Augmented control of hands free voice prostheses

Laryngectomy patients often use an electrolarynx to facilitate speech following a tracheotomy. Devices of this type provide the most intelligible means of communication for tracheotomy patients. However, the electro-larynx has inherent drawbacks such as the buzzing monotonic sound emitted, the need for a free hand to operate the device, and the difficulty experienced by many tracheotomy patients in adapting to use it. The most effective means of addressing the shortcomings of existing electro-larynges is to provide the user with a hands-free facility. This allows the user to perform other manual tasks whilst speaking, or simply to communicate more effectively through body language. Hands-free devices do exist but require a considerable amount of patient training as they involve the use of the shoulder muscles to control pitch. Furthermore, they are not suitable for all patients as the hands-free is suitable only for users with a certain type of tracheotomy. Goldstein et al in 2004 [1] produced a working prototype of a hands-free device that employed electromyographic signals to activate the device. However, it was quite cumbersome in design and failed to alleviate the monotonous sound produced. The goal of this research is to research the implementation of a hands-free electrolarynx, using various activation methods including electromyographic signals to vary parameters of the output signal. Once a satisfactory system of initiation has been devised and tested, a method of pitch variation shall be developed

Klasifikasi Intonasi Wicara Berbasis Sinyal EMG otot Leher

Human voice intonation is affected by pitch and loudness. Pitch is related to the frequency of human voice, while Loudness is related to the magnitude of human voice. Someone who does not have vocal cords, He has no ability to produce voice and speech. This problem is suffered by laryngectomy patients. Over half of all laryngectomy patients worldwide are using electrolarynx for the rehabilitation of their speech ability. Unfortunately, the electrolarynx voice is monotonic and flatted intonation. Small changes in pitch and loudness of electrolarynx will give a better expression in laryngectomy patients. Previous researches have focused on utilization of Electromyography (EMG) signal of neck muscle for only pitch control. In this research, the relationship between human voice intonation (i.e., frequency and magnitude) and EMG signals of neck muscles was studied by looking for their correlation and their mutual information. Human voice signal and EMG signal of neck muscle were recorded simultaneuosly while subjects were saying “A” with varying intonation. The EMG signal of neck muscle was processed using amplifying, filtering, rectifying and “moving average” process. On the other hand, the human voice was processed by FFT Algorithm to obtain magnitude and fundamental frequency. The result shows that the correlation coefficient between human voice magnitudes and EMG signal of neck muscle is 0.93, while the correlation coefficient between human voice frequency and EMG signal of neck muscle is 0.88. Moreover, the mutual information between human voice magnitudes and EMG signal of neck muscle is 1.07, while the mutual information between human voice frequency and EMG signal of neck muscle is 0.65. These results show that the relationship between human voice magnitudes and EMG signal of neck muscle is stronger than the relationship between human voice frequencies and EMG signal of neck muscle. Therefore, it is more appropriate to use the EMG signal of neck muscle for controlling loudness of electrolarynx than that of the pitch of electrolarynx

Pengembangan Instrumentasi dan Analisis Sinyal EMG pada Otot Leher

Orang yang telah kehilangan laring (laryngectomee) atau mengalami kerusakan laring akan kehilangan fungsi bicara dan menyebabkan sulitnya berkomunikasi. Electrolarynx (EL) adalah perangkat genggam berdayakan baterai yang merupakan salah satu alternatif untuk membangkitkan suara dengan memberi getaran pada otot leher. EL adalah alternatif yang mudah digunakan dan sederhana, akan tetapi suara yang dihasilkan EL tidak natural (seperti robot), monoton, dan memiliki kualitas yang rendah sehingga dibutuhkan pengembangan lanjut untuk meningkatkan kualitas suara dan kenyamanan penggunaan. Penelitian sebelumnya telah menunjukkan adanya hubungan antara aktivitas otot leher dengan pembentukan suara. Oleh karenanya, sinyal elektromiografi (EMG) pada otot leher dianalisis terhadap intensinya untuk memulai/berhenti bicara dan hubungannya dengan nada suara yang dihasilkan. Pada penelitian ini, instrumentasi EMG minimum dirancang untuk memperoleh sinyal EMG pada otot leher. Instrumentasi EMG terdiri dari penguat instrumentasi, rangkaian filter, dan rangkaian adder. Sinyal EMG kemudian direkam dan dilakukan proses filtering, rectification, dan kalkulasi envelope sinyal sederhana dengan low pass filter Pole-Zero. Korelasi amplitudo envelope EMG dengan sinyal suara ketika berbicara dianalisis. Thresholding sinyal EMG dengan batas ambang ganda (onset/offset) diusulkan dalam mendeteksi sinyal wicara. Hasil penelitian ini menunjukkan bahwa perekaman sinyal EMG pada otot leher membutuhkan instrumentasi dengan penguatan yang jauh lebih besar. Nilai threshold untuk onset mampu mendeteksi sinyal wicara sebelum wicara terjadi dengan selang waktu sekitar 0.2 ms. Akan tetapi, offset threshold tidak mampu memberikan waktu akhir dari sinyal wicara dengan tepat, di mana deteksi wicara diakhir lebih cepat sekitar 0.12 ms dari seharusnya

