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END-TIDAL CO 2 BASED VISUAL FEEDBACK METHOD IN THERAPY OF RESPIRATORY DISTURBANCES IN STUTTERING

COST B27 ENOC Joint WGs Meeting Swansea UK, 16-18 September 2006. END-TIDAL CO 2 BASED VISUAL FEEDBACK METHOD IN THERAPY OF RESPIRATORY DISTURBANCES IN STUTTERING Barbara Stankiewicz, Bogdan Adamczyk * , Krzysztof Zielinski, Marek Darowski

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END-TIDAL CO 2 BASED VISUAL FEEDBACK METHOD IN THERAPY OF RESPIRATORY DISTURBANCES IN STUTTERING

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  1. COST B27 ENOC Joint WGs Meeting Swansea UK, 16-18 September 2006 END-TIDAL CO2 BASED VISUAL FEEDBACK METHOD IN THERAPY OF RESPIRATORY DISTURBANCES IN STUTTERING Barbara Stankiewicz, Bogdan Adamczyk*, Krzysztof Zielinski, Marek Darowski Institute of Biocybernetics and Biomedical Engineering, Polish Academy ofSciences, Warsaw, Poland , *Institute of Physics, Maria Curie-Sklodowska University, Lublin, Poland

  2. BACKGROUND Respiratorydisturbances in stuttering can influence lung ventilation and gas exchange leading even to hyperventilation or hypoventilation. A new breathregulation method based on visual feedback (VF) using on-line registeredend-tidal CO2was implemented in computer system for therapy respiratory disturbances in stuttering. The VF method was preliminary tested.

  3. METHODS 24 stuttering persons and fluent speakers (aged 14-37) participated in the study. Sound and expired CO2 signals were recorded while speaking without and with VF to control breathing as well as during rest respiration, before each utterance.To assess the efficiency of VF the factor of breath ergonomics during speaking (FE) was proposed and stuttering intensity was determined.

  4. Fig. 1. The Computer-capnographic system for the therapy of respiratory disturbances in stuttering. Visual feedback method enables the regulation of the patient’s breath during speaking by controlling the end-tidal CO2 and keeping it within the standard range determined on the basis of rest respiration.

  5. Fig. 3.The application of therapy of respiratory disturbances in stuttering.

  6. FE - factor of breath ergonomics during speaking Ph – the number of the CO2 peaks connected with speaking; R – the number of the CO2 peaks placed in the standard range for the end-tidal CO2; A – the number of all the CO2 peaks of the capnographic signal of an utterance. Fig. 2. The calculation method of FE factor of breath ergonomics during speaking.

  7. STUTTERING INTENSITY • the number of the mispronounced syllables per 100 syllables of an utterance

  8. Tab. 1. The ANOVA analysis results - comparison of FE values obtained for stutterers and fluent speakers while speaking and speaking with visual feedback.The GROUP factor at the level of1) stutterers, and 2) fluent speakers. The CONDITION factor at the level of 1) speaking, and 2) speaking with VF. * p>0.05

  9. Fig. 4. FE - the factor of breath ergonomics during speaking (jointly: speaking with and without VF) obtained for stutterers and fluent speakers.

  10. Fig. 5. FE - the factor of breath ergonomics during speaking obtained for stutterersand fluent speakers during speaking and speaking with the CO2based visual feedback.

  11. ∆ETCO2=ETCO2 (p) - ETCO2(rr) ∆SCO2=SCO2 (p) - SCO2(rr) ∆ECO2=ECO2(p) - ECO2(rr) p – a phrase of an utterance rr – rest respiration Fig. 6. Determining of the parameters of capnographic curve.

  12. Tab. 2.1-way MANOVA analysis was carried out to compare the phrases containing tonic errors (repetitions, prolongations, and blockades) with thefluent phrases in the stuttereres’ utterances. The PHRASES factor occurredon two levels, i.e. 1) non-fluent phrases, 2) fluent phrases The results of the post-hoc Tuckey tests indicated that all three parameters (i.e. ∆ETCO2, ∆SCO2, and ∆ECO2) had an effect on the significance of the difference between non-fluent and fluent phrases; for each parameter p<0.0005.

  13. Fig. 7.Mean values of the change of end-tidal CO2duringspeaking in relation to rest respiration, standarddeviation and standard error for non-fluent phrasescontaining tonic errors and fluent phrases of the stutterers’ utterances.

  14. References • RACZEK B.: Speech ergonomics assessment in stutterers basedonexhaled CO2 concentration.Preliminary Study. Biocybernetics andBiomedicalEngineering 20 (4), 67-76 (2000). • 2. RACZEK B., ADAMCZYK B.: Concentration of carbondioxide in exhaled air in fluent and non-fluent speech. FoliaPhoniatrica et Logopaedica 56, 75-82 (2004). • 3. STANKIEWICZ B., ADAMCZYK B., ZIELINSKI K., DAROWSKI M.: The system of diagnosis and therapy of respiratory disturbances in stuttering. In Abstrcts: XXXII Annual ESAO Congress, 5-8 October 2005, Bologna, Italy. Journal of Artificial Organs 28 (9), 937 (2005). • 4. STANKIEWICZ B., ADAMCZYK B., ZIELINSKI K., DAROWSKI M.: Reduction of the respiratory disturbances in stuttering using a new method of breat regulation applying vusual feedback based on the CO2/time signal. In Abstrcts: XXXIII Annual ESAO Congress, 21-24 June 2006, Umea, Sweden. Journal of Artificial Organs 29 (5), 543 (2006). • Acknowledgements • This study was financed from science sources in 2004-2005 as the research project no. 3T11E 017 27 and in 2006 within the framework of statutory project St/11/2006 (IBIB PAS).

  15. I INVITE YOU TO MY POSTER (Sunday, 17 Sept, 15:45-16:45)

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