WO2011022314A1 - Procédé et appareil pour augmenter la correction physiologique pour la voix - Google Patents

Procédé et appareil pour augmenter la correction physiologique pour la voix Download PDF

Info

Publication number
WO2011022314A1
WO2011022314A1 PCT/US2010/045568 US2010045568W WO2011022314A1 WO 2011022314 A1 WO2011022314 A1 WO 2011022314A1 US 2010045568 W US2010045568 W US 2010045568W WO 2011022314 A1 WO2011022314 A1 WO 2011022314A1
Authority
WO
WIPO (PCT)
Prior art keywords
patient
noise
speech
control arrangement
ear
Prior art date
Application number
PCT/US2010/045568
Other languages
English (en)
Inventor
Jessica E. Huber
Scott Kepner
Derek Tully
James Thomas Jones
Kirk Solon Foster
Original Assignee
Purdue Research Foundation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Purdue Research Foundation filed Critical Purdue Research Foundation
Publication of WO2011022314A1 publication Critical patent/WO2011022314A1/fr
Priority to US13/398,399 priority Critical patent/US20120264091A1/en
Priority to US13/835,802 priority patent/US20130267766A1/en
Priority to US14/266,289 priority patent/US9381110B2/en
Priority to US14/332,679 priority patent/US9532897B2/en

Links

Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B19/00—Teaching not covered by other main groups of this subclass
    • G09B19/04—Speaking

