Jessica Gantenbein: How intention and the user are at the core of CYBATHLON

Jessica Gantenbein completed both her master's and doctorate degrees at ETH Zürich where she is now lab manager for the Rehabilitation Engineering Laboratory, RELab ETH Zürich. In this newsletter, Jessica tells us about the different ways an assistive device can be controlled, and how CYBATHLON impacts public perception of important advancements in the field.

The stoics believe intention is everything, so how do you translate intention into action? Jessica Gantenbein completed both her masters and doctorate degrees at ETH Zürich where she is now lab manager for the Rehabilitation Engineering Laboratory, RELab ETH Zürich. She tells us about the different ways an assistive device can be controlled through intention detection strategies and how CYBATHLON promotes the needs of individual users.

Let’s dive straight into this fascinating topic. Your doctoral thesis included a survey of users of assistive technology at a CYBATHLON event. Can you tell us a bit more about that and the impact it had on your research?

This was part of a larger survey, led by my colleague Jan Thomas Meyer, that investigated the influence of CYBATHLON on the development and the acceptance of assistive technologies. My part of the survey was related to the intention detection strategies; that is the way a user can tell the device how to move according to their intentions.

We found that the vast majority of participants in the exoskeleton, lower limb prosthesis, wheelchair race and the FES bike races use what I call conventional direct inputs; essentially buttons, joysticks or something similar.

On one hand, you could say that this is expected because these strategies are usually the most robust, which is crucial to participants with an event such as CYBATHLON, but it was also quite surprising if you compare it to literature because researchers tend to present more complex or advanced solutions.

We also found that the participants were generally satisfied with the choice of the strategies, but were open to using more advanced strategies in the future.

Can you expand a little bit on what intention detection strategies there are?

There is a spectrum of strategies, the simplest being buttons, joysticks or touchscreens, which we all know from our own daily lives. Then there are the more unconventional direct inputs, for example voice control or control using other body movements such as the shoulder or tongue.

More advanced or complex strategies measure residual muscular signals by electromyography (EMG), which is mostly done for the arm prosthesis race, or brain signals, as we see for the brain computer interface (BCI) race.

BCIs are not quite there yet, but I'm excited to see whether at some point in the future there will be a race that combines a BCI with physical assistive technology.

That would be quite a development. Going back to your master's research, you built a wheelchair-mountable arm-supporting device. What are the challenges in developing robotic assistive technologies like these?

One of the biggest challenges in the field, but also in my opinion one of the most interesting ones, is that usually these technologies need to be very strongly tailored to the individual requirements of the users. And I think the best way to tackle this challenge is to involve the users in the development from the beginning, to clearly define their requirements and wishes and to assess these accordingly. These devices should always be adaptable, so that they can continue to be used as the user’s requirements change, or by other users who might have different requirements.

For the device I built during my master's, I worked with someone who has spinal muscular atrophy. He wanted a device that helped to support his lower arm for eating and drinking. I found that there were already quite a lot of different arm supports available on the market, however, none of them really fit his individual requirements. So, we had to develop our own device, which in turn we tried to make as adaptable as possible so that if his condition progressed we could adapt it as necessary.

We also made the whole design, instruction manuals and everything else available on open access with the aim that if someone else required a similar device, they could download the instructions and adapt it to their particular demands.

That really follows the core intention of CYBATHLON to put the user first and foremost. What impact do you think CYBATHLON has in the research field and beyond?

I think the biggest role of CYBATHLON is to push developments in the field, but also to encourage the researchers or the engineers to make these developments not just for the user, but together with the user. It also creates a very valuable platform for research groups and teams to exchange knowledge and learn from each other to push the field forward.

The second part, which to me is also very important, is the impact CYBATHLON can have for the public. I remember the start of the lower limb exoskeleton race in 2016. The pilots’ first move was to just stand up from a chair and the whole arena was cheering so loudly. It was not super fast like we usually see in a sporting competition, but seeing the public acknowledging these tiny steps, these important advancements, and appreciating them so much to create this amazing atmosphere, was truly remarkable.