Perancangan Kontrol Aktivasi On-Off Electrolarynx Menggunakan Electromyograph

Perancangan kontrol aktivasi on-off electrolarynx menggunakan electromyograph adalah suatu teknik kontrol on-off electrolarynx yang sistem penggeraknya menggunakan electromyograph. Dapat dijelaskan bahwa electromyograph mendeteksi potensi listrik yang dihasilkan oleh sel otot ketika otot ini aktif ataupun tidak aktif berkontraksi.Untuk mengetahui electromyograph aktif ataupun tidak aktif diperlukan elektroda Ag/AgCl sebagai konduktor yang dilekatkan dipermukaan kulit dari otot yang akan di analisa kejadiannya.Otot yang digunakan sebagai kontrol aktivasi on-off electrolarynx adalah otot ekstrinsik laring pada leher. Electrolarynx tersebut akan digunakan oleh penderita tuna laring dan tuna rungu (orang bisu) sebagai alat bantu bicara yang menggetarkan pita suara atau sebagai getar pita suara buatan. Dipilihnya otot ekstrinsik laring sebagai kontrol aktivasi on-off electrolarynx karena otot ekstrinsik laring inilah yang tersisa setelah dilakukan operasi laring (laryngectomy). Otot ekstrinsik laring terletak di daerah sekitar kerongkongan dan otot laring tersebut sangat berpengaruh pada proses bicara. Oleh sebab itu electrolarynx sangat dibutuhkan agar tuna laring dan tuna rungu dapat berbicara kembali. Perancangan kontrol aktivasi on-off electrolarynx menggunakan electromyograph dilakukan dengan cara melekatkan elektroda Ag/AgCl pada permukaan kulit leher tepat dibawah rahang bawah mulut yang kemudian akan terdeteksipotensi listrik yang dihasilkan oleh sel otot ketika otot ini aktif ataupun tidak aktif berkontraksi sebagai masukan sinyal analog pada instrumentasi electromyograph. Instrumentasi electromyograph akan mengeluarkan sinyal analog menuju arduino nano sebagai pengolah sinyal analog menjadi sinyal digital untuk memberikan pengkodean pada rangkaian relay DC agar bisa menggetarkan electrolarynx. Hasil uji coba perancangan kontrol aktivasi on-off electrolarynx menggunakan electromyograph sudah di uji di Sekolah Luar Biasa (SLB) dan mendapatkan hasil uji coba yang beraneka ragam, ada suara terdengar kecil, ada suara bercampur udara, dan ada yang tidak terdengar suarasaat menggunakan electrolarynx.Hasil uji coba lainnya di depan dokter spesialis THT, secara lisan dokter setuju dengan hasil uji alat tersebut karena electrolarynx dapat membantu pasien tuna laring bicara. Alat ini diharapkan dapat di produksi dengan harga yang terjangkau. ========================================================= The design of electrolarynx on-off activation control using electromyograph is an electrolarynx on-off control technique that drives the system using electromyograph. It can be explained that the electromyograph detects the electrical potential generated by the muscle cells when these muscles are active or inactive contracting. To determine the active or inactive electromyograph, an Ag / AgCl electrode is needed as a conductor attached to the skin surface of the muscle which will be analyzed. The muscle used as a control for electrolarynx on-off activation is the extrinsic laryngeal muscle in the neck. The electrolarynx will be used by laryngeal and deaf tuna sufferers (mute people) as speech aids that vibrate the vocal cords or as vibrating artificial vocal cords. The extrinsic laryngeal muscle was chosen as the control of on-off electrolarynx activation because the extrinsic laryngeal muscle was left after laryngeal surgery (laryngectomy). Extrinsic laryngeal muscles located in the area around the esophagus and the laryngeal muscles are very influential in the speech process. Therefore electrolarynx is needed so that the tuna laring and deaf can talk again. Designing the on-off electrolarynx activation control using electromyograph is done by attaching the Ag / AgCl electrode to the surface of the neck skin just below the lower jaw of the mouth which then will detect the electrical potential generated by muscle cells when the muscle is active or not actively contracting as an analog signal input electromyograph instrumentation. The electromyograph instrument will output analog signals to arduino nano as analog signal processors into digital signals to provide encoding on DC relay circuits in order to vibrate electrolarynx. The results of the trial design of the electrolarynx on-off activation control using electromyograph have been tested in Sekolah Luar Biasa (SLB) and get the results of various trials, there is a small sound, there is sound mixed with air, and there are no audible sounds when using electrolarynx . Other trial results in front of THT specialists, orally, the doctor agrees with the test results of the device because electrolarynx can help the larynx patient. This tool is expected to be produced at an affordable price

