Exploring stimulation patterns for electrical stimulation of the larynx using surface electrodes

Feiner, Marlies; Gerstenberger, Claus; Mayr, Winfried; Hortobagyi, David; Gugatschka, Markus

doi:10.1007/s00405-019-05594-3

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…Based on these experiences we pursued a pretrial in humans, where stimulation was applied transcutaneously by surface electrodes and effects were confirmed via endoscopy. 11 The present study is the first prospective, randomized trial in humans exploring the effects of transcutaneous stimulation in a cohort of elderly women. Our stimulation paradigm is based on the concept that FES during vocal exercises fatigues the laryngeal muscles involved, leading to a muscular hypertrophy, which subsequently diminishes the glottal gap.…”

Section: Discussionmentioning

confidence: 99%

“…Suitable stimulation pattern procedures were established in a pretrial . In short, we used biphasic sawtooth or rectangular pulses with different amplitudes, impulse durations, and frequencies (see Supporting Table 1).…”

Section: Methodsmentioning

confidence: 99%

“…Individual stimulation parameters were stored on a stimulation device (Stimulette r2x; Dr. Schuhfried Medical, Vienna, Austria) and handed over to the participants for home training. They were instructed and trained by the investigators in placing the surface electrodes and applying the stimuli . They were also taught how to remove the surface electrode and switch the stimulation off in case of an adverse event.…”

Section: Methodsmentioning

confidence: 99%

“…Suitable stimulation pattern procedures were established in a pretrial. 11 In short, we used biphasic sawtooth or rectangular pulses with different amplitudes, impulse durations, and frequencies (see Supporting Table 1). Stimuli were delivered using a pair of conductive rubber electrodes, 40 × 28 mm in size (Schwa-Medico, Giessen, Germany), placed bilaterally alongside the upper posterior margin of the thyroid cartilage, with moistened sponge pads providing a low-resistance electrode skin junction.…”

Section: Interventionsmentioning

confidence: 99%

“…They were instructed and trained by the investigators in placing the surface electrodes and applying the stimuli. 11 They were also taught how to remove the surface electrode and switch the stimulation off in case of an adverse event.…”

Section: Interventionsmentioning

confidence: 99%

See 4 more Smart Citations

Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Gugatschka

Feiner

Mayr³

et al. 2020

The Laryngoscope

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The aim of this prospective study was to examine the effects of transcutaneous functional electrical stimulation (FES) in a group of elderly women with presbyphonia. Study Design: Prospective randomized study. Methods: Fourteen participants were enrolled prospectively and attributed randomly to two different treatment groups, where one group (n = 7) received 8 weeks of training (5 days a week), whereas the other group (n = 7) received 4 weeks of ineffective stimulation, followed by 4 weeks of effective training. Stimulation protocols were established during baseline examination and confirmed with endoscopy to ensure a glottal reaction. Numerous acoustical, vocal, patient-centered, and respiratory parameters were obtained at several time points. Results: Neither 4 weeks nor 8 weeks of functional electrical transcutaneous stimulation led to changes of vocal, acoustical, or respiratory parameters, apart from patient-centered items (Voice Handicap Index 12, Voice-Related Quality of Life), which improved over time. However, there were no differences between the two arms for both items. Conclusions: Transcutaneous FES over 4 weeks and 8 weeks did not lead to significantly improved objective voice and acoustical parameters, which could be caused by the fact that the muscles of interest cannot be targeted specifically enough. However, we found a significant improvement of subjective voice perception and voice-related quality of life in both groups. We explain this finding with an observer-expectancy effect secondary to the very time-consuming and elaborate study procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

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Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Gugatschka

Feiner

Mayr³

et al. 2020

The Laryngoscope

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Applicability of Selective Electrical Surface Stimulation in Unilateral Vocal Fold Paralysis

Kurz

Leonhard

et al. 2021

The Laryngoscope

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Objective Selective electrical surface stimulation (SES) of the larynx is not yet routinely considered therapy option in treatment of unilateral vocal fold paralysis (UVFP). Goal of this monocentric feasibility study was to provide systematic data on applicability of SES of intrinsic laryngeal muscles in UVFP under consideration of sensitivity and discomfort thresholds and nonselective side effects. Methods Thirty‐two UVFP patients were included in the study. Symmetric triangular‐shape, charge‐balanced pulse widths (PWs) of 1, 10, 25, 50, 100, 250, and 500 milliseconds (ms) were tested with increasing amplitudes (AMPs). The stimulation was delivered as a train of five pulses using square surface electrodes. Selective laryngeal responses were examined by flexible laryngoscopy. Nonselective side effects (swallowing reflex, coughing, different severity degrees of unspecific strap muscle/platysma response) were judged by observation. Results Selective laryngeal response could be triggered in 28/32 (87.5%) patients during respiration/rest and in 26/32 (81.3%) patients during phonation. The most effective PWs for the selective eliciting of selective bilateral vocal fold adduction are comprised between 50 and 100 ms in combination with an average AMP comprised between 7.1 and 7.2 mA. Conclusion Our results indicate that, in UVFP patients, PWs comprised between 50 and 100 ms in combination with a median AMP between 7.1 and 7.2 mA are expected to deliver in >75% of the cases a specific, effective, and safe bilateral adduction of the VF. Level of Evidence 3 Laryngoscope, 131:E2566–E2572, 2021

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Assessment of Changes in Laryngeal Configuration and Voice Parameters Among Different Frequencies of Neuromuscular Electrical Stimulation (NMES) and Cumulative Effects of NMES in a Normophonic Subject: A Pilot Study

2023

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Exploring stimulation patterns for electrical stimulation of the larynx using surface electrodes

Cited by 8 publications

References 20 publications

Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Functional Electrical Stimulation for Presbyphonia: A Prospective Randomized Trial

Applicability of Selective Electrical Surface Stimulation in Unilateral Vocal Fold Paralysis

Assessment of Changes in Laryngeal Configuration and Voice Parameters Among Different Frequencies of Neuromuscular Electrical Stimulation (NMES) and Cumulative Effects of NMES in a Normophonic Subject: A Pilot Study

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