Article

OBJECTIVES: To explore how respiratory impairment after cervical spinal cord
injury affects vocal function, and to explore muscle recruitment strategies used
during vocal tasks after quadriplegia. It was hypothesized that to achieve the
increased respiratory support required for singing and loud speech, people with
quadriplegia use different patterns of muscle recruitment and control strategies
compared with control subjects without spinal cord injury. DESIGN: Matched,
parallel-group design. SETTING: Large university-affiliated public hospital.
PARTICIPANTS: Consenting participants with motor-complete C5-7 quadriplegia (n=6)
and able-bodied age-matched controls (n=6) were assessed on physiologic and voice
measures during vocal tasks. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Standard respiratory function testing, surface electromyographic
activity from accessory respiratory muscles, sound pressure levels during vocal
tasks, the Voice Handicap Index, and the Perceptual Voice Profile. RESULTS: The
group with quadriplegia had a reduced lung capacity (vital capacity, 71% vs 102%
of predicted; P=.028), more perceived voice problems (Voice Handicap Index score,
22.5 vs 6.5; P=.046), and greater recruitment of accessory respiratory muscles
during both loud and soft volumes (P=.028) than the able-bodied controls. The
group with quadriplegia also demonstrated higher accessory muscle activation in
changing from soft to loud speech (P=.028). CONCLUSIONS: People with quadriplegia
have impaired vocal ability and use different muscle recruitment strategies
during speech than the able-bodied. These findings will enable us to target
specific measurements of respiratory physiology for assessing functional
improvements in response to formal therapeutic singing training.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS