No AccessJournal of Speech, Language, and Hearing ResearchResearch Article1 Apr 2007

Training Effects on Speech Production Using a Hands-Free Electromyographically Controlled Electrolarynx

    Purpose

    The electrolarynx (EL) is a widely used device for alaryngeal speech, but it requires manual operation and produces voice that typically has a constant fundamental frequency. An electromyographically controlled EL (EMG-EL) was designed and implemented to provide hands-free control with dynamic pitch modulation.

    Method

    Three participants who underwent total laryngectomy surgery and 4 participants with normal voice were trained to produce EMG-EL speech through a multiple-baseline, successive-stage protocol. Baseline performance was established through 3 testing probes, followed by multiple hour-long training sessions.

    Results

    At the end of the training, all participants learned to initiate, sustain, and terminate EMG-EL activation in correspondence with articulation, and most were able to modulate the pitch to produce intonational contrasts. After completing the testing/training protocol, 1 of the 3 participants who underwent total laryngectomy was encouraged to independently use the EMG-EL at his residence. This participant sustained his performance for an additional 6 weeks and also used the EMG-EL successfully to communicate over the phone.

    Conclusions

    Our findings suggest that some participants with laryngectomies and vocally normal individuals can learn to produce hands-free speech using the EMG-EL device within a few hours and that significant additional gains in device control (particularly pitch modulation) are attainable through subsequent training sessions.

