Effects of glossopharyngeal breathing on voice in cervical spinal cord injuries

Abstract

Aims: Glossopharyngeal Pistoning for Lung Insufflation (GI, also called glossopharyngeal breathing) is a method to increase vital capacity (VC) when respiratory muscle function is limited. The authors’ aims were to evaluate the effects of GI on voice and speech in people with cervical spinal cord injury (CSCI), and to document specific instantaneous effects of GI on voice and speech. Methods: Seven individuals with CSCI performed ten GI-cycles four days weekly for eight weeks. Intervention outcomes included spirometry, registration of the subglottal air pressure (PS), audio recording of speech and self-ratings with the Swedish version of the Voice Handicap Index (Sw-VHI). VC, PS and sound pressure level (SPL) were also registered with GI. Findings: Main changes pre/post intervention: Median SPL for syllable repetition increased 7.1 dB (P=0.046) and for loud reading 4.1 dB (P=0.018). Median phonatory instability decreased to 1.2% (P=0.046), median phrase length (words per breath) increased from 9.5 to 12.8 (P=0.004). Four participants pre and three post intervention scored >20 on Sw-VHI. With GI median VC increased 0.6 litres, median SPL for habitual voice increased 4.6 dB (P=0.030), for loud voice 7.2 dB (P=0.030) and median PS for loud voice increased 4.5 cm H2O (P=0.024). Conclusions: The results indicate some positive effects of GI on voice/speech and thus may support the implementation of GI in clinical practice.