Trial Outcomes & Findings for Evaluation of a Tongue Operated Assistive Technology for Individuals With Severe Paralysis (NCT NCT01124292)

Last Updated: 2013-09-18

Results Overview

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Horizontal Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. This data was then fed into an equation, which provided the throughput measure. The unit of throughput is "bits per second". The high value of throughput means better performance. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

61 participants

Primary outcome timeframe

24 months

Results posted on

2013-09-18

Participant Flow

Able-bodied subjects (groups A and B) were recruited by using local IRB-approved flyers, emails, and electronically distributed documents. Subjects with spinal cord injuries were recruited from the in- and outpatient departments of the Shepherd Center and the Rehabilitation Institute of Chicago. (May. 2010 - March. 2012)

Participant milestones

Participant milestones
Measure	Able-bodied Subject With Tongue Piercing Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Overall Study STARTED	16	24	21
Overall Study COMPLETED	14	9	11
Overall Study NOT COMPLETED	2	15	10

Reasons for withdrawal

Reasons for withdrawal
Measure	Able-bodied Subject With Tongue Piercing Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Overall Study Lost to Follow-up	2	4	3
Overall Study Physician Decision	0	3	2
Overall Study Withdrawal by Subject	0	6	2
Overall Study medical issue unrelated to the study	0	0	2
Overall Study piercing track closed	0	2	1

Baseline Characteristics

Evaluation of a Tongue Operated Assistive Technology for Individuals With Severe Paralysis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Able-bodied Subject With Tongue Piercing n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing: n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Total n=34 Participants Total of all reporting groups
Age, Categorical <=18 years	1 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants
Age, Categorical Between 18 and 65 years	13 Participants n=5 Participants	9 Participants n=7 Participants	11 Participants n=5 Participants	33 Participants n=4 Participants
Age, Categorical >=65 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants
Age Continuous	23.12 years STANDARD_DEVIATION 4.85 • n=5 Participants	22.56 years STANDARD_DEVIATION 4.00 • n=7 Participants	38.30 years STANDARD_DEVIATION 10.25 • n=5 Participants	27.61 years STANDARD_DEVIATION 9.72 • n=4 Participants
Sex: Female, Male Female	10 Participants n=5 Participants	5 Participants n=7 Participants	2 Participants n=5 Participants	17 Participants n=4 Participants
Sex: Female, Male Male	4 Participants n=5 Participants	4 Participants n=7 Participants	9 Participants n=5 Participants	17 Participants n=4 Participants
Region of Enrollment United States	14 participants n=5 Participants	9 participants n=7 Participants	11 participants n=5 Participants	34 participants n=4 Participants