Definitions

  • TITLE METHOD AND APPARATUS FOR INCREASING VOICE LOUDNESS
  • the above-identified application is incorporated herein by reference in its entirety for all purposes.
  • the present disclosure relates to a method and system for increasing voice loudness, and more specifically, the present disclosure comprises a voice enhancement system and method used to elicit the Lombard effect.
  • the Lombard effect is an external cue for increasing voice loudness.
  • the present method and system uses the Lombard effect to assist individuals experiencing problems with vocal intensity, articulation, and/or volume as a result of a physically degenerative condition.
  • Parkinson's Disease is a progressive movement disorder in which there is a deficit in dopamine production in the basal ganglia. Parkinson's Disease is a common degenerative disease of neurological origin. Parkinson's Disease can be characterized by reduced amplitude and velocity of movement and difficulty with movement initiation and premotor programming. Deficits in speech production have been reported in individuals with Parkinson's Disease that include both voice and articulation problems. Such deficiencies in the speech of individuals with Parkinson's Disease are characterized by hypophonia (reduced loudness), monoloudness, monopitch, disordered rate and articulation, and a voice that is hoarse, breathy, harsh, and/or tremulous.
  • Respiratory-related deficits in individuals with Parkinson's Disease have been demonstrated by reductions in forced vital capacity and forced expiratory volume in one second, even under the effects of anti-Parkinsonian medications.
  • Respiratory kinematic patterns for speech are also altered in individuals with Parkinson's Disease.
  • Individuals with Parkinson's Disease may experience respiratory and/or laryngeal muscle weakness or changes to the neural drive to these muscles.
  • Reduced vocal fold closure, reduced respiratory support, respiratory and laryngeal muscle weakness, and changes in neural drive to these muscles are all potential causes of hypophonia, a common symptom associated with Parkinson's Disease.
  • Parkinson's Disease-associated movement problems including hypophonia
  • Parkinson's Disease-associated movement problems including hypophonia
  • Frontal lobe and/or executive impairments may cause patients with Parkinson's
  • Parkinson's Disease to have problems developing their own plan of action or initiating and maintaining goal- directed behavior, along with concept formation and self-monitoring behavior.
  • persons with Parkinson's Disease typically have problems with efficient strategy formation. Not only are these underlying cognitive and behavioral deficits likely to contribute to speech and language difficulties, but also to the lack of success of treatment strategies for persons with Parkinson's Disease.
  • Parkinson's Disease has been identified as just one illness that can result in impairments relating to speech production. Other illnesses or diseases are also known to exist that have similar symptoms of low speech loudness and/or respiratory deficiencies. There is some disbelief in the medical field that long-term improvement of communication in Parkinson's Disease patients (PDPs) is possible through the use of a device that initiates an external cue for increasing voice loudness.
  • PDPs Parkinson's Disease patients
  • One example embodiment of the present disclosure comprises a system to improve communication having an arrangement fixedly positioned during use in close proximity to a user's ear.
  • the arrangement comprises an accelerometer to detect the initiation and duration of the user's speech and an output presentation system.
  • the output presentation system comprises a non-occlusive ear fitting that presents noise that is unrelated to the sound-frequency or intonation of the user's speech.
  • the system further comprises a control mechanism to maintain presentation of the noise throughout the detected duration of the user's speech for a prescribed period of time.
  • Another example embodiment of the present disclosure comprises a method to improve communication in a patient with Parkinson's Disease comprising training the patient's speech production mechanism and/or speech motor control mechanisms through a voice enhancement system that introduces noise to patient during their speech.
  • Yet another example embodiment of the present disclosure comprises a system for training a patient with Parkinson's Disease to have improved communication.
  • the system comprises an activation device responsive to movement or vibrations in a patient during speech and upon sensing the patient's speech movement or vibration produces an output signal.
  • the system also comprises a presentation assembly having a non-occlusive ear fitting that transmits noise to the ear of a patient during a noise enabling conditions.
  • the system also comprises a control arrangement coupled to the activation device for receiving the output signal.
  • the control arrangement comprises a signal processor having a prescribed threshold that is analyzed against the output signal such that one or more output signals above the threshold generates the noise enabling condition resulting in noise transmission from the control arrangement to the presentation assembly.
  • a further example embodiment of the present disclosure comprises a method for training a patient to have increased voice loudness.
  • the method comprises positioning a non- occlusive ear fitting in a patient's ear that transmits noise to the ear during a noise enabling condition.
  • the method further comprises positioning externally an accelerometer on a patient at a location that moves or vibrates during speech.
  • the method also comprises transmitting an output signal from the accelerometer to a control arrangement upon sensing movement or vibration experienced during speech of the patient.
  • the method yet also comprises analyzing the output signal with a signal processor within the control arrangement against a prescribed threshold and transmitting audio noise to the ear fitting from the control arrangement when the output signal is above the threshold generating the noise enabling condition.
  • FIG. 1 is a voice enhancement system constructed in accordance with one embodiment of the present disclosure
  • FIG. 2A is an earpiece positioned within an ear of a patient using the voice enhancement system and methods for treatment and the positioning of an activation device in accordance with one example embodiment of the present disclosure
  • FIG. 2B illustrates another example embodiment for the positioning of an activation device for a voice enhancement system of the present disclosure
  • FIG. 2C illustrates an example embodiment of a voice enhancement system comprising a compact design where the entire system is positioned near the patient's ear;
  • FIG. 3 is a rear cover of a housing for the voice enhancement system illustrated in FIG. 1;
  • FIG. 4 is a block diagram illustrating a control arrangement of a voice enhancement system constructed in accordance with one embodiment of the present disclosure
  • FIG. 5 are images of an accelerometer used in connection with one embodiment of the voice enhancement system
  • FIG. 6 is a printed circuit board of the voice enhancement system
  • FIG. 7 is a portion of the voice enhancement system illustrating the positioning of the printed circuit board of FIG. 6 within a housing
  • FIGS. 8-10 are electrical schematics forming the control arrangement of the voice enhancement system constructed in accordance with one example embodiment of the present disclosure
  • FIG. 11 is a flowchart summarizing a method for increasing voice loudness in a patient in accordance with one embodiment of the present disclosure.
  • FIGS. 12-19 illustrate testing data from Parkinson's Disease patients and the results realized by the patients as a result of wearing the voice enhancement systems over various periods of time.
  • the present disclosure relates to a method and system for increasing voice loudness. More specifically, the present disclosure comprises an electrical voice enhancement system and method used to elicit the Lombard effect.
  • the Lombard effect is an external cue for increasing voice loudness.
