“ER” Episode Highlights Assistive Technology for ALS

By Stephanie Dufner, ALSA Communications Coordinator

Actor James Woods’ upcoming appearance on “ER” on the February 2 episode titled “Body and Soul” will showcase the veteran performer’s talent, yet many people with ALS and their families will be familiar with the equipment he will be using.

Permobil’s C500 Corpus model that appears on “ER”

Woods’ character, Dr. Nate Lennox, is an ALS patient who will employ a motorized wheelchair, the C500 Corpus model, and a hands-free eye communication system that Permobil and Eye Response Technologies respectively provided to the critically-acclaimed NBC drama. Permobil’s C500 Corpus is a front-wheel drive model that works well both indoors and outdoors and offers its users a variety of practical functions.

The ALS Association’s former vice president of patient services, Mary Lyon, suggested Permobil’s C500 to the “ER” crew as Lyon—along with Dr. Catherine Lomen-Hoerth, medical director at The ALS Center at the University of California San Francisco—consulted with writer Joe Sachs on the show’s script. Sachs, Woods and other crew members from “ER” met with patients from ALSA’s Arizona, Greater Los Angeles and Orange County chapters.

“The C500 was chosen because of its functionality and modularity as a chair,” said Barry Steelman, marketing manager at Permobil, a Swedish-based firm founded in 1963 by Per Udden with an office in Lebanon, TN.

“We have become the chair of choice for ALS patients,” stated Steelman. As part of Permobil’s Corpus line, the C500 model provides its users optional power tilt, power recline, power elevating leg rest and a seat elevator.

This is not the first supporting role for a Permobil product. One of the firm’s wheelchairs appeared in the 1997 flick “Steel” which stars Shaquille O’Neal as a comic book character, and Steelman said his company has twice donated a wheelchair to “Extreme Makeover: Home Edition,” the ABC reality show that displays on-the-air home improvements for families whose abodes are in dire need of change.

“I see our chairs pop up from time to time on TV,” Steelman added, “but I think it’s people using power chairs randomly.”

Eye Response Technologies (ERT), however, made their debut on “ER.” According to the company’s chief technology officer, Christopher P. Lankford, Ph.D. of the Charlottesville, VA-based firm, Woods’ character will be using ERT’s Eye-gaze Response Interface Computer Aid (ERICA) to help him communicate with other characters on the show.

Christopher P. Lankford, Ph.D. of Eye Response Technologies with ERICA. Photo courtesy of Hawes Spencer/The Hook

“ERICA was created for the purpose to give individuals with disabilities a means to communicate with their eyes,” said Lankford, a UVA graduate who holds his undergraduate and graduate degrees in electrical engineering and obtained his doctorate from the same institution in systems engineering in 2002. “There are a number of advantages to this system: It’s portable. There’s free technical support and free software upgrades. And our dealers go out [to the clients] to make sure the system is working.”

Originally developed at the University of Virginia by Dr. Thomas Hutchinson 20 years ago, ERICA uses a camera and infrared light to view a user’s eyes to measure where the user is looking on a computer screen. With an onscreen keyboard, the user can “type” with his/her eyes; this system allows users to surf the internet and send emails exclusively through use of the eyes.

In addition, ERT’s users can perform typical computer mouse functions like dragging and clicking solely through eye movement. Users control ERICA with a tablet PC that runs on Windows XP or an iMac that runs Mac OS X.

“The ALS community is the largest number of users,” Lankford continued. During the past ten years, he has worked closely with people with ALS in the Charlottesville, VA and the Washington, DC environs with the ERICA system. “It was very fulfilling helping them. With engineering, you see the impact it has to benefit people. There’s an intellectual challenge to improve technology.”

A frontal view of Eye Response Technologies’ sleek ERICA system

The people with ALS who tested the ERICA system offered feedback to Lankford on how the system could be improved, and Lankford implemented these patients’ suggestions. Other users of this unit include people impacted by a stroke and those with spinal cord injuries.

Like ERT, Permobil’s distributors work closely with their clientele. “We work with dealers who offer assistance to the wheelchair user,” Steelman affirmed. “We sell through dealers that must be certified and trained by Permobil to work on our products.”

The cost for a C500 wheelchair with the corpus seat retails at $15,872 (including the power tilt option), while the ERT system begins at $7,900. “We have a version that functions as a dedicated communication device at $7,300 [A Medicare-approved system with an onscreen keyboard replete with speech output], stated Lankford.

As for the system that appears on “ER,” Woods will use the ERICA unit that in Lankford’s words “allows the user the most mobility.” This system was mounted on the C-500 Corpus wheelchair the actor used during the show. “We stay on the cutting edge of technology,” Lankford stated. “Our systems are getting smaller and more portable.”

Both companies upgrade their systems according to their users’ needs. About Permobil’s products, the Corpus models “are contoured to fit the back,” said Steelman. “Modularity is the greatest aspect of this product as people can add power controls. There are different power bases that are based on mobility needs. We have different seating systems and power bases.”

In addition to the C500, the Corpus line has two other models for wheelchair users—the C300 and the Street. The former is a more compact version of the C500 strictly for indoor use; the latter is a rear-wheel drive chair. “This model is for people not used to front wheel drive,” Steelman noted.

Similarly, ERT regularly modifies its device with annual hardware changes for ERICA, and they release new software for the system every six months. “We actually have new software coming out in March,” Lankford added. “We are always seeking to make improvements with our eye tracking device and eye tracking software.” The company wants the system to be usable for PALS during the progression of ALS.

For their participation on “ER,” neither company had to pitch their products to the series. “Rick Ladomade, the show’s property master, gave me a call before Thanksgiving,” recalled Lankford. “They were working on an episode on ALS with James Woods, and they wanted to use a system that allows people to communicate.”

The show made use of the executives’ technical expertise. Lankford ensured the ERICA system functioned correctly, and Steelman and two Permobil colleagues, Jeremy Sedlak and Tommy Mandala, demonstrated to the “ER” crew how to use the wheelchair.

Steelman said Permobil had “free reign” on configuring the chair for Woods’ use. “It was based on other chairs ALS patients have used in the past.”

Both companies offer their products internationally to people with mobility needs.

To learn more about these companies, visit their websites at www.permobil.com and www.eyeresponse.com.