PRIMARY outcome

Timeframe: 24 months

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) first session using TDS	1.97 bits per second Standard Deviation 0.44	2.03 bits per second Standard Deviation 0.44	1.54 bits per second Standard Deviation 0.56	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) second session using TDS	2.04 bits per second Standard Deviation 0.39	2.22 bits per second Standard Deviation 0.52	1.75 bits per second Standard Deviation 0.42	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) third session using TDS	2.34 bits per second Standard Deviation 0.32	2.48 bits per second Standard Deviation 0.51	1.90 bits per second Standard Deviation 0.51	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using TDS	2.37 bits per second Standard Deviation 0.50	2.54 bits per second Standard Deviation 0.48	2.14 bits per second Standard Deviation 0.54	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using TDS	2.44 bits per second Standard Deviation 0.52	2.47 bits per second Standard Deviation 0.54	2.09 bits per second Standard Deviation 0.41	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) sixth session using TDS	NA bits per second Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per second Standard Deviation NA Group-B subjects completed five-session trials.	2.22 bits per second Standard Deviation 0.51	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) first session using keypad	2.85 bits per second Standard Deviation 0.41	3.49 bits per second Standard Deviation 0.68	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) second session using keypad	2.96 bits per second Standard Deviation 0.45	3.69 bits per second Standard Deviation 0.48	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) third session using keypad	3.09 bits per second Standard Deviation 0.52	3.84 bits per second Standard Deviation 0.54	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using keypad	3.14 bits per second Standard Deviation 0.48	3.81 bits per second Standard Deviation 0.59	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using keypad	3.17 bits per second Standard Deviation 0.52	3.84 bits per second Standard Deviation 0.57	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Throughput) first session using mouse	3.89 bits per second Standard Deviation 0.97	4.17 bits per second Standard Deviation 0.68	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Horizontal Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. The error rate is the rate of outside of targets vs. total targets. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using TDS	29.14 Percentage of Missed Targets (%) Standard Deviation 13.96	23.85 Percentage of Missed Targets (%) Standard Deviation 11.04	37.84 Percentage of Missed Targets (%) Standard Deviation 21.65	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using TDS	24.08 Percentage of Missed Targets (%) Standard Deviation 17.30	18.36 Percentage of Missed Targets (%) Standard Deviation 10.11	30.62 Percentage of Missed Targets (%) Standard Deviation 18.02	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using TDS	24.64 Percentage of Missed Targets (%) Standard Deviation 14.89	13.70 Percentage of Missed Targets (%) Standard Deviation 8.14	28.77 Percentage of Missed Targets (%) Standard Deviation 17.72	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using TDS	20.74 Percentage of Missed Targets (%) Standard Deviation 14.36	14.90 Percentage of Missed Targets (%) Standard Deviation 9.34	24.01 Percentage of Missed Targets (%) Standard Deviation 14.16	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using TDS	17.96 Percentage of Missed Targets (%) Standard Deviation 10.41	16.34 Percentage of Missed Targets (%) Standard Deviation 10.26	18.45 Percentage of Missed Targets (%) Standard Deviation 9.83	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) sixth session using TDS	NA Percentage of Missed Targets (%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of Missed Targets (%) Standard Deviation NA Group-B subjects completed five-session trials.	19.81 Percentage of Missed Targets (%) Standard Deviation 12.63	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using keypad	9.49 Percentage of Missed Targets (%) Standard Deviation 7.96	10.63 Percentage of Missed Targets (%) Standard Deviation 8.35	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using keypad	6.94 Percentage of Missed Targets (%) Standard Deviation 6.21	8.44 Percentage of Missed Targets (%) Standard Deviation 7.40	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using keypad	6.70 Percentage of Missed Targets (%) Standard Deviation 6.12	5.97 Percentage of Missed Targets (%) Standard Deviation 3.96	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using keypad	5.03 Percentage of Missed Targets (%) Standard Deviation 4.41	8.12 Percentage of Missed Targets (%) Standard Deviation 6.54	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using keypad	4.99 Percentage of Missed Targets (%) Standard Deviation 4.27	6.24 Percentage of Missed Targets (%) Standard Deviation 5.19	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Horizontal Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using mouse	9.24 Percentage of Missed Targets (%) Standard Deviation 11.91	2.14 Percentage of Missed Targets (%) Standard Deviation 2.14	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Vertical Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. This data was then fed into an equation, which provided the throughput measure. The unit of throughput is "bits per second". The high value of throughput means better performance. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) second session using TDS	2.27 bits per second Standard Deviation 0.37	2.54 bits per second Standard Deviation 0.51	1.77 bits per second Standard Deviation 0.54	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) third session using TDS	2.31 bits per second Standard Deviation 0.45	2.74 bits per second Standard Deviation 0.30	1.79 bits per second Standard Deviation 0.56	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using TDS	2.44 bits per second Standard Deviation 0.36	2.76 bits per second Standard Deviation 0.45	1.97 bits per second Standard Deviation 0.33	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using TDS	2.61 bits per second Standard Deviation 0.30	2.69 bits per second Standard Deviation 0.49	2.01 bits per second Standard Deviation 0.43	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) sixth session using TDS	NA bits per second Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per second Standard Deviation NA Group-B subjects completed five-session trials.	2.18 bits per second Standard Deviation 0.60	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) first session using keypad	2.84 bits per second Standard Deviation 0.44	3.46 bits per second Standard Deviation 0.61	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) second session using keypad	2.90 bits per second Standard Deviation 0.56	3.88 bits per second Standard Deviation 0.58	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) third session using keypad	3.03 bits per second Standard Deviation 0.45	3.85 bits per second Standard Deviation 0.58	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using keypad	3.10 bits per second Standard Deviation 0.46	3.96 bits per second Standard Deviation 0.65	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using keypad	3.11 bits per second Standard Deviation 0.54	3.93 bits per second Standard Deviation 0.41	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) first session using mouse	4.28 bits per second Standard Deviation 0.71	4.32 bits per second Standard Deviation 0.63	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Throughput) first session using TDS	2.14 bits per second Standard Deviation 0.41	2.22 bits per second Standard Deviation 0.54	1.44 bits per second Standard Deviation 0.50	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Vertical Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. The error rate is the rate of outside of targets vs. total targets. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using TDS	26.16 Percentage of Missed Targets (%) Standard Deviation 15.39	19.47 Percentage of Missed Targets (%) Standard Deviation 9.95	38.95 Percentage of Missed Targets (%) Standard Deviation 19.61	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using TDS	21.83 Percentage of Missed Targets (%) Standard Deviation 13.78	15.88 Percentage of Missed Targets (%) Standard Deviation 11.74	30.37 Percentage of Missed Targets (%) Standard Deviation 17.31	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using TDS	22.72 Percentage of Missed Targets (%) Standard Deviation 12.43	12.67 Percentage of Missed Targets (%) Standard Deviation 7.52	26.67 Percentage of Missed Targets (%) Standard Deviation 15.57	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using TDS	20.30 Percentage of Missed Targets (%) Standard Deviation 13.55	10.97 Percentage of Missed Targets (%) Standard Deviation 10.06	23.77 Percentage of Missed Targets (%) Standard Deviation 11.32	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using TDS	14.77 Percentage of Missed Targets (%) Standard Deviation 11.79	10.97 Percentage of Missed Targets (%) Standard Deviation 7.71	21.90 Percentage of Missed Targets (%) Standard Deviation 11.35	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) sixth session using TDS	NA Percentage of Missed Targets (%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of Missed Targets (%) Standard Deviation NA Group-B subjects completed five-session trials.	19.99 Percentage of Missed Targets (%) Standard Deviation 12.44	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using keypad	9.91 Percentage of Missed Targets (%) Standard Deviation 8.92	10.43 Percentage of Missed Targets (%) Standard Deviation 7.80	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using keypad	8.95 Percentage of Missed Targets (%) Standard Deviation 7.91	8.26 Percentage of Missed Targets (%) Standard Deviation 5.72	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using keypad	6.16 Percentage of Missed Targets (%) Standard Deviation 6.02	6.41 Percentage of Missed Targets (%) Standard Deviation 5.55	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using keypad	5.47 Percentage of Missed Targets (%) Standard Deviation 5.42	6.00 Percentage of Missed Targets (%) Standard Deviation 4.82	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using keypad	5.83 Percentage of Missed Targets (%) Standard Deviation 5.44	7.27 Percentage of Missed Targets (%) Standard Deviation 6.01	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Vertical Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using mouse	5.02 Percentage of Missed Targets (%) Standard Deviation 7.37	2.13 Percentage of Missed Targets (%) Standard Deviation 2.28	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Center-out Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. This data was then fed into an equation, which provided the throughput measure. The unit of throughput is "bits per second". The high value of throughput means better performance. This task is tested by the TDS, keypad, mouse and the sip-and-puff device (SnP). Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) first session using TDS	0.83 bits per second Standard Deviation 0.32	0.77 bits per second Standard Deviation 0.48	0.37 bits per second Standard Deviation 0.21	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) second session using TDS	1.23 bits per second Standard Deviation 0.36	0.96 bits per second Standard Deviation 0.49	0.52 bits per second Standard Deviation 0.27	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) third session using TDS	1.39 bits per second Standard Deviation 0.26	1.10 bits per second Standard Deviation 0.40	0.51 bits per second Standard Deviation 0.31	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fourth session using TDS	1.41 bits per second Standard Deviation 0.37	1.29 bits per second Standard Deviation 0.50	0.73 bits per second Standard Deviation 0.45	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fifth session using TDS	1.58 bits per second Standard Deviation 0.25	1.41 bits per second Standard Deviation 0.53	0.75 bits per second Standard Deviation 0.45	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) sixth session using TDS	NA bits per second Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per second Standard Deviation NA Group-B subjects completed five-session trials.	0.81 bits per second Standard Deviation 0.40	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) first session using keypad	1.44 bits per second Standard Deviation 0.46	2.13 bits per second Standard Deviation 0.57	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) second session using keypad	1.74 bits per second Standard Deviation 0.47	2.60 bits per second Standard Deviation 0.44	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) third session using keypad	1.82 bits per second Standard Deviation 0.29	2.83 bits per second Standard Deviation 0.36	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fourth session using keypad	1.93 bits per second Standard Deviation 0.32	3.02 bits per second Standard Deviation 0.30	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fifth session using keypad	2.03 bits per second Standard Deviation 0.27	3.05 bits per second Standard Deviation 0.53	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) first session using mouse	3.86 bits per second Standard Deviation 0.54	3.31 bits per second Standard Deviation 0.50	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) first session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.31 bits per second Standard Deviation 0.20	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) second session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.42 bits per second Standard Deviation 0.20	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) third session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.45 bits per second Standard Deviation 0.19	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fourth session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.51 bits per second Standard Deviation 0.16	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) fifth session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.52 bits per second Standard Deviation 0.17	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Throughput) sixth session using SnP	NA bits per second Standard Deviation NA Group-A subjects did not test using SnP.	NA bits per second Standard Deviation NA Group-B subjects did not test using SnP.	0.52 bits per second Standard Deviation 0.19	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Center-out Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. The error rate is the rate of outside of targets vs. total targets. This task is tested by the TDS, keypad, mouse and the sip-and-puff device (SnP). Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Center-out Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. The movement time is the cursor movement time from the initial movement to the final movement for each target. This task is tested by the TDS, keypad, mouse and the sip-and-puff device (SnP). Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) first session using TDS	1.70 seconds Standard Deviation 0.30	1.29 seconds Standard Deviation 0.15	4.00 seconds Standard Deviation 1.41	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) second session using TDS	1.33 seconds Standard Deviation 0.17	1.22 seconds Standard Deviation 0.13	3.18 seconds Standard Deviation 1.44	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) third session using TDS	1.30 seconds Standard Deviation 0.17	1.21 seconds Standard Deviation 0.11	3.12 seconds Standard Deviation 1.38	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fourth session using TDS	1.34 seconds Standard Deviation 0.24	1.22 seconds Standard Deviation 0.15	2.81 seconds Standard Deviation 1.21	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fifth session using TDS	1.26 seconds Standard Deviation 0.16	1.18 seconds Standard Deviation 0.08	2.75 seconds Standard Deviation 1.25	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) sixth session using TDS	NA seconds Standard Deviation NA Group-A subjects completed 5-session trials.	NA seconds Standard Deviation NA Group-B subjects completed 5-session trials.	2.75 seconds Standard Deviation 1.24	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) first session using keypad	1.29 seconds Standard Deviation 0.15	1.29 seconds Standard Deviation 0.39	NA seconds Standard Deviation NA Group-C subjects could not use a keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) second session using keypad	1.22 seconds Standard Deviation 0.13	0.97 seconds Standard Deviation 0.12	NA seconds Standard Deviation NA Group-C subjects could not use a keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) third session using keypad	1.21 seconds Standard Deviation 0.11	0.95 seconds Standard Deviation 0.14	NA seconds Standard Deviation NA Group-C subjects could not use a keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fourth session using keypad	1.22 seconds Standard Deviation 0.15	0.88 seconds Standard Deviation 0.11	NA seconds Standard Deviation NA Group-C subjects could not use a keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fifth session using keypad	1.18 seconds Standard Deviation 0.08	0.87 seconds Standard Deviation 0.12	NA seconds Standard Deviation NA Group-C subjects could not use a keypad.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) first session using mouse	0.66 seconds Standard Deviation 0.08	0.78 seconds Standard Deviation 0.07	NA seconds Standard Deviation NA Group-C subjects could not use a mouse.	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) first session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	4.48 seconds Standard Deviation 1.08	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) second session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	4.14 seconds Standard Deviation 0.90	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) third session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	3.81 seconds Standard Deviation 0.71	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fourth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	3.69 seconds Standard Deviation 0.76	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) fifth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	3.64 seconds Standard Deviation 0.83	—
Fitts' Law: Center-Out Tapping Using TDS, Keypad, Mouse, and SnP (Movement Time) sixth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using SnP.	3.79 seconds Standard Deviation 0.89	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Multi-directional Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. This data was then fed into an equation, which provided the throughput measure. The unit of throughput is "bits per second". The high value of throughput means better performance. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) first session using TDS	0.40 bits per second Standard Deviation 0.19	0.80 bits per second Standard Deviation 0.30	0.39 bits per second Standard Deviation 0.17	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) second session using TDS	0.62 bits per second Standard Deviation 0.21	0.93 bits per second Standard Deviation 0.31	0.42 bits per second Standard Deviation 0.21	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) third session using TDS	0.77 bits per second Standard Deviation 0.30	1.05 bits per second Standard Deviation 0.30	0.45 bits per second Standard Deviation 0.16	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using TDS	0.85 bits per second Standard Deviation 0.32	1.10 bits per second Standard Deviation 0.26	0.65 bits per second Standard Deviation 0.21	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using TDS	0.98 bits per second Standard Deviation 0.26	1.16 bits per second Standard Deviation 0.31	0.64 bits per second Standard Deviation 0.27	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) sixth session using TDS	NA bits per second Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per second Standard Deviation NA Group-B subjects completed five-session trials.	0.73 bits per second Standard Deviation 0.31	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) first session using keypad	0.88 bits per second Standard Deviation 0.28	1.44 bits per second Standard Deviation 0.20	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) second session using keypad	1.03 bits per second Standard Deviation 0.24	1.69 bits per second Standard Deviation 0.20	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) third session using keypad	1.11 bits per second Standard Deviation 0.21	1.85 bits per second Standard Deviation 0.17	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) fourth session using keypad	1.19 bits per second Standard Deviation 0.18	1.86 bits per second Standard Deviation 0.22	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) fifth session using keypad	1.16 bits per second Standard Deviation 0.22	1.87 bits per second Standard Deviation 0.23	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Throughput) first session using mouse	4.32 bits per second Standard Deviation 0.59	4.06 bits per second Standard Deviation 0.60	NA bits per second Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—

