 |
|
 |
|
|
|
           
|
COMMUNIKAY Vol. 7, No. 1
Please look for Kay products on display at the following conferences, workshops, and congresses.
New
Digital Swallowing Workstation Kay is proud to introduce the new Digital Swallowing Workstation, Model 7200, the second generation of its acclaimed integrated Swallowing Workstation system for dysphagia assessment and treatment. According to Robert McClurkin, director of marketing, the new multifunctional workstation now boasts the addition of digital video recording to its impressive array of capabilities, which include visual feedback tools for therapy, physiologic data acquisition and assessment capabilities, and a complete videoendoscopic (FEES®) system for bedside patient assessment. Moreover, McClurkin adds, “The new digital video recording capability will be appreciated by new customers as well as those who wish to upgrade their current systems.” The digital video module records modified barium and videoendoscopic studies directly to computer storage media for instantaneous retrieval and playback of exams at full video resolution (60 fields/30 frames per second). “The system is equipped with broadcast-quality video-acquisition hardware which provides excellent image quality,” McClurkin explains. “With instant exam retrieval and playback, the time-savings alone for the practicing clinician is a tremendous benefit.” In addition, the system can record video exams in isolation or in combination with physiologic signals for precise, time-linked data analysis. Also, two video recordings can be loaded at once for side-by-side exam comparisons. The system’s innovative exam archiving capability automates the process of moving recorded video exams to long-term storage-retrieval on DVD-RAM disks. Because the workstation is modularized, clinicians (and researchers) can configure a system tailored to their needs. For example, a rehabilitation center may elect to purchase just the Swallowing Signals Lab for patient therapy. An acute care facility may be interested only in the FEES system. For modified barium exam recordings, the digital video recording module can be used. Each of these three modules can function, and be purchased, as a separate entity. The complete system is housed on a mobile cart that can be rolled to the clinic, radiology, or to patient bedside. The new system contains a report generator that includes patient demographics, critical exam findings and comments, and user-selected images in a Microsoft® Word-formatted printout. The report then serves as an objective summary for patient records or referring physicians. Reports, containing images and even video clips, can also be sent electronically to colleagues. Other features include a searchable database of patient/exam information with user-definable database fields. The Swallowing Signals Lab module contains a custom external hardware module and an array of transducers designed from the ground up for displaying and analyzing key physiologic aspects of swallowing. As McClurkin notes, “The data from each ofthese transducers can be acquired concurrently and displayed in real time. They’re very helpful in the therapy process. Published articles increasingly support the need for instrumentation to assist with dysphagia rehabilitation.” For example, sEMG may help a patient more quickly learn a compensatory swallowing maneuver. Another patient may benefit from feedback which clearly shows the coordination between breathing and swallowing using sEMG with the respiratory phase signal. The tongue transducers can be used effectively for isometric/strengthening exercises. For research and certain clinical tasks (e.g., manofluorography), the physiologic data can be acquired concurrently with video data, enabling frame-by-frame correlation of fluoroscopic (or FEES) and waveform data. The Digital Swallowing Workstation also contains a complete videoendoscopic system for administering FEES exams at bedside. All components have been selected to provide excellent endoscopic images. The hardware consists of a xenon light source, a flexible endoscope, and a CCD camera with lens adapter. The swallowing cart houses all FEES components along with an optional caddy system for disinfection. The new digital system, consisting of these separate, but integrated modules, provides clinicians and researchers with a powerful, proven and comprehensive arsenal of capabilities to assess and treat patients with swallowing problems. Numerous peer-reviewed articles in medical journals have validated each of the analysis techniques offered in the system. An extensive bibliography and application notes are available on Kay’s Web site and upon request.