  • the present method and system uses the Lombard effect to assist individuals experiencing problems with vocal intensity, articulation, and/or volume as a result of a physically degenerative condition, such as Parkinson's Disease.
  • the Lombard effect produces an involuntary reaction in speakers to increase their voice loudness when speaking in noisy environments.
  • the Lombard effect is known to not only influence the voice loudness in its speakers, but it can also alter the speaker's articulation quality, speech rate, and pitch.
  • the voice enhancement system 10 comprises a number of components and is designed to be used with patients diagnosed with physical ailments resulting in reduced vocal volume or intensity and experiencing problems with vocal loudness as a result of their disease.
  • the voice enhancement system 10 as shown in FIG. 1 comprises a number of electrical components that are both internal and external to a housing 12. Located externally from the housing 12 is an activation device or accelerometer 14 and earpiece 16 that are coupled via feeds 18, 20 having connectors 22, 24, respectively to ports 26, 28 of the housing.
  • the accelerometer 14 is an accelerometer manufactured by Knowles Acoustics of Itasca, IL. under part number BU-27135-000.
  • the activation device 14 is a sensor capable of transforming energy from one form to another such as a transducer.
  • the activation device 14 comprises a piezoelectric, piezoresistive, or capacitive type accelerometer.
  • the accelerometer 14 acts as an input device to the enhancement system 10.
  • the accelerometer 14 is relatively unaffected by noises in the environment.
  • the accelerometer 14 was chosen, rather than a microphone, so that the enhancement system 10 would not be activated as a result of noise in the room or communication by a third person's speech.
  • the activation device or accelerometer 14 provides an input signal to the voice enhancement system 10 that detects the initiation and duration of the patient's speech and is not activated by surrounding noise and/or non-patient noise.
  • the accelerometer 14 is placed on any body part suitable for detection of initiation of patient's speech.
  • the activation device 14 is worn on or attached to a portion of the patient's neck, such as on a skin surface adjacent one or both of the of thyroid lamina or in the sternal notch.
  • the accelerometer 14 is worn on or attached to the surface of the patient's skin covering the temporal bone to receive bone conduction vibrations from the wearer to detect the onset of speech.
  • Examples of body parts suitable for detection of speech initiation using the system 10, in addition to the temporal bone and neck, include areas near the patient's mouth or lips. All of such body parts and positions are intended to be within the scope and spirit of the present disclosure.
  • the accelerometer 14 is attached in close proximity to the patient's ear. In both the embodiments of FIGS. 2A and 2B, the accelerometer 14 is attached to an epidermal surface using an adhesive.
  • the earpiece 16 acts as an output of the system 10, transmitting noise to the patient's ear during prescribed times during treatment.
  • the prescribed time during a noise enabling condition starts when the patient initiates speech and continues while the patient talks and may continue for a prescribed duration when the patient ceases speech.
  • the earpiece 16 is a mono-aural device that, in the illustrated example embodiment is non-occlusive to the patient's ear.
  • the non-occlusive earpiece 16 advantageously allows the patient to hear their own speech during use of the system 10. Such advantageous results would not be experienced at the same level with an occlusive earpiece, which would have a tendency to obstruct the patient's hearing.
  • An occlusive earpiece would have the effect of making the patient's voice sound louder to themselves, causing them to talk more quietly. Use of a non-occlusive earpiece avoids this negative effect.
  • the earpiece 16 having a support 19 is fed to the ear of the patient through thin tubing or feed 20 and an open ear fitting 30 as best seen in FIG. 2A.
  • a suitable example of earpiece 16 that includes a feed 20 and an open ear fitting 30 is a product manufactured by Phonak AG of Switzerland under the name Fit'nGo Kit; however other open ear fittings made by other manufacturers could also be used with the system 10.
  • the open ear fitting 30 is typically fit into the patient's ear by an audiologist. Use of an open ear fitting 30 avoids a reduction in vocal intensity due to the occlusion effect, which can occur with a closed ear fitting.
  • the amplitude of the noise generated by the system 10 and transmitted to the output or earpiece 16 can be changed by a third party (e.g. a physician, speech-language pathologist, medical personnel etc.) treating the patient, but not by the user of the system.
  • a third party e.g. a physician, speech-language pathologist, medical personnel etc.
  • the highest output level of the system 10 is less than 85 dBA, and ranges between 70 and 78 dBA, which is adequate to elicit the Lombard Effect and would not be expected to cause damage to the hearing mechanism or hearing of the patient that is being treated.
  • FIG. 3 is a rear perspective view of the housing 12 used to support a portion of the electronics of the voice enhancement system 10.
  • the voice enhancement system 10 illustrated in the example embodiment of FIGS. 1 and 3 is a portable system, allowing unrestrained mobility of the patient since it is designed to attach to the patient's body.
  • rear view of the housing 12 shown in FIG. 3 illustrates a rear cover 32 of the housing having a support clip 34 integrated into the cover for attaching to the patient's clothing during use.
  • the support clip 34 is used to hold the system 10 by attaching it to the patient's waist through either a belt clip or a fanny pack (depending on the patient's preference).
  • the feeds 18, 20 can be fed underneath the patient's clothing to reduce the visible impact, that is, making the system 10 more inconspicuous to the patient's environment.
  • the system 10 weighs no more than 6 ounces.
  • Illustrated in FIG. 2C is an example embodiment of a voice enhancement system 10 comprising a compact design where the entire system 10 is positioned near the patient's ear.
  • the non-occlusive earpiece 16, housing 12, and activation device (e.g. accelerometer) 14 are in contact with the patient's ear.
  • the activation device 14 is cased partially within the housing 12 and is in contact with the surface of the patient's temporal bone and receives bone conduction vibrations from the patient to detect the onset of speech.
  • the housing 12 in FIG. 2C contains all the electronics necessary, as further discussed below for processing signals from activation device 14 and producing noise 31 to the earpiece 16.
  • the housing 12 also contains a power source such one or more batteries for supplying power to the system 10.
  • the patient may wear the voice enhancement system 10 for several hours a day, increasing with treatment up to eight (8) hours per day.
  • the treatment and design of the system 10 is such that it is highly mobile for the patient, allowing treatment to take place during daily living activities.
  • the system 10 is designed in such a way to externally cue the patient, for example, via the Lombard effect upon initiation of the patient' s speech, resulting in several positive and trained conditions in the patient, including increased sound pressure levels, reduced speech rate, improved respiratory support (reduced breathing pauses), and improved articulation.
  • the system 10 during treatment generates noise 31 that is projected from the earpiece 16 into the patient's ear upon the initiation of the patient's speech.
  • the noise 31 is communicative unintelligible noise, simulating conversation between individuals, which is sent to the earpiece 16 worn in one of the patient's ears while he/she is talking.
  • the communicative noise 31 is generated from a product called Multitalker (20 Talkers) (MT) digital audio manufactured by AUDiTEC of St. Louis, MO.
  • the noise 31 is white noise and/or random noise.
  • the presence of communicated noise 31 received by the earpiece 16 is an external cue to the patient to talk louder, naturally eliciting louder and clearer speech through the Lombard Effect.
  • the Lombard Effect provoked by the use of the system 10 causes the patient to naturally and automatically speak louder under conditions of background noise generated by the system.