PRIMARY outcome

Timeframe: 24 months

Subjects used the tongue drive system (TDS) to move the mouse cursor towards targets with various sizes and distances on the computer screen (Multi-directional Tapping task) and select those targets. The computer measured the time it took for the subjects to reach the targets and the accuracy of their selections from the center of the targets. The error rate is the rate of outside of targets vs. total targets. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using TDS	32.67 Percentage of Missed Targets (%) Standard Deviation 19.60	21.34 Percentage of Missed Targets (%) Standard Deviation 14.17	54.91 Percentage of Missed Targets (%) Standard Deviation 22.34	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using TDS	21.56 Percentage of Missed Targets (%) Standard Deviation 13.87	14.27 Percentage of Missed Targets (%) Standard Deviation 9.69	51.52 Percentage of Missed Targets (%) Standard Deviation 27.88	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using TDS	18.42 Percentage of Missed Targets (%) Standard Deviation 14.28	10.73 Percentage of Missed Targets (%) Standard Deviation 8.48	37.27 Percentage of Missed Targets (%) Standard Deviation 19.88	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using TDS	18.00 Percentage of Missed Targets (%) Standard Deviation 15.27	8.08 Percentage of Missed Targets (%) Standard Deviation 6.67	27.88 Percentage of Missed Targets (%) Standard Deviation 25.15	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using TDS	14.67 Percentage of Missed Targets (%) Standard Deviation 13.99	6.86 Percentage of Missed Targets (%) Standard Deviation 5.52	29.47 Percentage of Missed Targets (%) Standard Deviation 20.13	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) sixth session using TDS	NA Percentage of Missed Targets (%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of Missed Targets (%) Standard Deviation NA Group-B subjects completed five-session trials.	29.10 Percentage of Missed Targets (%) Standard Deviation 24.28	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using keypad	7.25 Percentage of Missed Targets (%) Standard Deviation 7.36	2.62 Percentage of Missed Targets (%) Standard Deviation 3.38	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) second session using keypad	6.38 Percentage of Missed Targets (%) Standard Deviation 8.73	1.64 Percentage of Missed Targets (%) Standard Deviation 2.36	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) third session using keypad	3.99 Percentage of Missed Targets (%) Standard Deviation 6.26	1.30 Percentage of Missed Targets (%) Standard Deviation 2.46	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) fourth session using keypad	3.65 Percentage of Missed Targets (%) Standard Deviation 4.77	1.84 Percentage of Missed Targets (%) Standard Deviation 2.37	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) fifth session using keypad	4.96 Percentage of Missed Targets (%) Standard Deviation 6.36	1.44 Percentage of Missed Targets (%) Standard Deviation 2.06	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
Fitts' Law: Multi-Directional Tapping Using TDS, Keypad, and Mouse (Error Rate) first session using mouse	6.77 Percentage of Missed Targets (%) Standard Deviation 7.13	2.78 Percentage of Missed Targets (%) Standard Deviation 3.21	NA Percentage of Missed Targets (%) Standard Deviation NA Subjects with Spinal cord injury cannot use the mouse.	—

