Functional Priorities in Activities of Daily Living and Assistive Device Development for Individuals Living with Cervical Spinal Cord Injuries

Background and/or Objectives: Individuals with cervical spinal cord injury (SCI) often rely on caregivers and assistive devices to perform activities of daily living (ADLs). However, current assistive technologies have design inefficiencies and are frequently abandoned. The long-term goal of this work is to better determine the needs and priorities of the SCI community to guide the development of more effective assistive devices.

Design: We surveyed SCI patients about ADL priorities, assistive devices, and control strategies.

Setting : Secure digital survey.

Participants : Nine individuals with cervical SCI resulting in hand weakness (primarily AIS A&B) who receive outpatient rehabilitation care completed this survey (mean age: 43.33, 45% Female). Level of injury: C1:1, C3:2, C4:3, C5:2, C6:1.

Interventions: N/A

Main Outcome Measures: Self-reported independence on ADLs, ranked priority for regaining independence with ADLs, current assistive device usage and satisfaction, and preferred control mechanisms for assistive devices.

Results: 67% and 78% of participants required total assistance for bladder and bowel care, respectively. 89% of respondents utilized voice controls daily, 44% used E-stim devices weekly, and 22% used assistive devices for gripping daily. Voice control and brain computer interfaces were the preferred control methods. Personal activities (e.g., eating, grooming, communication) had the highest perceived impact on quality of life. Gaming, media interaction, using a wallet, and device control had the lowest perceived impact on quality of life. All participants indicated they would feel comfortable using an assistive robotic device for bowel and bladder care.

Conclusions: These preliminary findings highlight inadequate assistive technology and a reliance on caregivers for essential ADLs, particularly for bowel and bladder care. Participants expressed a strong preference for future assistive devices controlled via voice or brain-computer interfaces, emphasizing the need for more intuitive, user-friendly solutions.