Assessment of voice, speech and communication changes associated with cervical spinal cord injury

Seiger, Åke; Forsén, Malin; Nilsson, Jeanette Holmgren; Hartelius, Lena; Schalling, Ellika

doi:10.1111/1460-6984.12380

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…Summarizing the results for clinical application, it was shown that patients with CSCIs were not conscious of their voice problems but had low speech intelligibility in voice user interfacing. Reduced respiratory function resulted in low speech sound pressure in people with CSCIs [19]. The decrease in speech sound pressure was associated with a decrease in CPPS value in people with and without speech impairment [22].…”

Section: Discussionmentioning

confidence: 96%

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Analysis of voice features of people with cervical spinal cord injuries with voice user interfaces

Hayashi,

Terashi,

Fujiwara

et al. 2024

Preprint

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Study design: A comparative study Objectives: To evaluate respiratory function, voice intensity, self-assessment of voice problems, and recordings in individuals with cervical spinal cord injuries (CSCIs), compare these parameters with a control group, and identify factors influencing speech intelligibility. Setting: Clinical setting at the Spinal Injuries Center Methods: Twenty individuals with CSCIs and 20 healthy participants were recruited for this study. Their respiratory function was assessed using an electric diagnostic spirometer, and voice intensity and recordings were measured using a smartphone sound analysis application. Self-assessed voice problems were evaluated using the Voice Handicap Index. Statistical analyses were conducted to compare the measurement data between the two groups. A simple regression analysis was used to assess the correlation between speech intelligibility and various vocal parameters. Results: Vital capacity was 60% lower in the CSCI group. Maximum voice intensity in the CSCI group (mean 78.8 dB) was significantly lower than that in the control group (mean 96.2 dB) (P<0.001). In the CSCI group, significant correlations between speech intelligibility and maximum phonation time (R2=0.298, P=0.013), maximum vocalization voice intensity (R2=0.673, P<0.001), reading voice intensity (R2=0.664, P<0.001), and the smoothed cepstral peak prominence value (R2=0.437, P=0.002) were observed. A weak correlation between vital capacity and speech intelligibility was also noted. Conclusions: Clinically, individuals with CSCIs were not consciously aware of their voice problems, despite exhibiting low speech intelligibility in voice user interfaces. Voice recognition performance could be improved through voice conversion techniques that increase voice intensity and speech rate. Sponsorship: not applicable

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Section: Discussionmentioning

confidence: 96%

“…Sound pressure level has been reported to be proportional to subglottic pressure [19,20]. Johansson et al reported on the relationship between subglottic pressure and sound pressure levels in a voice study that involved participants with CSCIs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of voice features of people with cervical spinal cord injuries with voice user interfaces

Hayashi,

Terashi,

Fujiwara

et al. 2024

Preprint

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“…Many devised their own strategies through trial and error to enhance their communicate abilities. Johansson et al (2018) reported that only one out of 19 cSCI participants had contact with SLT, despite reporting significant changes to voice and communication abilities. As a result, many individuals with cSCI developed compensatory habits that put additional strain on their voice function.…”

Section: Discussionmentioning

confidence: 99%

“…Other communication impairments are linked to a loss of voice due to ventilatory needs and reduced respiratory function (Laakso et al, 2011). These may be long-term impairments that have great impact on agency and control of environmental needs, especially in the community setting, so early identification to optimise clinical management and strategies is important (Johansson et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Speech and language therapy service provision in spinal injury units compared to major trauma centres in England: Are services matched?

McRae

Hayton

Smith

2021

Intl J Lang & Comm Disor

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Background: National UK guidance makes recommendations for speech and language therapy staffing levels in critical care and rehabilitation settings. Traumatic spinal cord injury patients often require admission primarily to critical care services within a major trauma centre prior to transfer to a specialist spinal injury unit but may not receive similar levels of care. Dysphagia and communication difficulties are recognised features of cervical spinal cord injury; however, little is known about access to speech and language therapy services to provide rehabilitation and improve outcomes. Aims: The aim of this study was to compare the workforce and clinical practices of speech and language therapy services in eight spinal injury units and four major trauma centres in England through an online survey. Methods & Procedures: An online survey was created with 26 multiple-choice questions across seven sub-sections, with options for free-text comments. These were sent to a named speech and language therapy contact at each of the specified units. Responses were uploaded into Excel for analyses, which included descriptive statistics and analysis of themes.Outcomes & Results: Responses were received from 92% (11/12) speech and language therapy services invited, which included seven out of eight spinal injury units and all four major trauma centres. No units met national staffing recommendations. Staff in spinal injury units provided an average of 27 h per week input to the unit compared to 80 h in a major trauma centre. Despite caseload variations, speech and language range of therapy involvement and prioritisation process were equivalent. Access to instrumental assessment varied, with less use of Fibreoptic Endoscopic Evaluation of Swallowing in spinal injury units despite its clinical value to the spinal cord injury caseload. Conclusions & Implications: Speech and language therapy services delivering post-acute and long-term rehabilitation to spinal cord injury patients are limited by their resources and capacity, which restricts the level of therapy delivered to patients. This may have an impact on clinical outcomes for communication and swallowing impairments. Further evidence is needed of the interventions 6

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Evaluation of Speech

Solomon

2020

Neurologic and Neurodegenerative Diseases of the Larynx

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Assessment of voice, speech and communication changes associated with cervical spinal cord injury

Cited by 7 publications

References 29 publications

Analysis of voice features of people with cervical spinal cord injuries with voice user interfaces

Analysis of voice features of people with cervical spinal cord injuries with voice user interfaces

Speech and language therapy service provision in spinal injury units compared to major trauma centres in England: Are services matched?

Evaluation of Speech

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