PRIMARY outcome

Timeframe: 24 months

Computer randomly highlights one out of six or four commands and the subjects issue that particular command using the tongue drive system (TDS) and the sip-and-puff device (SnP). Subjects are given a time period (T). The time intervals for the TDS:(Group-A)2.0s,1.5s,1.0s,(Group-B \&-C)1.0s,0.7s,0.5s, SnP:(Group-C)1.2s,1.0s,0.7s. The saturated results were observed from the second session during Group-A trials. Therefore, we reduced the time period from the Group-B trial. Moreover, the SnP device needs a certain time period to issue a command and we observed that the minimum possible time period was 0.7 seconds. At the end the percentage of correctly selected commands is calculated and fed into an equation along with the time given to the subjects for each selection.Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Information Transfer Rate (ITR) 1st ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	74.33 bits per minute Standard Deviation 5.99	128.40 bits per minute Standard Deviation 23.44	66.68 bits per minute Standard Deviation 25.01	—
Information Transfer Rate (ITR) 2nd ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	75.53 bits per minute Standard Deviation 5.18	146.34 bits per minute Standard Deviation 12.40	99.15 bits per minute Standard Deviation 41.14	—
Information Transfer Rate (ITR) 3rd ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	74.74 bits per minute Standard Deviation 6.38	146.99 bits per minute Standard Deviation 15.44	93.62 bits per minute Standard Deviation 32.01	—
Information Transfer Rate (ITR) 4th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	74.89 bits per minute Standard Deviation 7.04	146.29 bits per minute Standard Deviation 14.18	112.85 bits per minute Standard Deviation 42.17	—
Information Transfer Rate (ITR) 5th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	75.47 bits per minute Standard Deviation 6.66	146.45 bits per minute Standard Deviation 12.83	133.28 bits per minute Standard Deviation 24.46	—
Information Transfer Rate (ITR) 6th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per minute Standard Deviation NA Group-B subjects completed five-session trials.	127.83 bits per minute Standard Deviation 28.02	—
Information Transfer Rate (ITR) 1st ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	96.13 bits per minute Standard Deviation 14.07	184.28 bits per minute Standard Deviation 37.04	106.73 bits per minute Standard Deviation 36.05	—
Information Transfer Rate (ITR) 2nd ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	98.29 bits per minute Standard Deviation 8.90	208.64 bits per minute Standard Deviation 19.28	126.94 bits per minute Standard Deviation 59.05	—
Information Transfer Rate (ITR) 3rd ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	98.14 bits per minute Standard Deviation 10.16	208.15 bits per minute Standard Deviation 19.35	120.41 bits per minute Standard Deviation 43.85	—
Information Transfer Rate (ITR) 4th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	100.34 bits per minute Standard Deviation 7.82	209.85 bits per minute Standard Deviation 18.94	141.27 bits per minute Standard Deviation 53.89	—
Information Transfer Rate (ITR) 5th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	101.40 bits per minute Standard Deviation 5.50	208.45 bits per minute Standard Deviation 20.40	164.80 bits per minute Standard Deviation 51.32	—
Information Transfer Rate (ITR) 6th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per minute Standard Deviation NA Group-B subjects completed five-session trials.	169.31 bits per minute Standard Deviation 51.77	—
Information Transfer Rate (ITR) 1st ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	131.77 bits per minute Standard Deviation 24.28	258.08 bits per minute Standard Deviation 47.10	114.78 bits per minute Standard Deviation 45.40	—
Information Transfer Rate (ITR) 2nd ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	140.31 bits per minute Standard Deviation 19.85	279.59 bits per minute Standard Deviation 39.96	141.03 bits per minute Standard Deviation 43.06	—
Information Transfer Rate (ITR) 3rd ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	138.62 bits per minute Standard Deviation 17.13	277.63 bits per minute Standard Deviation 42.97	110.20 bits per minute Standard Deviation 67.33	—
Information Transfer Rate (ITR) 4th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	146.82 bits per minute Standard Deviation 16.34	282.89 bits per minute Standard Deviation 33.87	127.45 bits per minute Standard Deviation 55.50	—
Information Transfer Rate (ITR) 5th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	146.37 bits per minute Standard Deviation 14.43	283.06 bits per minute Standard Deviation 37.54	198.45 bits per minute Standard Deviation 77.99	—
Information Transfer Rate (ITR) 6th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	NA bits per minute Standard Deviation NA Group-A subjects completed five-session trials.	NA bits per minute Standard Deviation NA Group-B subjects completed five-session trials.	175.21 bits per minute Standard Deviation 81.23	—
Information Transfer Rate (ITR) 1st ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	24.14 bits per minute Standard Deviation 23.30	—
Information Transfer Rate (ITR) 2nd ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	28.81 bits per minute Standard Deviation 24.00	—
Information Transfer Rate (ITR) 3rd ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	37.34 bits per minute Standard Deviation 21.91	—
Information Transfer Rate (ITR) 4th ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	52.04 bits per minute Standard Deviation 24.45	—
Information Transfer Rate (ITR) 5th ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	54.44 bits per minute Standard Deviation 16.57	—
Information Transfer Rate (ITR) 6th ses. using SnP (Grp C T=1.2s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	54.70 bits per minute Standard Deviation 23.15	—
Information Transfer Rate (ITR) 1st ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	18.12 bits per minute Standard Deviation 21.88	—
Information Transfer Rate (ITR) 2nd ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	39.87 bits per minute Standard Deviation 31.31	—
Information Transfer Rate (ITR) 3rd ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	52.03 bits per minute Standard Deviation 29.57	—
Information Transfer Rate (ITR) 4th ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	57.79 bits per minute Standard Deviation 22.72	—
Information Transfer Rate (ITR) 5th ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	57.73 bits per minute Standard Deviation 24.68	—
Information Transfer Rate (ITR) 6th ses. using SnP (Grp C T=1.0s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	55.23 bits per minute Standard Deviation 25.69	—
Information Transfer Rate (ITR) 1st ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	28.81 bits per minute Standard Deviation 35.64	—
Information Transfer Rate (ITR) 2nd ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	40.72 bits per minute Standard Deviation 35.24	—
Information Transfer Rate (ITR) 3rd ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	39.89 bits per minute Standard Deviation 37.63	—
Information Transfer Rate (ITR) 4th ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	54.66 bits per minute Standard Deviation 44.31	—
Information Transfer Rate (ITR) 5th ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	54.30 bits per minute Standard Deviation 30.86	—
Information Transfer Rate (ITR) 6th ses. using SnP (Grp C T=0.7s)	NA bits per minute Standard Deviation NA Group-A subjects did not test using the SnP.	NA bits per minute Standard Deviation NA Group-B subjects did not test using the SnP.	65.00 bits per minute Standard Deviation 50.28	—

PRIMARY outcome

Timeframe: 24 months

Computer randomly highlights one out of six or four commands and the subjects issue that particular command using the tongue drive system (TDS) and the sip-and-puff device (SnP). Subjects are given a time period (T). The time intervals for the TDS:(Group-A)2.0s,1.5s,1.0s,(Group-B \&-C)1.0s,0.7s,0.5s,SnP:(Group-C)1.2s,1.0s,0.7s. The saturated results were observed from the second session during Group-A trials. Therefore, we reduced the time period from the Group-B trial. Moreover, the SnP device needs a certain time period to issue a command and we observed that the minimum possible time period was 0.7 seconds. At the end the percentage of correctly selected commands is calculated and fed into an equation along with the time given to the subjects for each selection.Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

PRIMARY outcome

Timeframe: 24 months

Subjects were instructed to use four directional commands (Left, Right, Up, and Down) to move the mouse cursor using the tongue drive system (TDS), keypad, and the sip-and-puff device (SnP) as fast and accurately as possible on a maze. One out of eight maze patterns was randomly selected in each round. The performance measures were completion time (CT) from start to end and sum of deviation (SoD) from the track. SoD was calculated as the sum of all areas between the actual trajectory of the cursor when it was out of the track and the closest edge of the track divided by 1000. Group-A and -B were scheduled for five consecutive TDS trials with intervals ranging from two to ten days. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) first session using TDS	27.80 seconds Standard Deviation 18.77	23.36 seconds Standard Deviation 9.87	34.27 seconds Standard Deviation 13.25	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) second session using TDS	16.61 seconds Standard Deviation 4.35	17.13 seconds Standard Deviation 5.72	28.71 seconds Standard Deviation 12.58	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) third session using TDS	15.41 seconds Standard Deviation 3.45	16.81 seconds Standard Deviation 12.28	32.70 seconds Standard Deviation 21.24	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fourth session using TDS	15.04 seconds Standard Deviation 3.57	13.03 seconds Standard Deviation 4.49	25.93 seconds Standard Deviation 9.91	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fifth session using TDS	14.26 seconds Standard Deviation 2.77	12.59 seconds Standard Deviation 3.41	25.99 seconds Standard Deviation 15.27	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) sixth session using TDS	NA seconds Standard Deviation NA Group-A subjects completed five-session trials.	NA seconds Standard Deviation NA Group-B subjects completed five-session trials.	19.47 seconds Standard Deviation 14.66	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) first session using keypad	20.26 seconds Standard Deviation 4.21	17.56 seconds Standard Deviation 6.24	NA seconds Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) second session using keypad	16.76 seconds Standard Deviation 3.30	13.14 seconds Standard Deviation 2.34	NA seconds Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) third session using keypad	15.30 seconds Standard Deviation 2.54	12.31 seconds Standard Deviation 2.08	NA seconds Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fourth session using keypad	14.65 seconds Standard Deviation 1.67	11.76 seconds Standard Deviation 2.12	NA seconds Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fifth session using keypad	14.25 seconds Standard Deviation 1.42	10.96 seconds Standard Deviation 1.99	NA seconds Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) first session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	49.86 seconds Standard Deviation 28.22	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) second session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	37.48 seconds Standard Deviation 18.15	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) third session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	33.49 seconds Standard Deviation 12.42	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fourth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	30.56 seconds Standard Deviation 10.08	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) fifth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	30.65 seconds Standard Deviation 9.28	—
On-screen Maze Using TDS, Keypad, and SnP (Completion Time) sixth session using SnP	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	30.89 seconds Standard Deviation 10.33	—

