One of the most underestimated side effects of high paraplegia is breathing difficulties. This is due to the paralysis of important respiratory muscles. This worsens coughing and secretion defense, which can lead to complications such as pneumonia. More than that, respiratory problems are among the leading causes of death. It has been scientifically proven that regular respiratory training can prevent this, which is why sufferers should undergo ongoing respiratory training, explains graduate engineer Michael Gstöttenbauer from the Austrian research facility LIFEtool in Linz. The non-profit company specializes in assistive technologies, particularly for people with severe mobility impairments.
Access to regular breathing training
Now the research facility wants to enable those affected to do breathing training independently of others and on their own at home. This is because training should be carried out regularly, just like brushing one’s teeth, but in practice is usually neglected. This is because it can be tedious and can only be carried out with assistance from others. “So it makes sense to offer users an autonomous and motivating approach to regular training,” says Gstöttenbauer.
IntegraMouse AIR
In doing so, LIFEtool ties in with the existing product IntegraMouse, launched by the research institution back in 2003. It is a computer mouse that can be operated intuitively using the mouth – clicks are made by sucking and blowing. Now in its second generation, IntegraMouse Plus enables people to perform everyday work and education-related tasks on computers and mobile devices. It also enables affected individuals to effortlessly and autonomously engage in social media, remotely control smart homes and even play complex video games. It is precisely this mouse that is now entering the third generation to additionally enable those affected to perform respiratory training autonomously at home. Thus the name IntegraMouse AIR.
Computer mouse and device for respiratory training
The IntegraMouse AIR will combine the functions of its predecessor with a respiratory training device. The project goal is to develop an AI-assisted, adaptive and multimodal computer input device that can be operated intuitively by using the mouth. For additional use as a device for respiratory training, the mouthpiece needs to be optimized and a respiratory training app needs to be added. The R&D team is interdisciplinary and consists – in addition to LIFTEtool – of regional partners: Entwickler Elektronik GmbH, Haratech GmbH and the Software Competence Center Hagenberg.
Evaluation of breathing patterns
The breathing patterns of users vary. Therefore, one of the main challenges is to adapt the device to the respective pattern. To do this the consortium will first collect breathing patterns from test persons. The evaluation of these breathing patterns is intended to expand the scientific knowledge base. At the same time, it will form the basis for the development of adaptive breathing training. This function is intended to enable users to derive the greatest possible benefit from their breathing training. “A prototypically developed artificial intelligence (AI) will support the individual planning of the training as the core of the training app,” explains Gstöttenbauer.
Automatic calibration
The automatic calibration of the IntegraMouse AIR is important because it can be used in all possible positions. The neutral state should be defined at the beginning. But the device also has to be recalibrated repeatedly during use. This is because the forces acting on the mouse can change, for example, due to saliva collecting in the mouthpiece. Calibration should take place without input, i.e., automatically, so that unwanted behavior does not occur, such as independent mouse movements or unintentional clicks.
Individual adaptability
In addition, the IntegraMouse AIR will be individually adjustable since different users have varying requirements. Above all, the suction and blowing strength required for clicking must be adaptive. “In an optional settings app, important parameters can be set individually, Gstöttenbauer emphasizes. This adaptivity to the user’s needs ensures a continuous and efficient training program for respiratory muscles.
Maximum independence
IntegraMouse AIR is designed to offer its users maximum independence during use. This means that users should have independent access to respiratory training and be able to switch between mouse use and respiratory training without assistance. This only works if there is no need to change mouthpieces. Therefore, the researchers face the challenge of optimizing the mouthpiece. This is important in that achieving this goal can make an enormous contribution to increased autonomy and thus increased patient empowerment along the Patient Journey.
The number of people with paraplegia is around 2.7 million worldwide. But IntegraMouse AIR can be used not only for severe or complete paraplegia but also for a range of other impairments such as bilateral arm amputation, progressive diseases like muscular dystrophy or amyotrophic lateral sclerosis (ALS).
R&D with affected persons
LIFEtool offers computer-assisted solutions that enable self-determined communication and specializes, among other things, in assistive technologies, especially for people with severe mobility impairments. This is important because it enables them to participate in social, professional and community life in a self-determined manner. The company is a non-profit organization and is owned equally by AIT Austrian Institute of Technology and Evangelisches Diakoniewerk. In this constellation, the legal prerequisites are given to be able to cooperate in research and development with affected persons. This is also how the IntegraMouse AIR project came about, which was launched in May 2022 and will run until October 2024. The IntegraMouse Plus and IntegraMouse AIR were both inspired by Mario Marusic, who has been a paraplegic since he had a swimming accident at age 19. By the way, he uses the IntegraMouse Plus not only for gaming but also for his performances as a DJ. Soon he will also be able to use the computer mouse for breathing training. Marusic was initially a consultant and is now an employee at LIFEtool. He is involved in research and development, as well as the support team.
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