  • the system 10 is believed to be most effective when the noise transmitted to the patient's earpiece 16 is more communicative in nature. However, random noise could also be transmitted to the patient's earpiece 16 without departing from the scope and spirit of this disclosure.
  • FIG. 4 Illustrated in FIG. 4 is a block diagram depicting a control arrangement 38 forming the voice enhancement system 10 in accordance with one example embodiment of the present disclosure.
  • the control arrangement 38 in block diagram of FIG. 4 illustrates generally the components of the system 10, further shown in detail in FIGS. 8-10 and how the electrical components are interconnected.
  • Centrally located within diagram is a central processing unit ("CPU") or microcontroller 40.
  • the microcontroller 40 is a 16 Bit 120K microprocessor.
  • An example of a suitable microcontroller 40 is an MSP430F2618TPN manufactured by Texas Instruments.
  • the accelerometer 14 during use in one example embodiment is mounted on the patient's neck and is connected to electrical components 42 that are coupled the microprocessor 40 using feed 18 (see FIGS. 1 and 5).
  • the feed 18 is a thin, flexible cable and a 3.5mm mini-phone audio connector 22 (see FIG. 1).
  • the connector 22 applies an output signal 43 upon speech by the patient generating movement detected by the accelerometer 14 to a preamplifier 44 with a gain of 2000.
  • the accelerometer 14 activates the system 10 by sensing vibrations solely from the patient's vocal folds.
  • An amplified signal 46 is transmitted through lead 48 that couples the preamplifier 44 to a bandpass filter 50.
  • the band-pass filter 50 limits the frequency content of the signal 46 to form a filtered signal 52.
  • the filtered signal 52 is limited by the band-pass filter 50 to a frequency content of approximately IOOHZ to 400HZ.
  • the filtered signal 52 is transmitted via lead 54 that couples the band-pass filter 50 to a comparator 56.
  • the filtered signal 52 is then compared by the comparator 56 to a reference level 58 that is set by an adjustment 60 located on the housing 12. Every time the amplitude of the filtered signal 52 exceeds the reference level 58, the comparator 56 changes state, from low to high in an output signal 62.
  • the output signal 62 is transferred to the microcontroller 40 via lead 64. In one example embodiment, the output signal 62 switches between 3.3 volts DC to 0 volts DC when changing from high to low state.
  • the comparator 56 changes state from high to low. This produces a stream of pulses in the output signal 62 that are applied to an interrupt 66 located within the microcontroller 40.
  • the noise transmitted from the system 10 into the earpiece 16 of the patient is enabled and disabled as the change in state occurs.
  • the adjustment 60 that changes the reference level 58 allows medical personnel (such as physicians, nurses, speech-language pathologists etc.) treating the patient to manually optimize the sensitivity of the voice enhancement system 10 to the needs of each individual patient. Stated another way, the adjustment 60 allows the threshold for enabling and disabling the noise 31 received by the patient through the earpiece 16 to be adjusted based on the output signal 43 transmitted by the accelerometer 14.
  • the interrupt 66 of the microcontroller 40 uses a subroutine to analyze the pulses in the output signal 62 from the comparator 56 to determine when the patient begins speaking. Once it is determined that the patient is speaking, the microcontroller 40 begins reading the communicative noise 31 or audio 68, such as the product Multitalker (20 Talkers) (MT) digital audio manufactured by AUDiTEC of St. Louis, MO. from a micro memory card 70 that is coupled via lead 72 to the microcontroller. The microcontroller 40 then begins playing the communicative noise, random noise 31, or audio 68 through an amplifier 74 and a speaker 78 coupled to the microcontroller through lead 76 and feed 20 of the earpiece 16.
  • the communicative noise 31 or audio 68 such as the product Multitalker (20 Talkers) (MT) digital audio manufactured by AUDiTEC of St. Louis, MO.
  • the amplifier 74 is a Class D amplifier and is combined with the speaker 78, using a digital to analog converter located within the microcontroller 40.
  • the speaker 78 is connected to the patient's ear with thin clear plastic tubing of the earpiece 16.
  • One suitable example of the earpiece 16 and speaker 78 is a product called Fit'nGo Kit open ear fitting manufactured by Phonak AG of Switzerland.
  • the microcontroller 40 is programmed 140 (see FIG.
  • FIG. 9 via software such that once the patient stops speaking for approximately 0.5 seconds, the microcontroller 40 stops playing the audio 68 or communicative noise 31.
  • the software is programmed such that the audio or communicative noise 31 continues to occur for a range of approximately 500-750 milliseconds. This reduces breaks in audio 68 or communicative noise 31, which could be irritating to the patient during voiceless sound periods.
  • the microcontroller 40 continues playing the audio 68 or communicative noise 31 from where it stopped previously.
  • the micro memory card 70 contains about 12 minutes and 30 seconds of communicative noise 31 or audio 68 data on a data file 80 located within the memory card. Once the entire audio data file 80 is played, the entire data file is started over at its beginning. This ensures that there is no obvious repetition of the audio generating the communicative noise 31 or audio 68.
  • the micro memory card 70 is also used to store data 82 about the usage of the voice enhancement system 10.
  • a data record 84 is written to the memory card 70.
  • another data record 86 is written to the memory card.
  • the memory card 70 further contains a patient information record 88 that includes the patient number, as well as the date and time that the system 10 was initialized.
  • Each patient information record 88 further contains audio 68 ON/OFF occurrences, elapsed time in days, hours, minutes, seconds and hundredths of seconds since the system 10 was initialized.
  • the voice enhancement system 10 is designed to be connected to a computer
  • the usage data 82-88 can then be downloaded from the system's memory card 70 via the interface 92 to the computer 90.
  • the usage data 82-88 is downloaded to the computer 90 using a program called PKTalker that is written in Lab VIEW.
  • the system 10 receives its power from a power supply 94.
  • the source of the power supply 94 is two AA alkaline batteries that depending on usage, will provide power to the system to operate for approximately 7-10 days on one set of batteries.
  • the batteries that act as the power supply 94 are located within the housing 12.
  • the power supply 94 supporting the system 10 is smaller and uses for example a rechargeable battery that is charged via a USB connection to the system.
  • PCB printed circuit board
  • the PCB 96 is located within the housing 12 as best seen in FIG. 7.
  • the PCB 96 used by the system 10 is a four (4) layer PCB and constructed using surface mount components.
  • the system 10 further comprises hardware to allow for external communication to a remote computer source.
  • the system 10 includes a universal serial bus (“USB”) or wireless connection, allowing communications with a remote computer for retrieving data and programming the data card 70.
  • USB universal serial bus
  • the system 10 is small enough for mounting to allow the accelerometer or transducer 14 to attach with a short connection to the patient's ear.
  • One example embodiment is constructed such that the entire system 10 is small enough to be configured for positioning behind the patient's ear with the accelerometer 14 in contact with the patient's temporal bone (see FIG. 2A) to receive bone conduction vibrations from the wearer to detect the onset of speech.
  • the system 10 uses an open wireless protocol, such as Bluetooth to deliver the audio to the patient's ear with a wireless connection to the accelerometer 14.
  • the system 10 is constructed to work with a Bluetooth headset, using processing capabilities of the microphone signal to determine when the patient is talking instead of the accelerometer 14.
  • the accelerometer 14 is coupled to the system 10 via the connector 22, which is shielded cable.