PRIMARY outcome

Timeframe: 24 months

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) first session using TDS	30.05 pixel^2/1000 Standard Deviation 89.76	23.59 pixel^2/1000 Standard Deviation 20.28	64.86 pixel^2/1000 Standard Deviation 91.42	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) second session using TDS	4.51 pixel^2/1000 Standard Deviation 4.08	13.27 pixel^2/1000 Standard Deviation 20.28	41.86 pixel^2/1000 Standard Deviation 41.83	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) third session using TDS	4.17 pixel^2/1000 Standard Deviation 5.20	13.91 pixel^2/1000 Standard Deviation 31.22	59.19 pixel^2/1000 Standard Deviation 84.68	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fourth session using TDS	4.54 pixel^2/1000 Standard Deviation 5.18	5.89 pixel^2/1000 Standard Deviation 13.05	28.43 pixel^2/1000 Standard Deviation 24.97	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fifth session using TDS	1.80 pixel^2/1000 Standard Deviation 1.68	4.27 pixel^2/1000 Standard Deviation 3.58	29.05 pixel^2/1000 Standard Deviation 35.49	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) sixth session using TDS	NA pixel^2/1000 Standard Deviation NA Group-A subjects completed five-session trials.	NA pixel^2/1000 Standard Deviation NA Group-B subjects completed five-session trials.	17.18 pixel^2/1000 Standard Deviation 29.84	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) first session using keypad	1.88 pixel^2/1000 Standard Deviation 2.32	4.03 pixel^2/1000 Standard Deviation 5.85	NA pixel^2/1000 Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) second session using keypad	1.10 pixel^2/1000 Standard Deviation 1.48	1.46 pixel^2/1000 Standard Deviation 1.82	NA pixel^2/1000 Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) third session using keypad	0.60 pixel^2/1000 Standard Deviation 1.01	1.08 pixel^2/1000 Standard Deviation 1.01	NA pixel^2/1000 Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fourth session using keypad	0.56 pixel^2/1000 Standard Deviation 0.66	1.55 pixel^2/1000 Standard Deviation 1.40	NA pixel^2/1000 Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fifth session using keypad	0.39 pixel^2/1000 Standard Deviation 0.60	1.16 pixel^2/1000 Standard Deviation 1.57	NA pixel^2/1000 Standard Deviation NA Subjects with Spinal cord injury cannot use the keypad.	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) first session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	47.05 pixel^2/1000 Standard Deviation 104.05	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) second session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	20.26 pixel^2/1000 Standard Deviation 18.68	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) third session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	14.04 pixel^2/1000 Standard Deviation 11.87	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fourth session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	12.19 pixel^2/1000 Standard Deviation 11.27	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) fifth session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	15.32 pixel^2/1000 Standard Deviation 19.02	—
On-screen Maze Using TDS, Keypad, and SnP (Sum of Deviation / 1000) sixth session using SnP	NA pixel^2/1000 Standard Deviation NA Group-A subjects did not test using the SnP.	NA pixel^2/1000 Standard Deviation NA Group-B subjects did not test using the SnP.	11.17 pixel^2/1000 Standard Deviation 9.06	—

PRIMARY outcome

Timeframe: 24 months

An obstacle course will be laid out in an open space and the subjects drive an electric powered wheelchair using the tongue drive system (TDS) and the sip-and-puff device (SnP) to drive through the obstacle course. The operator measured the amount of time it takes for the subjects to begin and return back to the starting point and counts the number of collisions with the obstacles. Unlatched and latched: utilize four TDS commands for forward, backward, left, and right motions. Unlatched: hold their tongue to keep the PWC moving. Latched: (5 linear speed levels:Backward, Stop, Forward-1, Forward-2, and Forward-3) Issuing the forward or backward commands can increase or decrease the linear speed. Semi-proportional: Quickly touching the left and right cheeks- forward or backward commands, sliding tongue over the lip- steer the PWC to the left or right. Group-A\&-B:5 consecutive TDS trials (intervals ranging from two to ten days) Group-C:computer and PWC within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Driving a Wheelchair Using TDS vs SnP (Completion Time) first session using TDS (unlatched)	198.17 seconds Standard Deviation 34.01	240.85 seconds Standard Deviation 81.77	253.45 seconds Standard Deviation 70.11	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) second session using TDS (unlatched)	169.21 seconds Standard Deviation 25.08	194.93 seconds Standard Deviation 29.48	219.46 seconds Standard Deviation 56.02	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) third session using TDS (unlatched)	173.46 seconds Standard Deviation 30.27	179.39 seconds Standard Deviation 29.80	186.04 seconds Standard Deviation 18.25	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fourth session using TDS (unlatched)	170.00 seconds Standard Deviation 38.80	179.74 seconds Standard Deviation 22.78	183.70 seconds Standard Deviation 23.27	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fifth session using TDS (unlatched)	160.08 seconds Standard Deviation 18.22	154.59 seconds Standard Deviation 23.52	181.24 seconds Standard Deviation 27.39	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) sixth session using TDS (unlatched)	NA seconds Standard Deviation NA Group-A subjects completed five-session trials.	NA seconds Standard Deviation NA Group-B subjects completed five-session trials.	170.76 seconds Standard Deviation 19.76	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) first session using TDS (latched)	230.29 seconds Standard Deviation 48.45	260.86 seconds Standard Deviation 84.97	295.54 seconds Standard Deviation 151.08	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) second session using TDS (latched)	192.46 seconds Standard Deviation 27.50	210.22 seconds Standard Deviation 34.42	264.78 seconds Standard Deviation 107.65	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) third session using TDS (latched)	196.08 seconds Standard Deviation 35.78	200.96 seconds Standard Deviation 39.60	228.78 seconds Standard Deviation 101.65	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fourth session using TDS (latched)	181.42 seconds Standard Deviation 26.28	193.75 seconds Standard Deviation 37.92	217.63 seconds Standard Deviation 84.98	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fifth session using TDS (latched)	179.13 seconds Standard Deviation 23.22	174.33 seconds Standard Deviation 34.15	189.52 seconds Standard Deviation 19.68	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) sixth session using TDS (latched)	NA seconds Standard Deviation NA Group-A subjects completed five-session trials.	NA seconds Standard Deviation NA Group-B subjects completed five-session trials.	179.37 seconds Standard Deviation 23.16	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) first session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	234.97 seconds Standard Deviation 70.94	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) second session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	213.28 seconds Standard Deviation 68.29	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) third session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	196.24 seconds Standard Deviation 37.78	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fourth session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	183.98 seconds Standard Deviation 36.22	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fifth session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	191.43 seconds Standard Deviation 38.12	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) sixth session using SnP (latched)	NA seconds Standard Deviation NA Group-A subjects did not test using the SnP.	NA seconds Standard Deviation NA Group-B subjects did not test using the SnP.	182.33 seconds Standard Deviation 21.34	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) first session using TDS (semi-pro)	196.54 seconds Standard Deviation 16.46	232.75 seconds Standard Deviation 66.47	319.21 seconds Standard Deviation 112.70	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) second session using TDS (semi-pro)	178.58 seconds Standard Deviation 14.42	205.44 seconds Standard Deviation 32.64	239.18 seconds Standard Deviation 62.38	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) third session using TDS (semi-pro)	177.75 seconds Standard Deviation 11.87	206.71 seconds Standard Deviation 30.35	233.92 seconds Standard Deviation 60.00	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fourth session using TDS (semi-pro)	178.83 seconds Standard Deviation 14.70	196.57 seconds Standard Deviation 28.86	212.67 seconds Standard Deviation 44.90	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) fifth session using TDS (semi-pro)	175.25 seconds Standard Deviation 17.07	177.50 seconds Standard Deviation 37.44	181.18 seconds Standard Deviation 27.27	—
Driving a Wheelchair Using TDS vs SnP (Completion Time) sixth session using TDS (semi-pro)	NA seconds Standard Deviation NA Group-A subjects completed five-session trials.	NA seconds Standard Deviation NA Group-B subjects completed five-session trials.	204.96 seconds Standard Deviation 35.23	—