Nicosia, M.A., J.A. Hind, E.B. Roecker, M. Carnes, J. Doyle, G.A. Dengel, and J. Robbins. “Age Effects on Temporal Evolution of Isometric and Swallowing Pressure,” Journal of Gerontology-Medical Sciences, Nov. 2000. To accurately diagnose swallowing problems in the elderly, it is important to differentiate normal age-related alterations in swallowing physiology from disease-related changes. This article focuses on tongue physiology changes in the elderly given its key role in bolus propulsion. The authors used the Swallowing Workstation to acquire data from three-bulb tongue manometry and concurrent fluoroscopy. Using the time-linked data to study changes in tongue physiology as a function of aging, the authors found 1) decreased maximum isometric pressure and unchanged maximum swallowing pressure with increased age, 2) increased time to reach peak isometric pressure with increased age, 3) increased time to reach peak swallowing pressure with increased age for liquid but not semi-solid boluses, and 4) a change in the pattern of lingual pressure generation with increased age. The findings are discussed in relation to swallowing physiology changes in the elderly. Rosen, Clark A., Lori E. Lombard, and Thomas Murry. “Acoustic, Aerodynamic, and Videostroboscopic Features of Bilateral Vocal Fold Lesions,” Annals of Otology, Rhinology, and Laryngology, Vol. 109 (9), Sept. 2000. This article presents instrumental analysis techniques to help accurately diagnose bilateral nodules versus unilateral vocal fold lesions with contralateral vocal fold lesions (UVFL/RL). They point out the challenges this diagnostic differentiation presents to clinicians, and how successful treatment depends on accurate diagnosis. By using acoustic analysis, aerodynamics, stroboscopy, and the Voice Handicap Index, the authors found that the diagnostic profiles among these two patient groups differed significantly in 1) symmetry of vocal fold vibration, 2) amplitude perturbations, 3) estimated subglottic pressure, and 4) Voice Handicap Index. The authors conclude “The improved diagnostic accuracy afforded by multiparametric assessment provides a comprehensive framework for the treatment of these two distinct vocal fold disorders.” Kay’s computer-integrated stroboscopy system, Computerized Speech Lab (MDVP program), and Aerophone II were the instruments used in the study. Kent, Ray D., Houri K. Vorperian, and Joseph D. Duffy. “Reliability of the Multi-Dimensional Voice Program for the Analysis of Voice Samples of Subjects with Dysarthria,” American Journal of Speech-Language Pathology, Vol. 8, 129-136, May 1999. This article evaluates the “robustness and reliability” of the Multi-Dimensional Voice Program (MDVP) for vocal analyses of 32 individuals with dysarthria of various etiologies. MDVP, a software option for the Computerized Speech Lab (CSL), calculates up to 33 acoustic parameters on sustained phonation. The authors found the reliability of MDVP to be “generally very good,” with the potential for quick quantitative assessment of voice for research and clinical applications. Furthermore, certain parameters “hold particular value” in the description of voice qualities in dysarthric speech. Norrdzij, J. Pieter and Peak Woo. “Glottal Area Waveform Analysis of Benign Vocal Fold Lesions Before and After Surgery,” Annals of Otology, Rhinology, and Laryngology, Vol. 109, May 2000. Glottal area waveform (GAW) is a plot of relative glottal area versus time through a representative glottal cycle and is derived from a quantitative analysis of the videostroboscopic image. GAW analysis was performed before and after surgery on 24 subjects with a variety of vocal fold lesions. Five parameters were analyzed: 1) maximum normalized glottal area, 2) maximum opening rate, 3) maximum closing rate, 4) percent open time at 50% glottal opening, and 5) glottal gap size. The statistically significant differences were discussed in relation to clinical applicability of GAW. KSIP, the Kay Stroboscopy Image Processing Software, was used to perform the analysis in this study. Q. I purchased a CSL 4300B about seven years ago and continue to use the DOS-based software supplied with the system. Can a system like mine be upgraded to your current Windows-based CSL software? A. Yes. The core CSL software and almost all of the 17 software options/databases have been upgraded to Windows since you purchased your system. You can still use your current CSL hardware, but it may be necessary to purchase a new computer with more robust specifications (see Kay’ s Web site under Products, CSL 4300B for current computer requirements; be certain that the computer has a full-size ISA expansion slot). Contact the company for a quotation on the software upgrade by specifying which options you purchased. On your host computer, you will need either the Windows ’95 or ’98 operating system. Note that the successor to the CSL 4300B, the new CSL 4400, has different computer requirements, runs under more operating systems, and uses a USB port (no expansion slot required). Q. Do you recommend a particular CD-ROM R/W for the Digital Strobe? A. Customers are asking this question increasingly because of the desire to move large AVI video clips to another computer (e.g., for sending e-mail attachments or using them in a PowerPoint slide presentation). Kay generally does not recommend attaching a Zip drive to the Digital Strobe because doing so may reassign drive letters on the computer, which causes problems with the built-in exam archiving system. The most practical device for saving large files is a CD-ROM R/W drive. Kay recommends the Plextor Plexwriter, model PX-W1210TA (internal IDE type). Kay’s technical support will provide phone assistance for those wishing to install a CD-ROM R/W. Q. The microphone supplied with my sound card does not provide adequate input gain for usage with Multi-Speech. What is your recommendation? A. Both Multi-Speech and Sona-Speech are used in conjunction with generic sound cards, many of which are supplied with low-quality microphones. When recording speech from these microphones, the signal level being digitized at normal conversational intensity (and especially soft voices) is often too low in level for the sound card. To get around this problem, we recommend that you purchase a condenser microphone. These microphones usually contain a battery to increase the signal level fed to the sound card for digitization. We use the Shure 16A condenser microphone which you can obtain from Kay (Model 3706) or locally. Other condenser microphones may be suitable as well.