    References

    • Agnew, P. J., & Shannon, G. F. (1981). Training program for a myo-electrically controlled prosthesis with sensory feedback system.American Journal of Occupational Therapy, 35, 722–727.
    • Benjuya, N., & Kenney, S. B. (1990). Myoelectric hand orthosis.Journal of Prosthetics and Orthotics, 2, 149–153.
    • Choi, H. S., Park, Y. J., Lee, S. M., & Kim, K. M. (2001). Functional characteristics of a new electrolarynx “Evada” having a force sensing resistor sensor.Journal of Voice, 15, 592–599.
    • Erickson, D. (1993). Laryngeal muscle activity in connection with Thai tones.Annual Bulletin Research Institute of Logopedics and Phoniatrics, 27, 135–149.
    • Fairbanks, G. (1960). The rainbow passage (2nd ed.). New York: Harper and Row.
    • Gandour, J., & Weinberg, B. (1983). Perception of intonational contrasts in alaryngeal speech.Journal of Speech and Hearing Research, 26, 142–148.
    • Gandour, J., & Weinberg, B. (1984). Production of intonation and contrastive stress in electrolaryngeal speech.Journal of Speech and Hearing Research, 27, 605–612.
    • Goldstein, E. A. (1998). An improved prosthetic electrolarynx controlled by pressure variations and electromyographic signals. Unpublished S.B. honor’s thesis, Harvard University
    • Goldstein, E. A. (2003). Prosthetic voice controlled by muscle electromyographic signals. Unpublished doctoral dissertation, Harvard University
    • Goldstein, E. A., Heaton, J. T., Kobler, J. B., Stanley, G. B., & Hillman, R. E. (2004). Design and implementation of a hands-free electrolarynx device controlled by neck strap muscle electromyographic activity.IEEE Transactions on Biomedical Engineering, 51, 325–332.
    • Gray, S., & Konrad, H. R. (1976). Laryngectomy: Postsurgical rehabilitation of communication.Archives of Physical Medicine and Rehabilitation, 57, 140–142.
    • Heaton, J. T., Goldstein, E. A., Kobler, J. B., Zeitels, S. M., Randolph, G. W., & Walsh, M. J. (2004). Surface electromyographic activity in total laryngectomy patients following laryngeal nerve transfer to neck strap muscles.Annals of Otolaryngology, Rhinology, and Laryngology, 113, 754–764.
    • Hillman, R. E., Walsh, M. J., Wolf, G. T., Fisher, S. G., & Hong, W. K. (1998). Functional outcomes following treatment for advanced laryngeal cancer. Part I: Voice preservation in advanced laryngeal cancer. Part II: Laryngectomy rehabilitation: The state of the art in the VA System.Annals of Otology, Rhinology, and Laryngology, 172, 1–27.
    • Hirano, M., Koike, Y., & von Leden, H. (1967). The sternohyoid muscle during phonation: Electromyographic studies.Acta Oto-Laryngologica, 64, 500–507.
    • Hirano, M., Ohala, J., & Vennard, W. (1969). The function of laryngeal muscles in regulating fundamental frequency and intensity of phonation.Journal of Speech and Hearing Research, 12, 616–628.
    • Hodge, M. M., & Rochet, A. P. (1989). Characteristics of speech breathing in young women.Journal of Speech and Hearing Research, 32, 466–480.
    • Hoit, J. D., & Hixon, T. J. (1987). Age and speech breathing.Journal of Speech and Hearing Research, 30, 351–366.
    • Hoit, J. D., Hixon, T. J., Altman, M. E., & Morgan, W. J. (1989). Speech breathing in women.Journal of Speech and Hearing Research, 32, 353–365.
    • Izdebski, K. (1980). Effects of prestimulus interval on phonation initiation reaction times.Journal of Speech and Hearing Research, 23, 485–489.
    • Jacobsen, S. C., Knutti, D. F., Johnson, R. T., & Sears, H. H. (1982). Development of the Utah artificial arm.IEEE Transactions on Biomedical Engineering, 29, 249–269.
    • Junker, A. (1995). Brain–body actuated system.United States Patent No. 5474082.
    • Kearns, K. P. (2000). Single-subject experimental designs in aphasia.In S. E. Nadeau, L. J. Rothi, & B. Grosson (Eds.), Aphasia and language: Theory to practice (pp. 421–441). New York: Guilford Press.
    • Keith, R. L., Shanks, J. C., & Doyle, P. C. (2005). Historical highlights: Laryngectomy Rehabilitation.In P. Doyle (Ed.), Contemporary considerations in the treatment and rehabilitation of head and neck cancer (pp. 17–58). Austin, TX: Pro-Ed.
    • Koike, Y., & Kawato, M. (1995). Estimation of dynamic joint torques and trajectory formation from surface electromyography signals using a neural network model.Biological Cybernetics, 73, 291–300.
    • Latwesen, A., & Patterson, P. E. (1994). Identification of lower arm motions using the EMG signals of shoulder muscles.Medical Engineering and Physics, 16, 113–121.
    • McRae, R. G., & Pillsbury, H. R. (1979). A modified intraoral electrolarynx.Archives of Otolaryngology, 105, 360–361.
    • Meltzner, G., Hillman, R. E., Heaton, J., Houston, K., Kobler, J., & Qi, Y. (2005). Electrolarynx speech: The state-of-the-art and future directions.In P. Doyle (Ed.), Contemporary considerations in the treatment and rehabilitation of head and neck cancer (pp. 571–590). Austin, TX: Pro-Ed.
    • Mendenhall, W. M., Morris, C. G., Stringer, S. P., Amdur, R. J., Hinerman, R. W., Villaret, D. B., & Robbins, K. T. (2002). Voice rehabilitation after total laryngectomy and postoperative radiation therapy.Journal of Clinical Oncology, 20, 2500–2505.
    • Min, H., Takahashi, M., Nishizawa, N., Nishizawa, S., Uemi, N., Ifukube, T., & Inuyama, Y. (1994a). Performance of an electrolarynx controlled by the sternohyoid muscle.IPSJ SIGNotes Human Interface Abstract, No. 056(005)
    • Min, H., Takahashi, M., Nishizawa, N., Nishizawa, S., Uemi, N., Ifukube, T., & Inuyama, Y. (1994b). Two pitch control methods of an electrolarynx controlled by the sternohyoid muscle.IPSJ SIGNotes Human Interface Abstract, No. 056(006)
    • Mitchell, H. L., Hoit, J. D., & Watson, P. J. (1996). Cognitive–linguistic demands and speech breathing.Journal of Speech and Hearing Research, 39, 93–104.
    • Morris, H. L., Smith, A. E., Van Demark, D. R., & Maves, M. D. (1992). Communication status following laryngectomy: The Iowa experience 1984–1987.Annals of Otology, Rhinology & Laryngology, 101, 503–510.
    • Northmore-Ball, M. D., Heger, H., & Hunter, G. A. (1980). The below-elbow myo-electric prosthesis: A comparison of the Otto Bock myo-electric prosthesis with the hook and functional hand.Journal of Bone and Joint Surgery [Brit], 62B, 363–367.
    • Roubeau, B., Chevrie-Muller, C., & Lacau Saint Guily, J. (1997). Electromyographic activity of strap and cricothyroid muscles in pitch change.Acta Oto-Laryngologica, 117, 459–464.
    • Saridis, G. N., & Gootee, T. P. (1982). EMG pattern analysis and classification for a prosthetic arm.IEEE Transactions on Biomedical Engineering, 29, 403–412.
    • Scargle, S. (1998). EMG/EEG head–computer–interface system for computer cursor control. Unpublished master’s thesis, International University of Florida
    • Solomon, N. P., & Hixon, T. J. (1993). Speech breathing in Parkinson’s disease.Journal of Speech and Hearing Research, 36, 294–310.
    • Takahashi, H., Nakao, M., Okusa, T., Hatamura, Y., Kikuchi, Y., & Kaga, K. (2001a). Pitch control input by finger pressure using electrolarynx or intra-mouth vibrator.The Japan Journal of Logopedics and Phoniatrics, 42, 1–8.
    • Takahashi, H., Nakao, M., Okusa, T., Hatamura, Y., Kikuchi, Y., & Kaga, K. (2001b). Voice generation system using an intra-mouth vibrator.Journal of Artificial Organs, 4, 228–294.
    • Uemi, I., & Takahashi, M. (1994). Design of a new EL having a pitch control function.IEEE International Workshop on Robot and Human Communications. 378–383.
    • Watson, B. C. (1994). Foreperiod duration, range, and ordering effects on acoustic LRT in normal speakers.Journal of Voice, 8, 248–254.
    • Yamada, M., Niwa, N., & Uchiyama, A. (1983). Evaluation of a multifunctional hand prosthesis system using EMG controlled animation.IEEE Transactions on Biomedical Engineering, 30, 759–763.
    • Yorkston, K. M., & Beukelman, D. R. (1981). Communication efficiency of dysarthric speakers as measured by sentence intelligibility and speaking rate.Journal of Speech and Hearing Disorders, 46, 296–301.

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