Noncontact Gesture-Based Switch Improves Communication Speed and Social Function in Advanced Duchenne Muscular Dystrophy: A Case Report

Augmentative and alternative communication (AAC) enables digital access for individuals with severe motor impairment. Conventional contact-based switches rely on residual voluntary movement, limiting efficiency. We report the clinical application of a novel, researcher-developed noncontact assistive switch, the Augmentative Alternative Gesture Interface (AAGI), in a 39-year-old male with late-stage Duchenne Muscular Dystrophy (DMD) retaining minimal motion. The AAGI converts subtle, noncontact gestures into digital inputs, enabling efficient computer operations. Before intervention, the participant used a conventional mechanical switch, achieving 12 characters per minute (CPM) in a 2 min text entry task and was unable to perform high-speed ICT tasks such as gaming or video editing. After 3 months of AAGI use, the input speed increased to 30 CPM (+2.5-fold), and previously inaccessible tasks became feasible. The System Usability Scale (SUS) improved from 82.5 to 90.0, indicating enhanced usability, whereas the Short Form 36 (SF-36) Social Functioning (+13) and Mental Health (+4) demonstrated meaningful gains. Daily living activities remained stable. This case demonstrates that the AAGI system, developed by our group can substantially enhance communication efficiency, usability, and social engagement in advanced DMD, highlighting its potential as a practical, patient-centered AAC solution that extends digital accessibility to individuals with severe motor disabilities.