  • the connector 22 is a 3.5mm mini-phone audio jack.
  • Two ferrite beads, Ll and L2 are connected between an input lead 102 and reference lead 104 from the accelerometer 14 to an input 106 of the preamplifier 44 and an internal ground reference 108 of the system 10.
  • the ferrite beads, Ll and L2 attenuate radio frequency noise picked up by the accelerometer 14 and connector 22.
  • the ferrite beads Ll and L2 also attenuate radio frequency noise created by the system's microcontroller 40 to reduce the system's 10 radio frequency emissions.
  • the size of the ferrite beads Ll and L2 have a 330 ohm impedance at 100 Mhz.
  • an electrostatic discharge suppressor (“ESD”) 110 also identified in the electrical schematic as CRl protects the preamplifier 44 input 106 from static discharges.
  • a resistor 112 also identified in the electrical schematic as R16 is an appropriate load resistor for the accelerometer. In the illustrated embodiment, the resistor 112 is a 5.6K Ohm .1W rated resistor.
  • the dashed box representing the preamplifier 44 contains three (3) operational amplifiers (“OP-AMPS”) that combine to produce a voltage gain of 2000X.
  • a variable potentiometer 114 also identified in the electrical schematic as R3 is used to adjust the DC balance of the preamplifier 44.
  • a test point 116 also identified in the electrical schematic as Jl is used to analyze the preamplifier 44 output and to adjust the DC level to 1.5 volts with no signal present.
  • the amplified signal 46 is transmitted by an output 118 from the preamplifier
  • the band-pass filter 50 is a fourth (4 th ) order band-pass filter that is centered at approximately 200HZ.
  • a test point 120 also identified in the electrical schematic as J4 is used to observe an output 124 of the band-pass filter 50.
  • the output 124 of the band-pass filter 50 is connected to one input 126 of the comparator 56.
  • Another input 128 of the comparator 56 is connected to the adjustable voltage reference 130 formed by R25, R27, R24 and C18.
  • R27 is a potentiometer connected to a variable adjustment 60 that is accessible from the front panel 132 (see FIG. 1).
  • the variable adjustment 60 in combination with potentiometer R27 is used to adjust the amplitude at which the system 10 detects that the patient is speaking through the vibration, movement of muscle, facial tissue, etc. , generated during speech. This allows the sensitivity of the system 10 to be set for a given patient.
  • a test point 136 also identified in the electrical schematic as J3 is used to monitor the reference level during initial testing and adjustment.
  • An additional test point, identified as reference character J6 in the electrical schematic is used to monitor the comparator output 62 to the microcontroller interrupt 66.
  • FIG. 9 shows that the output of the level comparator 58 (VOX) is connected to pin 37 (P4.1/TB1) of the TMS430F2618 microcontroller 40 also identified in the electrical schematic as U12.
  • Pin 37 is configured in software to function as an interrupt.
  • the system 10 includes a program 140 internal to the microcontroller 40 that uses this interrupt to trigger the playback of the audio 68 to the patient.
  • the audio data 82-88 is stored in memory card 70 also identified in the electrical schematic as U15.
  • the memory card 70 is connected to the microcontroller 40 using an SPI serial interface connection to UCBO (serial interface).
  • the system program 140 also stores patient usage data 88 in flash memory 142 (see FIG. 9) every time the audio 68 is played.
  • Connector 144 also identified in the electrical schematic of FIG. 9 as J 12 is an
  • RS232 serial interface IC U16 used to connect the system 10 to a serial interface of a computer 90 so that the usage data 82-88 can be read from the flash memory 142 and the flash memory can be cleared of the usage data.
  • the clearing of data in flash memory via software is understood by one skilled in the art.
  • the usage data 82-88 stored in the flash memory 142 is cleared using custom software written in Lab View.
  • the software code or operating program 148 used to operate the system 10 and is downloaded into the microcontroller 40 using conventional interfaces appreciated by one skilled in the art.
  • a JTAG connector 146 also identified in the electrical schematic as J13 is used during testing and loading of the system's 10 operating program 148 into the microcontroller's flash memory 142.
  • the amplifier 74 and speaker 78 module also identified in the electrical schematic as U9 is used to deliver the audio 68 to the patient.
  • the amplifier 74 and speaker 78 are connected to the microcontroller 40 digital-to-analog output pin 5 also identified in the electrical schematic FIG. 9 as (DACO).
  • the audio 68 is delivered to the patient through a 0.05 inch ID 0.09 inch OD piece of TYGON® tubing 20 ⁇ see FIG. 1) manufactured by Saint-Gobain Performance Plastics Corporation of Aurora, Ohio.
  • the audio data 80 is output from the microcontroller 40 at a sample rate of 8kHZ.
  • Resistor 150 and capacitor 152 also identified in the electrical schematic as
  • R31 and C30 respectively form a low pass filter 154 used to attenuate converter artifact.
  • the low pass filter 154 attenuates converter artifact that is over approximately 5kHZ.
  • the externally accessible potentiometer 134 also identified in the electrical schematic as R28 is used to adjust the amplitude of the output audio 68 signal.
  • a test point 156 also identified in the electrical schematic as J9 is used to measure the audio output signal 68 during device testing.
  • FIG. 10 illustrates the schematics for the device power supplies 94.
  • a screw terminal connector 158 also identified in the electrical schematic as JlO is coupled to the two battery power source.
  • two (2) AA batteries are used to power the system 10.
  • the power supplies 94 comprise a single or multiple rechargeable battery or batteries.
  • L3 and L4 are ferrite beads used to attenuate RF interference.
  • the L3 and L4 ferrite beads have a 330 ohm impedance at 100 Mhz.
  • a schottky diode 160 also identified in the electrical schematic as CR2 is used to protect the power supply 94 from backward connected batteries.
  • a switched capacitor power supply regulator IC 162 also identified in the electrical schematic as U 14 produces a main DC power supply 164 for the system 10.
  • the main DC power supply 164 provides 3.3 volts DC of power to the digital circuitry of the system 10.
  • a test point 166 also identified in the electrical schematic as J5 connects a reference for measurements made during device setup and testing.
  • a test point 168 also identified in the electrical schematic as JIl is used to check the main DC power 164.
  • a low dropout linear regulator 170 also identified in the electrical schematic as
  • UI l provides regulated DC power for the analog and audio circuitry in the system 10.
  • the linear regulator 170 provides 3.0V DC power to the analog and audio circuitry in the system 10.
  • a test point 172 also identified in the electrical schematic as J8 is used to check the 3.0V DC supply.
  • a low dropout linear regulator 174 also identified in the electrical schematic as UlO is used to provide 1.5 volt DC power for the system 10. The regulator 174 is used to power the amplifier 74 and speaker 78 as well as for a pseudo reference for the OP-AMPS in the preamplifier 44 and filter 50.
  • a test point 176 also identified in the electrical schematic as J7 is used to check the 1.5V DC supply.
  • FIG. 11 Illustrated in FIG. 11 is a flowchart summarizing a method 200 for increasing voice loudness in a patient in accordance with one embodiment of the present disclosure.
  • the method 200 comprises positioning an accelerometer on a patient.
  • the method 200 comprises transmitting an output signal from the accelerometer when the patient is speaking.
  • the method 200 comprises analyzing the output signal against a prescribed threshold.
  • the method 200 comprises transmitting audio noise to the patient from a microcontroller when the output signal is above the threshold.
