Eye tracking communication devices in amyotrophic lateral sclerosis: Impact on disability and quality of life

TLDR

Amyotrophic lateral sclerosis causes progressive loss of voluntary muscle strength, severely impairing communication in advanced stages. The study assessed how eye‑tracking communication devices affect disability, quality of life, and user satisfaction in 35 late‑stage ALS patients with tetraplegia and anarthria. Participants completed the Individually Prioritized Problem Assessment, Psychosocial Impact of Assistive Devices Scale, and Quebec User Evaluation of Satisfaction with Assistive Technology under conditions with and without the device. Use of the eye‑tracking device, especially with an Eye Transfer board, significantly improved communicative abilities, quality of life, and satisfaction, supporting its recommendation for late‑stage ALS patients.

Abstract

People with amyotrophic lateral sclerosis (PwALS) show progressive loss of voluntary muscle strength. In advanced disease, motor and phonatory impairments seriously hinder the patient's interpersonal communication. High-tech devices such as eye tracking communication devices (ETCDs) are used to aid communication in the later stages of ALS. We sought to evaluate the effect of ETCDs on patient disability, quality of life (QoL), and user satisfaction, in a group of 35 regular ETCD users in late-stage ALS with tetraplegia and anarthria. The following scales were administered: 1) the Individually Prioritized Problem Assessment (IPPA) scale, in three conditions: without device, with ETCD and, when applicable, with an Eye Transfer (ETRAN) board; 2) the Psychosocial Impact of Assistive Devices Scale (PIADS); and 3) the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). With ETRAN, IPPA showed an increase in communicative abilities with respect to the condition without device, but ETCD produced a further significant increase. PIADS evidenced a large increase of QoL, and QUEST 2.0 showed high user satisfaction with ETCD use. In conclusion, ETCDs should be considered in late-stage ALS with tetraplegia and anarthria, since in these patients they can reduce communication disability and improve QoL.