Using Visual Feedback to Enhance Intonation Control within Electrolaryngeal Speech

This study evaluated the effectiveness of visual feedback in facilitating pitch control using a pressure sensitive electrolarynx (EL). This proof-of-concept pilot study was a single-subject design that included two healthy adults (1 female aged 23;6 years old, and 1 male aged 67;0 years old). Both participants were provided with visual feedback over two consecutive weeks. Changes in pitch and force control accuracy over 4 hours were analyzed. The results demonstrated that both participants showed an improvement in force control accuracy from the first to the last training session. The results of this proof-of-concept study are a preliminary step towards the development of a clinical training protocol for the use of a pressure sensitive EL. Further, these results highlight the importance of developing a clinically relevant tool for the improvement of a laryngectomee’s quality of life postlaryngectomy

Prediction of larynx function using multichannel surface EMG classification

Total laryngectomy (TL) affects critical functions such as swallowing, coughing and speaking. An artificial, bioengineered larynx (ABL), operated via myoelectric signals, may improve quality of life for TL patients. To evaluate the efficacy of using surface electromyography (sEMG) as a control signal to predict instances of swallowing, coughing and speaking, sEMG was recorded from submental, intercostal and diaphragm muscles. The cohort included TL and control participants. Swallowing, coughing, speaking and movement actions were recorded, and a range of classifiers were investigated for prediction of these actions. Our algorithm achieved F1-scores of 76.0 ± 4.4 % (swallows), 93.8 ± 2.8 % (coughs) and 70.5 ± 5.4 % (speech) for controls, and 67.7 ± 4.4 % (swallows), 71.0 ± 9.1 % (coughs) and 78.0 ± 3.8 % (speech) for TLs, using a random forest (RF) classifier. 75.1 ± 6.9 % of swallows were detected within 500 ms of onset in the controls, and 63.1 ± 6.1 % in TLs. sEMG can be used to predict critical larynx movements, although a viable ABL requires improvements. Results are particularly encouraging as they encompass a TL cohort. An ABL could alleviate many challenges faced by laryngectomees. This study represents a promising step toward realising such a device

Restorative procedures in cases of impaired voice function following complete laryngectomy

Surgical voice restoration with a tracheo-oesophageal fistula using an alloplastic voice prosthesis is the current standard in Germany for patients with laryngectomy. With the increasing widespread use of this type of rehabilitation new duties emerge, not only for ones colleagues in the hospital but also for those in general practice. Care of these patients close to their home must be the aim of us all. With the use of voice prostheses on the increase any problems arising for the clinician are few and easily treatable; for these a therapy concept should be borne in mind. Surgical voice restoration is indicated only in individual cases due, among other reasons, to the high operational costs involved. If surgical voice restoration is impossible or unsuccessful, oesophageal voice replacement and electronic voice support are realistic alternatives. Improvements can be expected as regards the durability of voice prostheses, methods of replacing them, and speech procedure with finger-free tracheostomy closure. Greater use of the artificial larynx without tracheostomy is the objective for the distant future

Multimodal Wearable Sensors for Human-Machine Interfaces

Certain areas of the body, such as the hands, eyes and organs of speech production, provide high-bandwidth information channels from the conscious mind to the outside world. The objective of this research was to develop an innovative wearable sensor device that records signals from these areas more conveniently than has previously been possible, so that they can be harnessed for communication. A novel bioelectrical and biomechanical sensing device, the wearable endogenous biosignal sensor (WEBS), was developed and tested in various communication and clinical measurement applications. One ground-breaking feature of the WEBS system is that it digitises biopotentials almost at the point of measurement. Its electrode connects directly to a high-resolution analog-to-digital converter. A second major advance is that, unlike previous active biopotential electrodes, the WEBS electrode connects to a shared data bus, allowing a large or small number of them to work together with relatively few physical interconnections. Another unique feature is its ability to switch dynamically between recording and signal source modes. An accelerometer within the device captures real-time information about its physical movement, not only facilitating the measurement of biomechanical signals of interest, but also allowing motion artefacts in the bioelectrical signal to be detected. Each of these innovative features has potentially far-reaching implications in biopotential measurement, both in clinical recording and in other applications. Weighing under 0.45 g and being remarkably low-cost, the WEBS is ideally suited for integration into disposable electrodes. Several such devices can be combined to form an inexpensive digital body sensor network, with shorter set-up time than conventional equipment, more flexible topology, and fewer physical interconnections. One phase of this study evaluated areas of the body as communication channels. The throat was selected for detailed study since it yields a range of voluntarily controllable signals, including laryngeal vibrations and gross movements associated with vocal tract articulation. A WEBS device recorded these signals and several novel methods of human-to-machine communication were demonstrated. To evaluate the performance of the WEBS system, recordings were validated against a high-end biopotential recording system for a number of biopotential signal types. To demonstrate an application for use by a clinician, the WEBS system was used to record 12‑lead electrocardiogram with augmented mechanical movement information

