A Wearable Multimodal Assistive Interface for Virtual Cursor Control in Stroke Survivors with Upper-Limb Impairment

Abstract

Stroke survivors with upper-limb impairments often have difficulty using conventional computer interfaces, which limits their ability to perform daily computer-related activities independently. This study developed a wearable multimodal assistive interface that enables computer interaction through a virtual cursor. A lightweight headband equipped with electrooculography (EOG), electroencephalography (EEG), and an inertial measurement unit (IMU) was used to acquire multimodal signals for interaction control. EOG signals were processed to detect voluntary blinks to generate clicks, head movements were mapped to cursor movements through IMU-based control, and frontal EEG signals were used to estimate attention as an auxiliary mechanism for command verification. A rapid user-specific calibration procedure was introduced to adapt blink-detection thresholds to individual EOG characteristics without requiring extensive training. Thirty stroke patients with upper-limb impairments participated in experiments involving common computer tasks, including news reading, video playback, and character spelling. The system achieved an average operation accuracy of 87.53 ± 4.92%, an average operation time of 3.49 ± 0.49 s, and an information transfer rate of 62.04 ± 15.93 bits/min in the spelling task. The mean NASA-TLX score was 32.1 ± 5.4, indicating a moderate subjective workload during system use. These results demonstrate the feasibility of the proposed wearable multimodal assistive interface for supporting computer interaction in stroke survivors with upper-limb impairments.