assistive glove. This support will prevent the arm s weight pulling the shoulder out of joint, which is common for stroke survivors and causes persistent pain, and delayed rehabilitation. The movement of the hand will be invisibly controlled using The Earswitch control developed in Stage 1. Future developments will incorporate forward movement of the elbow, driven from control motors in the waist-band, allowing the user further useful movements for reach/ grip & hold/ and &ldquo;hand to mouth&rdquo; movements. This provides benefit over other technologies because none currently offer; 1) function and rehabilitation in an ergonomic device easily taken on and off despite arm and hand weakness, 2) natural handsfree control. The most important consideration is to incorporate co-design to enable successful adoption of desirable devices, and continuing dialogue with potential users & PPI advisors will be essential. We are lucky be supported by two potential users with lived experience of upper limb neurological weakness, and also have support from the Research Director of the Stroke Association, and several local (and leading national) stroke specialist doctors and a neuro-physiotherapist. After proving the initial concept and desirability of the design in this rapid &ldquo;sprint&rdquo; 6 month project, we will apply for further grant funding to improve the design further, with formal user testing and validation at NHS Technologies Trials units.

Lay abstract: This project provides: handsfree control of upper limb prosthetics (robotic arms for people with amputations or poor arm growth from birth) from earphones using &quot;The Earswitch&quot; development of a new solution for people with neurological (nerve or brain related) upper limb (arm & hand) weakness (e.g. stroke, spinal cord injuries at the neck and nerve damage; neuropathies). 1) The Earswitch is an earpiece which detects eardrum movement, controlled by intentionally squeezing a middle-ear muscle. NIHR i4i Connect funded work with University of Bath, indicates this to be controllable by a majority of people. The Earswitch may provide unobtrusive control of upper limb prostheses, unlike current prosthetics which use a physical switch operated by the other hand to alter grip pattern. We will develop this control using an existing and marketed robotic prosthetic Open Bionics &ldquo;Hero Arm&rdquo;. This will allow the user to use both hands at the same time in activities of daily living. We will use the learning from developing this new control interface to develop the software control for the following Earswitch FAAS-brace in Stage 2. 2) The Earswitch FAAS-brace will be developed as a new device to improve hand movement after a stroke or other neurological disability. The brace is worn as a waist-band (similar to a lumbar support) with an attached forearm support. Hand movements are driven by cables passing from the waist-band, via the elbow, to a cable-driven assistive glove. This support will prevent the arm s weight pulling the shoulder out of joint, which is common for stroke survivors and causes persistent pain, and delayed rehabilitation. The movement of the hand will be invisibly controlled using The Earswitch control developed in Stage 1. Future developments will incorporate forward movement of the elbow, driven from control motors in the waist-band, allowing the user further useful movements for reach/ grip & hold/ and &ldquo;hand to mouth&rdquo; movements. This provides benefit over other technologies because none currently offer; 1) function and rehabilitation in an ergonomic device easily taken on and off despite arm and hand weakness, 2) natural handsfree control. The most important consideration is to incorporate co-design to enable successful adoption of desirable devices, and continuing dialogue with potential users & PPI advisors will be essential. We are lucky be supported by two potential users with lived experience of upper limb neurological weakness, and also have support from the Research Director of the Stroke Association, and several local (and leading national) stroke specialist doctors and a neuro-physiotherapist. After proving the initial concept and desirability of the design in this rapid &ldquo;sprint&rdquo; 6 month project, we will apply for further grant funding to improve the design further, with formal user testing and validation at NHS Technologies Trials units.

Research activity codes: 5.3 MEDICAL DEVICES
Health categories: NEUROLOGICAL;INJURIES AND ACCIDENTS;STROKE