‘Smart retainer’ aims to restore speech for patients with neurological disorders
Part of CCTS's Works in Progress series
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An interdisciplinary team at the University of Illinois Chicago (UIC) is developing a device to help individuals with neurological impairments who struggle with tongue movement, particularly those with speech difficulties.
Supported by a Center for Clinical and Translational Science pilot grant, the team is creating diagnostic and rehabilitation tools for people with motor speech disorders resulting from neurological injuries like stroke or traumatic brain injury.
Recovering tongue function, which is critical for speaking, swallowing, eating, and breathing, is a top priority for patients after neural injuries.
“The tongue is directly connected to the brain; it bypasses the spinal cord. You can use the tongue to move a cursor on the screen,” said Hananeh Esmailbeigi, a clinical associate professor in the department of biomedical engineering and the pilot project’s primary investigator.
Currently, there are no clinically-ready diagnostic and rehabilitation tools that measure tongue movement. Unlike therapy for arm or leg rehabilitation, patients do not have the benefit of visual feedback within the oral cavity; most of the work is done qualitatively by hearing and applying feedback from a practitioner. There is also a lack of user-friendly, portable devices to help doctors assess tongue movement affected by neurological disorders.
“A quantitative diagnostic device is currently something this area of work does not have. Our device is the first of its kind that is a stand-alone, intra-oral retainer that allows you to continuously monitor tongue movement and provide visual feedback of the movement without any external hardware,” said Esmailbeigi.
A ‘smart retainer’
Utilizing her skills in developing novel sensors and electronics and drawing upon research on lower and upper limb rehabilitation, Esmailbeigi’s group invented the Tongue-Trackpad. This smart wireless intra-oral retainer will allow them to study tongue movement after a neurological injury, identify shortcomings, and design personalized therapies to help improve tongue function. The hope is that this methodology will lead to improved speech clarity and communication skills.
The Tongue-Trackpad does exactly as its name implies, it provides a visual representation of how the tongue is moving inside the mouth. As patients are asked to accomplish tasks, such as reaching a target on a screen, the Tongue-Trackpad can show them what is happening inside the oral cavity. This quantitative feedback allows the team to design paradigms that understand a patient’s comfort zones, where they need more assistance (deficit regions), and how to provide better feedback in order for the patient to successfully complete the task.
Esmailbeigi likened the process to learning a new language with a non-native accent.
“For someone like me who has learned English as a second language, through my own device I understood that my tongue should be moving like this versus that,” said Esmailbeigi.
Different tongue movements for different speech disorders
Neurological injury can result in speech disorders like dysarthria and apraxia. Dysarthria is a condition where problems with muscle control make it hard to plan and coordinate the movements needed for speech. This results in slurred, breathy, or interrupted speech due to weak or uncoordinated muscles. In apraxia, the muscles work correctly, but the brain has trouble sending the correct signals, making it difficult to form words or sounds. Both disorders can vary in severity.
The team believes that tongue movement measurements can not only reveal disorder-specific movement patterns, but that personalized, ability-based visual feedback interventions can improve tongue performance. Preliminary data suggests that providing visual feedback can reduce deficit regions within a single intervention session.
Without them, none of this would be possible
Esmailbeigi said this project would not be possible without her team of students and collaborators.
As an expert in the field of rehabilitation and movement analysis, James Patton, a professor in the department of biomedical engineering at the University of Illinois Chicago, is a driving force behind this project. It was Patton who spearheaded a collaboration with speech-language pathologists at Shirley Ryan AbilityLab, a prestigious translational research hospital providing invaluable opportunities for scientists to collaborate with clinicians and conduct patient experiments.
Over the last three years, Patton and Esmailbeigi established a close partnership with Edna Babbitt, a speech and language pathologist and program manager at the Think & Speak Lab Center for Aphasia Research and Treatment at Shirley Ryan AbilityLab. Babbitt spearheads the clinical arm of the study, leading study volunteer recruitment and data collection efforts, as well as providing integral feedback from a clinical rehabilitation perspective.
Leila Ahmadian, clinical assistant professor in the department of restorative dentistry at the University of Illinois Chicago, is also a key contributor to the project. As a prosthesis expert, she helped create three versions of the device for more universal fit options.
“If we want to do clinical trials, we don’t have the time or luxury to create custom devices for each participant. It was using Dr. Ahmadian’s advice and wealth of knowledge that we were able to develop these devices in four sizes. We can quickly measure people’s mouth size, give them a device, and move forward,” said Esmailbeigi.
Esmailbeigi also credits study volunteers for shaping the project, stating that their feedback is the most valuable piece of the puzzle.
“These volunteers have given us anecdotal feedback about how it’s impacting other aspects of their life, and their families have been willing to bring them back multiple times for multiple sessions. That’s the biggest reason we’re working on this,” she said.
Independence through innovation
When Esmailbeigi launched her own research lab, she wanted to see the results of her work come to life faster and have a positive impact on the quality of life for those who are suffering from various neurological diseases.
“For me, it’s just the patients, the excitement they show. It is the best part of the day,” said Esmailbeigi.
In spite of enthusiasm from patients and their families, Esmailbeigi shared that finding participants can be a challenge given that the study requires a more extensive time commitment. Yet she remains confident in the device’s ability to translate. She envisions implementation in a therapeutic setting where patients would work directly with a health practitioner to complete a task, watching their progress live on a screen. And because the device is compact and portable, patients can take it home and continue to work through exercises independently, similar to standard physical therapy.
Esmailbeigi said, “The deepest value is being able to impact the quality of life for these patients and improve their speech and their communication and their independence. I feel like when it gets hard, that’s why we move forward.”
The “Study of Tongue Movement for Diagnostics and Rehabilitation” is actively recruiting through the Shirley Ryan AbilityLab. If you are interested in learning more, email Hananeh Esmailbeigi at hesmai2@uic.edu.