  • An additional benefit of the system 10 is that the patient will be trained to use a louder voice even when not wearing the system over the course of the treatment period, leading to an extended therapeutic effect. For example, patients after using the system 10 for an extended period of time will produce louder and clearer speech, increasing a number of decibels (dB) in SPL than experienced at the start of treatment without the device on. This therapeutic effect will beneficially grow over a treatment period using the system 10 on and off the patient, allowing the patient to maintain louder and clearer speech between longer treatment periods. Testing Results and Training of Parkinson's Disease Patents ("PDPs”)
  • PDPs Parkinson's Disease Patents
  • FIGS. 12-19 and discussion below involve testing results from training PDPs using or having the voice enhancement system 10 "on” and “off over an eight (8) week period.
  • the PDPs realized a number of positive changes in their communication as a result of the training and use of the system 10.
  • the positive changes that were realized discussed further below include: increased Sound Pressure Levels; reduced Speech Rate; improved breath support; and improved Vowel Articulation.
  • FIGS. 12-19 relating to the testing results illustrate data taken from one or two sessions before the system 10 was positioned on the patient or user is labeled "pre”.
  • the data taken four (4) weeks into the eight (8) week training period (when available) is labeled "Tr2".
  • the data taken as the end of the eight (8) week training period is labeled "Pol”.
  • the data was measured with the system 10 off (labeled "Of) and then on (labeled "On”).
  • the training consisted of the patients wearing the system in communicative environments for 4-6 hours per day for eight (8) weeks.
  • the PDPs returned every two (2) weeks for evaluation. Testing then occurred with the patients having the system 10 off and on.
  • Sound Pressure Level is a measure of the intensity of the voice.
  • FIG. 12 the SPLs (shown along the vertical axis) were higher with the system 10 on than when the system 10 was off due to the Lombard Effect.
  • the SPL data in FIG. 1 was collected from an extemporaneous speech task where PDPs talked about a topic of their choice for two (2) minutes. This task is indicative of real- world speech production.
  • FIG. 1 it is clear that SPL increased when the system 10 was on. This increase in SPL levels lasted throughout the eight (8) week training period.
  • the participants charted in the testing illustrated in FIG. 1, resulted in no maintenance of the SPL effect without the use of the system 10.
  • Speech Rate is a measure of the number of syllables produced per second.
  • PDPs sometimes speak more quickly than typical speakers, making a reduction in rate a therapy target.
  • typical adults speak more loudly (including under the Lombard effect), they have been shown, in some studies, to slow their speech rate.
  • Speech rate data was collected (see FIG. 13) in the study from an extemporaneous speech task where patients talked about a topic of their choice for two (2) minutes. This task is indicative of real- world speech production. It is clear when look at FIG. 13 that when the system 10 is first used, the speech rate declines markedly. After four (4) weeks of training, the patients' speech rate off use of the system 10 is lower than at baseline, but the system 10 results in an increase in speech rate. By the end of the eight (8) weeks of training, the patients' speech rate off or during non-use of the system 10 is still lower than at baseline, and the system results in a small decrease in speech rate. Such results suggest that the system 10 provides a benefit to speech rate, even when the system 10 is not on after eight (8) weeks of training and therapy. A slower speech rate is particularly important helping listeners to understand what the patient is saying.
  • Breath Pausing behaviors can provide information about the patient's respiratory support for speech.
  • PDPs have reduced respiratory support and have been reported to not use pauses, except when they need to breathe.
  • Typically adults pause both to breathe (breath pauses) and for emphasis (non-breath pauses).
  • Evidence that the system 10 trains respiratory support would result in an increase non-breath pauses and a decrease in breath pauses.
  • FIG. 14 depicts the percent of breath pauses (out of the total number of pauses).
  • the percent of breath pauses increase.
  • the patients must use more respiratory muscle effort and increase the number of breaths taken.
  • PDPs may find that, in the beginning of treatment, they need to take more breaths to support speech when the system 10 is on.
  • the percent of breath pauses as illustrated in FIG. 14 declined.
  • the system 10 trains and conditions PDPs to take fewer breath pauses and more non-breath pauses.
  • the system 10 after training the PDP for a period eight (8) weeks speaks more loudly and does not require the patient to take more breath pauses.
  • Vowel Articulation can be indexed by looking at the resonances produced in the vocal tract for point vowels.
  • the three point vowels in English are “ee” as in “feet”, “oo” and in “boot”, and “ah” as in “dot”.
  • the resonances are called the first and second formant frequency.
  • vowel articulation improves, the distance between the formants for the point vowels will increase.
  • PDPs often have slurred or indistinct articulation.
  • Improving articulation involves making the acoustic distance between the vowels larger (relative to the first and second formants), suggesting that they are perceptually more distinct as well.
  • Evidence that the system 10 trains PDPs relating to vowel articulation would result in the vowels becoming more distinct when the patients are using the system due to the Lombard effect.
  • the data in FIG. 15 was collected during the study from a sentence repetition to ensure that the analysis included the same words for each vowel across patients.
  • FIG. 15 depicts the formant frequencies for a female patient. For the vowel
  • FIG. 16 depicts the formant frequencies for a male patient. For the vowel
  • the first and second formant frequencies decreased, in the direction for improved articulation for the vowel “oo”.
  • the second formant frequency increased, but only in the post-treatment off condition, in the direction for improved articulation for the vowel "ee”.
  • the first and second formant frequencies decreased, in the direction for improved articulation for the vowel "ah”.
  • FIGS. 17-19 illustrate long-term data relating to two PDP subjects.
  • the methodology periods (pre-training, training, and post-training), and nomenclature ("pre” "Tr2"
  • the first subject's speech rate is lower off (i.e. not wearing the system 10 during testing) the system 10 starting after four (4) weeks of training.
  • the training effect is maintained (speech rate lower than pre values) for the entire ten (10) months.
  • FIG. 19 Illustrated FIG. 19 are SPL data from a second subject who was on the system
  • SPL is variable in the five (5) month off period, but for all four testing periods, SPL is higher than data taken from two sessions before the system 10 was positioned on the patient or user is labeled "pre".
  • FIGS. 12-19 along with the discussion above demonstrate that the
  • PDP subjects realize improved communication characteristics throughout training and while wearing the system 10. These improved communication characteristics include increased sound pressure levels, eliciting louder speech, reduced speech rate, improved respiratory support (reduced breathing pauses), and improved vowel articulation.
  • the data discussed in connection with FIGS. 12-19 indicate that the improved communication characteristic of eliciting louder speech continues over a period of at least six (6) months while the system 10 is on (i.e. the patient is wearing the system).
  • test results also indicate that the improved communication characteristics of at least sound pressure level ("SPL") and speech rate continue when the system 10 is off and not worn at all by the patient over at least a one-month period.
  • SPL sound pressure level
  • speech rate continue when the system 10 is off and not worn at all by the patient over at least a one-month period. This provides evidence that the system 10 trains and conditions the patient. Stated another way, the system 10 creates improved communication characteristics not only throughout training and while the system is being worn by the patient, but also after the patient ceases wearing or using the system.