PRIMARY outcome

Timeframe: 24 months

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) first session using TDS (unlatched)	2.67 Navigation Errors Standard Deviation 1.87	8.44 Navigation Errors Standard Deviation 5.78	8.76 Navigation Errors Standard Deviation 5.04	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) second session using TDS (unlatched)	1.17 Navigation Errors Standard Deviation 1.30	6.59 Navigation Errors Standard Deviation 6.76	7.48 Navigation Errors Standard Deviation 4.85	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) third session using TDS (unlatched)	1.08 Navigation Errors Standard Deviation 0.79	3.96 Navigation Errors Standard Deviation 4.07	5.82 Navigation Errors Standard Deviation 5.04	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fourth session using TDS (unlatched)	1.04 Navigation Errors Standard Deviation 1.46	2.58 Navigation Errors Standard Deviation 2.26	5.06 Navigation Errors Standard Deviation 4.03	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fifth session using TDS (unlatched)	0.75 Navigation Errors Standard Deviation 0.66	2.22 Navigation Errors Standard Deviation 2.14	2.97 Navigation Errors Standard Deviation 3.56	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) sixth session using TDS (unlatched)	NA Navigation Errors Standard Deviation NA Group-A subjects completed five-session trials.	NA Navigation Errors Standard Deviation NA Group-B subjects completed five-session trials.	2.76 Navigation Errors Standard Deviation 3.46	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) first session using TDS (latched)	3.50 Navigation Errors Standard Deviation 2.06	7.80 Navigation Errors Standard Deviation 6.41	10.61 Navigation Errors Standard Deviation 7.61	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) second session using TDS (latched)	1.83 Navigation Errors Standard Deviation 1.13	6.00 Navigation Errors Standard Deviation 2.77	7.16 Navigation Errors Standard Deviation 5.00	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) third session using TDS (latched)	1.38 Navigation Errors Standard Deviation 1.17	4.79 Navigation Errors Standard Deviation 2.72	7.03 Navigation Errors Standard Deviation 7.26	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fourth session using TDS (latched)	0.71 Navigation Errors Standard Deviation 1.06	3.71 Navigation Errors Standard Deviation 3.16	6.78 Navigation Errors Standard Deviation 9.51	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fifth session using TDS (latched)	0.96 Navigation Errors Standard Deviation 1.44	3.70 Navigation Errors Standard Deviation 3.60	3.06 Navigation Errors Standard Deviation 3.17	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) sixth session using TDS (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects completed five-session trials.	NA Navigation Errors Standard Deviation NA Group-B subjects completed five-session trials.	2.06 Navigation Errors Standard Deviation 2.26	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) first session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	4.27 Navigation Errors Standard Deviation 3.06	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) second session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	3.30 Navigation Errors Standard Deviation 2.01	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) third session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	3.82 Navigation Errors Standard Deviation 2.92	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fourth session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	2.39 Navigation Errors Standard Deviation 2.59	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fifth session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	2.97 Navigation Errors Standard Deviation 2.30	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) sixth session using SnP (latched)	NA Navigation Errors Standard Deviation NA Group-A subjects did not test using the SnP.	NA Navigation Errors Standard Deviation NA Group-B subjects did not test using the SnP.	2.61 Navigation Errors Standard Deviation 2.16	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) first session using TDS (semi-pro)	2.08 Navigation Errors Standard Deviation 1.23	2.52 Navigation Errors Standard Deviation 1.41	7.81 Navigation Errors Standard Deviation 3.94	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) second session using TDS (semi-pro)	1.00 Navigation Errors Standard Deviation 0.91	2.92 Navigation Errors Standard Deviation 1.76	5.79 Navigation Errors Standard Deviation 3.85	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) third session using TDS (semi-pro)	0.96 Navigation Errors Standard Deviation 0.84	2.00 Navigation Errors Standard Deviation 2.52	5.15 Navigation Errors Standard Deviation 3.76	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fourth session using TDS (semi-pro)	1.00 Navigation Errors Standard Deviation 1.18	1.89 Navigation Errors Standard Deviation 0.96	3.64 Navigation Errors Standard Deviation 2.97	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) fifth session using TDS (semi-pro)	0.88 Navigation Errors Standard Deviation 1.04	1.71 Navigation Errors Standard Deviation 1.69	2.97 Navigation Errors Standard Deviation 3.56	—
Driving a Wheelchair Using TDS vs SnP (Number of Navigation Errors) sixth session using TDS (semi-pro)	NA Navigation Errors Standard Deviation NA Group-A subjects completed five-session trials.	NA Navigation Errors Standard Deviation NA Group-B subjects completed five-session trials.	3.12 Navigation Errors Standard Deviation 3.20	—

PRIMARY outcome

Timeframe: 24 months

Randomly selected ten-digit target phone number was visually prompted on the top of the smartphone screen, and the subject entered the same number in the following line as quickly and as accurately as possible. If the wrong number was registered, then the subjects were allowed to delete the one by issuing the deleting command.At the end of the number entering, the subject needs to move the cursor at the green colored "CALL" button, in the middle of the bottom line, and it should be selected to complete the trial. The completion time and error rate were considered to evaluate the performance. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=11 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) first session using TDS	187.69 seconds Standard Deviation 66.09	—	—	—
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) second session using TDS	109.11 seconds Standard Deviation 47.05	—	—	—
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) third session using TDS	89.99 seconds Standard Deviation 21.08	—	—	—
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) fourth session using TDS	88.37 seconds Standard Deviation 29.56	—	—	—
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) fifth session using TDS	89.37 seconds Standard Deviation 27.05	—	—	—
Phone Dialing Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) sixth session using TDS	81.87 seconds Standard Deviation 22.75	—	—	—

PRIMARY outcome

Timeframe: 24 months

The TDS commands were designated to change the wheelchair mode from driving to tilting and to control the wheelchair angle. The completion time was from the initial mode change to the end of the weight shifting. Testing sessions for Group-C were divided into computer access and PWC navigation within a week, over 6 weeks.

