Binding the abdomen can improve speech in men with phrenic nerve pacers

Two men with high cervical spinal cord injuries and phrenic nerve pacers were studied with and without an elastic binder around the abdomen. Speech improved with the binder, as determined by listener preference ratings provided by 10 judges and by the subjects themselves. Improvement was substantial in one subject and slight in the other. The subject with the greater improvement exhibited higher peak tracheal pressure, higher sound pressure level, and longer utterance duration with the binder in place. Speech improvement was attributed primarily to augmentation of tidal volume associated with the use of the binder. An abdominal binder can be an effective intervention to improve speech in certain individuals with spinal cord injuries and phrenic nerve pacers. Speech may be further improved by using behavioral strategies, such as neck muscle activation, glossopharyngeal breathing, and pharyngeal or buccal speech production.