Landscapes

  • Business, Economics & Management (AREA)
  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Audiology, Speech & Language Pathology (AREA)
  • General Health & Medical Sciences (AREA)
  • Entrepreneurship & Innovation (AREA)
  • Physics & Mathematics (AREA)
  • Educational Administration (AREA)
  • Educational Technology (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

La présente invention concerne un procédé et un système (10) pour améliorer la communication. Le système (10) comprend un ensemble positionné fixement durant son utilisation à proximité immédiate de l’oreille d’un utilisateur. L’ensemble comporte un accéléromètre (14) pour détecter le commencement et la durée des paroles de l’utilisateur et un système de présentation de sortie. Le système de présentation de sortie comprend un seul adaptateur d’oreille non occlusif (16) qui présente le bruit (31, 68) des paroles de l’utilisateur, lequel bruit n’étant pas lié aux fréquences sonores ou à l’intonation. Le système (10) comprend en outre un agencement de commande (38) pour maintenir la présentation du bruit (31, 68) pendant toute la durée détectée des paroles de l’utilisateur pendant une période de temps prescrite.
PCT/US2010/045568 2009-08-17 2010-08-16 Procédé et appareil pour augmenter la correction physiologique pour la voix WO2011022314A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
US13/398,399 US20120264091A1 (en) 2009-08-17 2012-02-16 Method and system for training voice patterns
US13/835,802 US20130267766A1 (en) 2010-08-16 2013-03-15 Method and system for training voice patterns
US14/266,289 US9381110B2 (en) 2009-08-17 2014-04-30 Method and system for training voice patterns
US14/332,679 US9532897B2 (en) 2009-08-17 2014-07-16 Devices that train voice patterns and methods thereof

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US23440109P 2009-08-17 2009-08-17
US61/234,401 2009-08-17

Related Parent Applications (2)

Application Number Title Priority Date Filing Date
US13/398,399 Continuation-In-Part US20120264091A1 (en) 2009-08-17 2012-02-16 Method and system for training voice patterns
PCT/US2012/026033 Continuation-In-Part WO2012116015A1 (fr) 2009-08-17 2012-02-22 Procédé et système pour la formation de modèles vocaux