Outcome measures

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=11 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) first session using TDS	116.19 seconds Standard Deviation 42.69	—	—	—
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) second session using TDS	74.82 seconds Standard Deviation 39.10	—	—	—
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) third session using TDS	78.24 seconds Standard Deviation 29.93	—	—	—
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) fourth session using TDS	75.52 seconds Standard Deviation 29.60	—	—	—
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) fifth session using TDS	74.46 seconds Standard Deviation 32.67	—	—	—
Weight Shifting Using the Tongue Drive System (TDS) for People With Spinal Cord Injuries (Completion Time) sixth session using TDS	71.35 seconds Standard Deviation 23.22	—	—	—

PRIMARY outcome

Timeframe: 24 months

Q1.How much thought was necessary to decide where to put your tongue to issue a specific command?1:A lot,5:A Little Q2.Was the speed of the movement of the cursor on the computer screen:1:Too slow,3:Just right,5:Too fast Q3.How difficult was pointing accurately at specific targets on the computer screen?1:Very difficult,5:Very easy Q4.Accurately guiding the powered wheelchair through the obstacle course was:1:Very difficult,5:Very easy Q4.Accurately guiding the powered wheelchair through the obstacle course was:1: Very difficult,5:Very easy (TDS:Q4-1.Unlatched,Q4-2.Latched,Q4-3.Semi-pro,SnP:Q4-4.Latched) Q5.Was the speed of the wheelchair:1:Too slow,5:Too fast Q6.Was the movement of the wheelchair:1:Very jerky,5:Very smooth Q7.Was TDS effective in dialing phone numbers:1:Completely ineffective,5:Very effective Q8.Was TDS effective in doing the weight shift:1:Completely ineffective,5:Very effective

Outcome measures

Adverse Events

Able-bodied Subject With Tongue Piercing (Group-A)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Able-bodied Subject Without Tongue Piercing (Group-B)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Subjects With Spinal Cord Injury (Group-C)

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Maysam Ghovanloo

Georgia Institute of Technology

Phone: 404-385-7048

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place

Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects completed five-session trials.	89.71 Percentage of correctly completed cmd(%) Standard Deviation 11.71	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	98.62 Percentage of correctly completed cmd(%) Standard Deviation 2.61	93.51 Percentage of correctly completed cmd(%) Standard Deviation 1.24	73.87 Percentage of correctly completed cmd(%) Standard Deviation 11.72	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	99.12 Percentage of correctly completed cmd(%) Standard Deviation 2.30	98.15 Percentage of correctly completed cmd(%) Standard Deviation 0.51	83.70 Percentage of correctly completed cmd(%) Standard Deviation 15.37	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	98.75 Percentage of correctly completed cmd(%) Standard Deviation 3.03	98.73 Percentage of correctly completed cmd(%) Standard Deviation 0.45	83.93 Percentage of correctly completed cmd(%) Standard Deviation 9.60	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	98.75 Percentage of correctly completed cmd(%) Standard Deviation 3.45	98.08 Percentage of correctly completed cmd(%) Standard Deviation 0.61	90.95 Percentage of correctly completed cmd(%) Standard Deviation 10.80	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	99.79 Percentage of correctly completed cmd(%) Standard Deviation 1.58	98.17 Percentage of correctly completed cmd(%) Standard Deviation 0.54	94.63 Percentage of correctly completed cmd(%) Standard Deviation 6.60	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using TDS (Grp A:T=2.0s, Grp B&C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects completed five-session trials.	93.00 Percentage of correctly completed cmd(%) Standard Deviation 7.64	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	97.50 Percentage of correctly completed cmd(%) Standard Deviation 5.46	93.18 Percentage of correctly completed cmd(%) Standard Deviation 1.25	96.92 Percentage of correctly completed cmd(%) Standard Deviation 8.85	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using TDS (Grp A:T=1.5, Grp B&C T=0.7s)	98.33 Percentage of correctly completed cmd(%) Standard Deviation 2.99	98.06 Percentage of correctly completed cmd(%) Standard Deviation 0.57	82.54 Percentage of correctly completed cmd(%) Standard Deviation 14.00	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	98.20 Percentage of correctly completed cmd(%) Standard Deviation 3.65	97.99 Percentage of correctly completed cmd(%) Standard Deviation 0.57	78.70 Percentage of correctly completed cmd(%) Standard Deviation 11.02	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	98.97 Percentage of correctly completed cmd(%) Standard Deviation 2.69	98.24 Percentage of correctly completed cmd(%) Standard Deviation 0.56	85.00 Percentage of correctly completed cmd(%) Standard Deviation 11.75	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using TDS (Grp A:T=1.5s, Grp B&C T=0.7s)	99.37 Percentage of correctly completed cmd(%) Standard Deviation 1.73	98.01 Percentage of correctly completed cmd(%) Standard Deviation 0.63	91.47 Percentage of correctly completed cmd(%) Standard Deviation 7.93	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	94.61 Percentage of correctly completed cmd(%) Standard Deviation 6.69	93.67 Percentage of correctly completed cmd(%) Standard Deviation 1.25	69.34 Percentage of correctly completed cmd(%) Standard Deviation 12.83	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	96.53 Percentage of correctly completed cmd(%) Standard Deviation 4.94	96.44 Percentage of correctly completed cmd(%) Standard Deviation 0.99	73.91 Percentage of correctly completed cmd(%) Standard Deviation 8.11	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	94.32 Percentage of correctly completed cmd(%) Standard Deviation 3.99	96.12 Percentage of correctly completed cmd(%) Standard Deviation 1.05	67.66 Percentage of correctly completed cmd(%) Standard Deviation 16.01	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	98.07 Percentage of correctly completed cmd(%) Standard Deviation 4.04	96.96 Percentage of correctly completed cmd(%) Standard Deviation 0.77	72.99 Percentage of correctly completed cmd(%) Standard Deviation 13.34	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	98.07 Percentage of correctly completed cmd(%) Standard Deviation 3.28	96.87 Percentage of correctly completed cmd(%) Standard Deviation 0.89	84.87 Percentage of correctly completed cmd(%) Standard Deviation 11.87	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using TDS (Grp A:T=1.0s, Grp B&C T=0.5s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects completed five-session trials.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects completed five-session trials.	78.81 Percentage of correctly completed cmd(%) Standard Deviation 14.70	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	56.48 Percentage of correctly completed cmd(%) Standard Deviation 22.92	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	62.65 Percentage of correctly completed cmd(%) Standard Deviation 19.53	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	73.51 Percentage of correctly completed cmd(%) Standard Deviation 15.05	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	79.72 Percentage of correctly completed cmd(%) Standard Deviation 13.96	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	82.41 Percentage of correctly completed cmd(%) Standard Deviation 9.05	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using SnP (Grp C T=1.2s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	82.72 Percentage of correctly completed cmd(%) Standard Deviation 10.57	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	56.48 Percentage of correctly completed cmd(%) Standard Deviation 21.85	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	62.65 Percentage of correctly completed cmd(%) Standard Deviation 25.88	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	75.89 Percentage of correctly completed cmd(%) Standard Deviation 15.44	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	80.00 Percentage of correctly completed cmd(%) Standard Deviation 12.11	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	78.40 Percentage of correctly completed cmd(%) Standard Deviation 11.15	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 2nd ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	54.63 Percentage of correctly completed cmd(%) Standard Deviation 26.49	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using SnP (Grp C T=1.0s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	73.81 Percentage of correctly completed cmd(%) Standard Deviation 16.62	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 1st ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	43.21 Percentage of correctly completed cmd(%) Standard Deviation 26.15	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 3rd ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	52.78 Percentage of correctly completed cmd(%) Standard Deviation 24.40	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 4th ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	63.06 Percentage of correctly completed cmd(%) Standard Deviation 28.17	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 5th ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	62.96 Percentage of correctly completed cmd(%) Standard Deviation 21.72	—
Information Transfer Rate (Percentage of Correctly Completed Commands) 6th ses. using SnP (Grp C T=0.7s)	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-A subjects did not test using the SnP.	NA Percentage of correctly completed cmd(%) Standard Deviation NA Group-B subjects did not test using the SnP.	62.78 Percentage of correctly completed cmd(%) Standard Deviation 26.15	—

