BackgroundMUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user’s direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects.MethodsThe definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users.Five end-users (3 SCI and 2 MS) tested the system in the configuration suitable to their specific level of impairment. They performed two exemplary tasks: reaching different points in the working volume and drinking. Three experts evaluated over a 3-level score (from 0, unsuccessful, to 2, completely functional) the execution of each assisted sub-action.ResultsThe functionality of all modules has been successfully demonstrated. User’s intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity.ConclusionsThe MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user’s need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.

Although the paramount goal in BCI research still remains the improvement of classification accuracy and communication speed, it is of significance to note that it is equally important for end-users to keep up their motivation and prevent frustration. By including pragmatic as well as hedonic quality aspects, this study is the first effort to gain a holistic perspective of the UX while interacting with BCI-driven assistive technology aimed at actual end-users. The broad-scale methodology provided valuable insights into the underlying dynamics causing the users' experience to differ across the GUIs. The results will be used to refine a BCI-driven neuroprosthesis and test it with end-users.

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In this study we show how healthy subjects are able to use a non-invasive Motor Imagery (MI)-based Brain Computer Interface (BCI) to achieve linear control of an upperlimb neuromuscular electrical stimulation (NMES) controlled neuroprosthesis in a simple binary target selection task. Linear BCI control can be achieved if two motor imagery classes can be discriminated with a reliability over 80% in single trial. The results presented in this work show that there was no significant loss of performance using the neuroproshesis in comparison to MI where no stimulation was present. However, it is remarkable how different the experience of the users was in the same experiment. The stimulation either provoked a positive reinforcement feedback, or prevented the user from concentrating in the task.