Voice restoration after total laryngectomy

Totalna laringektomija je opsežan kirurški zahvat, indiciran kod bolesnika s uznapredovalim karcinomom larinksa, stadija T3 i T4 prema TNM klasifikaciji. Grkljan, anatomski složen organ, povezuje gornji i donji dišni put i time osigurava tri glavne funkcije: štiti donji respiratorni trakt, omogućuje respiraciju i sudjeluje u fonaciji, tj. stvaranju glasa. Nakon potpunog uklanjanja grkljana i okolnih struktura, bolesnik se suočava s brojnim promjenama u načinu života: udisaj i izdisaj se odvija na traheostomi (trajnom otvoru na prednjoj strani vrata), zrak bez prethodne pripreme direktno ulazi u traheju i pluća, bolesniku je poremećen osjet mirisa i okusa, i najvažnije, ne može govoriti. Gubitak glasa značajno utječe na komunikaciju i odnose s ljudima, te rezultira bolesnikovim povlačenjem, psihološkim smetnjama i smanjenjem kvalitete života. Još od kada je 1873. Theodor Billroth izveo prvu totalnu laringektomiju, uloženi su značajni napori u istraživanje i razvoj najboljeg načina govorne rehabilitacije kod laringektomiranih bolesnika. Uspješnu rehabilitaciju danas je moguće postići s tri najvažnije metode: učenjem ezofagealnog govora, upotrebom elektrolarinksa i traheoezofagealnim glasom i govorom uz govornu protezu (GP). Ezofagealni glas nastaje tako što bolesnik ubaci zrak u gornji dio jednjaka, te prilikom njegovog propuštanja prema usnoj šupljini dolazi do vibracije faringoezofagealnog segmenta (PES). Elektrolarinks je govorni aparat koji zahvaljujući elektro bateriji stvara vanjski izvor vibracija. Prislanjanjem uređaja na kožu vrata, one se prenose u usnu šupljinu gdje artikulacijom nastaje glas i govor. Traheoezofagealni govor s GP nastaje prolaskom zraka iz pluća prema gornjem dijelu jednjaka, kroz GP postavljenu u traheoezofagealnu fistulu. Zadnjih nekoliko desetljeća, traheoezofagealni govor s GP je zlatni standard govorne rehabilitacije u svijetu.Total laryngectomy (TL) is an extensive surgical procedure, reserved for patients with advanced laryngeal carcinoma, staged as T3 and T4 by the TNM classification. The larynx, an anatomically complex organ by its structure, connects the upper and lower respiratory tract, and therefore it serves three important functions in humans: protection of the lower airways, facilitation of respiration and voice production. Following complete removal of the larynx and nearby structures, the patient has to adapt to new forms of living; breathing trough a stoma (permanent aperture in the neck), inhaling unprepared air directly into the trachea and lungs, loss of smell and taste, and most importantly, being voiceless. The loss of vocal communication severely disrupts interactions with others and leads to social withdrawal, psychological changes and a decrease in the quality of life. Since the first TL was described by Theodore Billroth in 1873, great effort has been put in finding the best option for voice resuscitation and improvement in the quality of life in laryngectomized patient. Successful voice restoration can be attained with one of three speech options: esophageal speech, electrolarynx, and, most recently, tracheoesophageal speech using an artificial valve. Esophageal speech is produced after the air has been drawn into the upper esophagus and then released in a controlled manner to vibrate the pharyngoesophageal segment (PES). An electrolarynx is an artificial, mechanical device which creates an external buzzing vibrations. By placing it on the neck, vibrations reach the throat and mouth of the user so he can convert this energy into the voice and speech. Tracheoesophageal speech with voice prosthesis is produced after expiratory air from the lungs has been drawn into the upper esophagus, directed through the voice prosthesis inserted into the fistula. The last method has become the most preferred speech method in the past decade in the world