Outcome measures
Measure	Able-bodied Subject With Tongue Piercing (Group-A) n=14 Participants Able-bodied subjects who already have tongue piercing.	Able-bodied Subject Without Tongue Piercing (Group-B) n=9 Participants Able-bodied subjects who willing to receive a tongue piercing for this study.	Subjects With Spinal Cord Injury (Group-C) n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.	Subjects With Spinal Cord Injury (Group-C): Wheelchair Session n=11 Participants Persons with mobility limitations requiring power wheel chair, able to move tongue, able to follow simple commands, and have some experience with computers. All participants willingly received a mid-line tongue piercing.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q5. (session1) 1: Too slow, 5: Too Fast	2.71 scores on a scale Standard Deviation 0.47	2.67 scores on a scale Standard Deviation 0.87	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.70 scores on a scale Standard Deviation 0.67
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q5. (session4) 1: Too slow, 5: Too Fast	2.50 scores on a scale Standard Deviation 0.67	2.25 scores on a scale Standard Deviation 0.46	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.55 scores on a scale Standard Deviation 0.82
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q6. (session5) 1: Very jerky, 5: Very smooth	4.00 scores on a scale Standard Deviation 1.11	3.63 scores on a scale Standard Deviation 0.92	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.82 scores on a scale Standard Deviation 1.08
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses2)1:Very difficult,5:Very easy(GrpC:Q4-3)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.73 scores on a scale Standard Deviation 1.27
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses4)1:Very difficult,5:Very easy(GrpC:Q4-4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.55 scores on a scale Standard Deviation 0.82
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses5)1:Very difficult,5:Very easy(GrpC:Q4-4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.27 scores on a scale Standard Deviation 1.01
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q7.(ses2)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.00 scores on a scale Standard Deviation 1.41
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q7.(ses4)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.40 scores on a scale Standard Deviation 1.07
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q8.(ses2)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.60 scores on a scale Standard Deviation 0.97
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses1)1:Very difficult,5:Very easy(GrpC:Q4-2)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.20 scores on a scale Standard Deviation 0.79
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses2)1:Very difficult,5:Very easy(GrpC:Q4-2)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.45 scores on a scale Standard Deviation 1.13
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses3)1:Very difficult,5:Very easy(GrpC:Q4-2)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.91 scores on a scale Standard Deviation 0.70
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses4)1:Very difficult,5:Very easy(GrpC:Q4-2)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.64 scores on a scale Standard Deviation 1.36
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses5)1:Very difficult,5:Very easy(GrpC:Q4-2)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.91 scores on a scale Standard Deviation 0.83
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses1)1:Very difficult,5:Very easy(GrpC:Q4-3)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.40 scores on a scale Standard Deviation 1.43
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses3)1:Very difficult,5:Very easy(GrpC:Q4-3)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	4.00 scores on a scale Standard Deviation 0.89
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses4)1:Very difficult,5:Very easy(GrpC:Q4-3)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	4.00 scores on a scale Standard Deviation 1.00
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses5)1:Very difficult,5:Very easy(GrpC:Q4-3)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	3.64 scores on a scale Standard Deviation 0.92
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses1)1:Very difficult,5:Very easy(GrpC:Q4-4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.70 scores on a scale Standard Deviation 0.67
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses2)1:Very difficult,5:Very easy(GrpC:Q4-4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.64 scores on a scale Standard Deviation 0.92
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q4.(ses3)1:Very difficult,5:Very easy(GrpC:Q4-4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-A PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This question was not separately asked for Group-B PWC session. (Check Q4)	NA scores on a scale Standard Deviation NA This questionnaire does not contain the PWC related questions.	2.64 scores on a scale Standard Deviation 0.81
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q7.(ses1)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	3.22 scores on a scale Standard Deviation 1.86
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q7.(ses3)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.10 scores on a scale Standard Deviation 1.37
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q7.(ses5)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have phone dialing task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.80 scores on a scale Standard Deviation 0.63
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q8.(ses1)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	3.71 scores on a scale Standard Deviation 1.70
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q8.(ses3)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.70 scores on a scale Standard Deviation 0.67
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q8.(ses4)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.70 scores on a scale Standard Deviation 0.67
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q8.(ses5)1:Completely ineffective,5:Very effective	NA scores on a scale Standard Deviation NA Group-A subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA Group-B subjects did not have weight shifting task.	NA scores on a scale Standard Deviation NA This questionnaire does not contain the smartphone related questions.	4.70 scores on a scale Standard Deviation 0.67
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session1) 1: A lot, 5: A little	2.57 scores on a scale Standard Deviation 1.16	2.78 scores on a scale Standard Deviation 0.67	2.91 scores on a scale Standard Deviation 1.38	3.10 scores on a scale Standard Deviation 1.29
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session2) 1: A lot, 5: A little	4.07 scores on a scale Standard Deviation 0.83	3.44 scores on a scale Standard Deviation 1.13	3.90 scores on a scale Standard Deviation 1.10	3.91 scores on a scale Standard Deviation 0.70
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session3) 1: A lot, 5: A little	4.25 scores on a scale Standard Deviation 0.87	3.56 scores on a scale Standard Deviation 1.01	3.82 scores on a scale Standard Deviation 0.87	4.00 scores on a scale Standard Deviation 1.10
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session4) 1: A lot, 5: A little	4.50 scores on a scale Standard Deviation 0.80	3.63 scores on a scale Standard Deviation 1.06	3.91 scores on a scale Standard Deviation 1.30	3.73 scores on a scale Standard Deviation 1.35
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session5) 1: A lot, 5: A little	4.17 scores on a scale Standard Deviation 0.96	3.33 scores on a scale Standard Deviation 1.00	4.27 scores on a scale Standard Deviation 0.90	4.09 scores on a scale Standard Deviation 1.83
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q1. (session6) 1: A lot, 5: A little	NA scores on a scale Standard Deviation NA Group-A subjects completed 5-session trials.	NA scores on a scale Standard Deviation NA Group-B subjects completed 5-session trials.	4.36 scores on a scale Standard Deviation 0.81	NA scores on a scale Standard Deviation NA Group-C subjects were asked about wheelchair related questionnaire only for 5-session trials.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session1) 1: Too slow, 3: Just right, 5: Too	3.21 scores on a scale Standard Deviation 0.43	3.11 scores on a scale Standard Deviation 0.78	3.27 scores on a scale Standard Deviation 0.47	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session2) 1: Too slow, 3: Just right, 5: Too	3.07 scores on a scale Standard Deviation 0.47	3.22 scores on a scale Standard Deviation 1.09	0.34 scores on a scale Standard Deviation 0.52	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session3) 1: Too slow, 3: Just right, 5: Too	3.00 scores on a scale Standard Deviation 0.43	3.22 scores on a scale Standard Deviation 1.30	3.00 scores on a scale Standard Deviation 0.89	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session4) 1: Too slow, 3: Just right, 5: Too	3.00 scores on a scale Standard Deviation 0.43	3.13 scores on a scale Standard Deviation 0.64	3.27 scores on a scale Standard Deviation 0.79	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session5) 1: Too slow, 3: Just right, 5: Too	3.08 scores on a scale Standard Deviation 0.49	3.00 scores on a scale Standard Deviation 0.71	3.18 scores on a scale Standard Deviation 0.75	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.
Short Questionnaire at the End of Each Session Group-A&-B:5 Consecutive TDS Trials (Intervals Ranging From Two to Ten Days) Group-C:Computer and PWC Within a Week, Over 6 Weeks. Q2. (session6) 1: Too slow, 3: Just right, 5: Too	NA scores on a scale Standard Deviation NA Group-A subjects completed 5-session trials.	NA scores on a scale Standard Deviation NA Group-B subjects completed 5-session trials.	3.18 scores on a scale Standard Deviation 0.75	NA scores on a scale Standard Deviation NA This questionnaire does not contain the computer related questions.