Related Child Applications (3)

Application Number Title Priority Date Filing Date
US13/398,399 Continuation-In-Part US20120264091A1 (en) 2009-08-17 2012-02-16 Method and system for training voice patterns
PCT/US2012/026033 Continuation-In-Part WO2012116015A1 (fr) 2009-08-17 2012-02-22 Procédé et système pour la formation de modèles vocaux
US13/835,802 Continuation-In-Part US20130267766A1 (en) 2009-08-17 2013-03-15 Method and system for training voice patterns

Publications (1)

Publication Number Publication Date
WO2011022314A1 true WO2011022314A1 (fr) 2011-02-24

Family

ID=43607289

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2010/045568 WO2011022314A1 (fr) 2009-08-17 2010-08-16 Procédé et appareil pour augmenter la correction physiologique pour la voix

Country Status (1)

Country Link
WO (1) WO2011022314A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3566858A (en) * 1968-11-04 1971-03-02 Zenith Radio Corp Antistuttering therapeutic device
US4143648A (en) * 1977-04-13 1979-03-13 Behavioral Controls, Inc. Portable therapeutic apparatus having patient responsive feedback means
US5659620A (en) * 1992-09-10 1997-08-19 Kuhlman; Peer Ear microphone for insertion in the ear in connection with portable telephone or radios
US20030195588A1 (en) * 2002-04-16 2003-10-16 Neuropace, Inc. External ear canal interface for the treatment of neurological disorders
US7181024B1 (en) * 1999-11-11 2007-02-20 Sony Corporation Portable audio listening apparatus
US20070102525A1 (en) * 2005-11-10 2007-05-10 Research In Motion Limited System and method for activating an electronic device

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3566858A (en) * 1968-11-04 1971-03-02 Zenith Radio Corp Antistuttering therapeutic device
US4143648A (en) * 1977-04-13 1979-03-13 Behavioral Controls, Inc. Portable therapeutic apparatus having patient responsive feedback means
US5659620A (en) * 1992-09-10 1997-08-19 Kuhlman; Peer Ear microphone for insertion in the ear in connection with portable telephone or radios
US7181024B1 (en) * 1999-11-11 2007-02-20 Sony Corporation Portable audio listening apparatus
US20030195588A1 (en) * 2002-04-16 2003-10-16 Neuropace, Inc. External ear canal interface for the treatment of neurological disorders
US20070102525A1 (en) * 2005-11-10 2007-05-10 Research In Motion Limited System and method for activating an electronic device

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
ADAMS ET AL.: "Can the Lombard effect be used to improve low voice intensity in Parkinson's disease?", EUROPEAN JOURNAL OF DISORDERS OF COMMUNICATION, vol. 27, no. 2., 1992, Retrieved from the Internet <URL:http://www.ncbi.nlm.nih.gov/pubmed/1446099> [retrieved on 20100929] *
LEVINE ET AL.: "Diagnosis and Treatment of Parkinson's Disease: A Systematic Review of the Literature", EVIDENCE REPORT/TECHNOLOGY ASSESSMENT., June 2003 (2003-06-01), pages 61, Retrieved from the Internet <URL:http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.136.4096&rep=rep1&type=pdf> [retrieved on 20100929] *

Similar Documents

Publication Publication Date Title
US9532897B2 (en) Devices that train voice patterns and methods thereof
US20120264091A1 (en) Method and system for training voice patterns
Ramig et al. Speech treatment in Parkinson's disease: Randomized controlled trial (RCT)
Tjaden et al. Vowel acoustics in Parkinson's disease and multiple sclerosis: Comparison of clear, loud, and slow speaking conditions
US6231500B1 (en) Electronic anti-stuttering device providing auditory feedback and disfluency-detecting biofeedback
Darling et al. Changes to articulatory kinematics in response to loudness cues in individuals with Parkinson’s disease
Tjaden et al. Consonant acoustics in Parkinson's disease and multiple sclerosis: Comparison of clear and loud speaking conditions
US10692397B2 (en) Smart nasometer
US9381110B2 (en) Method and system for training voice patterns
Dromey et al. Speech adaptation to kinematic recording sensors: Perceptual and acoustic findings
Mefferd et al. Tongue-and jaw-specific articulatory changes and their acoustic consequences in talkers with dysarthria due to amyotrophic lateral sclerosis: Effects of loud, clear, and slow speech
Huber et al. Respiratory function and variability in individuals with Parkinson disease: Pre-and post-Lee Silverman Voice Treatment
KR20180023853A (ko) 스마트 나조미터 시스템
Richardson et al. The effect of increased vocal intensity on interarticulator timing in speakers with Parkinson's disease: A preliminary analysis
Freitas et al. An introduction to silent speech interfaces
Matheron et al. Laryngeal aerodynamics in healthy older adults and adults with Parkinson's disease
Wong et al. Discrimination of consonant articulation location by tactile stimulation of the forearm
Countryman et al. Supraglottal hyperadduction in an individual with Parkinson disease: A clinical treatment note
Ifukube Sound-based assistive technology
WO2011022314A1 (fr) Procédé et appareil pour augmenter la correction physiologique pour la voix
Roy et al. A description of phonetic, acoustic, and physiological changes associated with improved intelligibility in a speaker with spastic dysarthria
Nagle Elements of clinical training with the electrolarynx
Murdoch et al. Dysarthria following traumatic brain injury
Huber et al. Respiratory and laryngeal responses to an oral air pressure bleed during speech
Oerlemans et al. Touch and auditory-visual speech perception

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10810433

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 10810433

Country of ref document: EP

Kind code of ref document: A1