Other proportional input devices such as trackballs, some head arrays, or touchpads are also available. These devices can also be referred to as movement sensing joysticks (MSJ) because the stick physically moves as a user exerts force on it. The standard EPW joystick commonly prescribed in the clinic is a type of proportional control, so named because the device's output (here, the wheelchair's velocity) increases as the stick is progressively moved away from center. First, we will examine the current state of control interface technology. While newer joysticks allow customization of a variety of features, completely customizable joysticks for EPWs is not yet a reality in clinical practice, and later in this article we discuss novel research aimed to make this customization possible. Joystick show software#Hence, in the last five years, more research has started to focus on combinations of hardware and specialized software applications could theoretically be used to create a customized device for each individual user. Riley and Rosen 8 showed that customization of a joystick to an individual user can significantly improve an individual's performance with that control interface. While there are some conventional control interfaces on the market today that can compensate for some unintentional movements like small amplitude tremor during tasks like EPW driving, we do not yet have the technology that can accommodate many severe movement disorders like larger amplitude tremor or involuntary movements like severe athetosis. These studies demonstrated the ability of control interfaces to distinguish between intentional or unintentional movements. Most classic research on control interfaces in general has focused on unimpaired individuals such as surgeons, pilots, and computer operators 5 - 7. The authors concluded that about half of the individuals who cannot currently operate an EPW by conventional methods could benefit if new technology were developed that could accommodate their needs and abilities. A survey study by Fehr, et al 4 demonstrated that approximately one quarter of a million individuals cannot use EPWs because of a variety of impairments in motor function, sensation, or cognition. The number of device users continues to grow 3 as does the number of people who cannot use the technology available today. By 2010, approximately 4 million Americans will be users of wheeled mobility devices in community settings, with about 17% using electric power wheelchairs (EPW) or scooters 1, 2.
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