Every year at the ASHA convention, we encourage participants to visit the Kay Elemetrics booth and to register for our free drawing. This past year, in Washington, DC, winners were given the opportunity to choose either a Facilitator or Multi-Speech. Kay is pleased to announce that the 2000 winners were Christine McMahon of the Forsyth County School System, Winston-Salem, NC, who opted for the Facilitator, and Celia Cruz, from San Antonio, TX, who chose Multi-Speech.
Sending Digital Strobe Images Over the Internet You can send digital stills or motion video clips captured in an exam with Kay’s Digital Strobe as an e-mail attachment to your colleagues over the Internet. To save a digital still, find an image of interest in the exam; click File, then Export Current Video Image. Next, select a file format type (we recommend .jpg), and name the file. Your stills will be stored in a directory under c:\strb\exported stills\. To save a video clip, click Tools, then Convert Video to AVI. Choose a starting point of interest in the strobe exam and click Set Start Frame. Advance the video to a suitable endpoint, and click Set End Frame. Then click Start Conversion to generate the AVI file. Note that it is not practical to send a video clip e-mail attachment of more than a couple of seconds (AVI clips take up about 1 Mbyte per second). The AVI files will be stored under c:\strb\AVI\. Stills can generally be moved to another computer by copying the files to a floppy disk. AVI clips will need a larger storage medium such as a CD R/W (see question in adjacent section regarding a preferred CD R/W drive for your Digital Strobe). An AVI file on the CD-ROM can be moved to another computer to be sent electronically. If it is important to send a longer file, or multiple exam segments, to a colleague, it may be more practical to send the CD itself rather than sending the file(s) over the Internet. The exam(s) can be played on most computers containing a CD-ROM drive and Windows. New Speech Products Introduced Kay is pleased to announce the introduction of several new products and product enhancements for speech applications. The complete line not only offers unmatched versatility, but also a product for every budget. First is CSL, Model 4400, Kay’s new, top-tier speech analysis system. Model 4400, is a professional-level hardware platform, integrated with a rich array of speech analysis and biofeedback software packages. Explains Stephen Crump, sales manager, “The 4400 is well-tailored for the most exacting speech processing requirements. It offers input signal-to-noise performance far superior to generic, plug-in sound cards. And, the new USB interface between the external module and host computer allows the 4400 to be easily installed and used with laptops.” In addition to its comprehensive analysis features (spectrograms, FFTs, pitch, intensity, LPC, cepstrum, etc.,), the CSL has a family of options for many applications, including therapy, clinical, linguistic, research, and forensic. It is CE-approved with Windows 98, 2000, and ME drivers. Another newly introduced product is the Visi-Pitch III, Model 3900. The most widely used clinical product for the assessment and treatment of speech and voice disorders is now available in an all-new Windows format. “With seven modules (and two optional programs), Visi-Pitch III has more versatility than ever,” notes Crump. “And all of these new features have been added without sacrificing ease of use or the intuitive displays that Visi-Pitch users have come to know and love.” Among these new features are a module to objectify important parameters for motor speech disorders and a new auditory feedback module of various therapy tasks from articulation disorders to stuttering. A games module with enriched graphics is included as well. The low-cost, software-only correlate of Visi-Pitch III is the new Sona-Speech, Model 3600. Sona-Speech relies on standard sound cards for data acquisition and playback, rather than the more robust hardware of the Visi-Pitch III. For this reason, Kay recommends Sona-Speech primarily for routine therapy tasks rather than for research or voice labs. “Sona-Speech brings the sophistication of the Visi-Pitch III software to the soundcard hardware environment,” says Crump. “It is the perfect solution for those clinicians that have portability requirements or for those working within a small budget.” Sona-Speech offers the same tremendous versatility as the Visi-Pitch II, with modules designed for assessment and treatment of voice, articulation, fluency, motor speech (dysarthria), and other communication disorders. Games, too, are provided to make therapy tasks more appealing for children. The Nasometer II is the latest hardware/software version of the acclaimed Nasometer, which has become a standard clinical tool, internationally, for the assessment and treatment of patients with nasality problems. Non-invasive and easy-to-use, Nasometer II provides real-time biofeedback of nasality in patients’ speech. It includes standard passages for adults to provide quantified, objective assessment. Children benefit from the simplified passages and stimuli in the SNAP test (MacKay/Kummer). The Nasometer II has been updated with new hardware and a new Windows software program. All of these new products complement Kay’s family of instrumentation in the areas of laryngeal imaging, aerodynamics, electroglottography, and swallowing. For further information about any Kay product, contact a Product Specialist or your local representative.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Copyright © 1996-2008 KayPENTAX. All rights reserved. Site Map | Contact Us |
