CASL
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item The application of Ultrasound Evaluation of Swallowing (USES) to the analysis of hyoid kinematics in healthy swallows(American Speech-Language-Hearing Association, 2025-04-07) Ma, Joan K-Y; Wrench, Alan A.Purpose: Using ultrasound as an adjunct tool for swallowing assessment has gained significant momentum in recent years, with research gaps in areas such as speech and language therapist–driven protocol and measurement methods. This study outlines the recording protocol of Ultrasound Evaluation of Swallowing (USES). Additionally, a set of multidimensional measurements capturing the hyoid kinematics in typical swallows was compared with previous studies to evaluate the current protocol and to develop an ultrasound database of healthy swallows to further the clinical implementation of USES. Method: Swallowing data were acquired from 41 healthy participants. Both discrete swallows (5- and 10-ml) and continuous swallows (100-ml) were analyzed. Automatic tracking of the hyoid and mandible positions using a deep neural net was applied. Six swallowing events of interest were identified for each swallow (beginning hyoid position, maximal hyoid position, hyoid advancement, hyoid retraction, peak forward velocity, and peak backward velocity), and a series of hyoid parameters characterizing the amplitude, velocity, and timing of the movement were calculated and compared across different types of swallows. Results: Results showed significant differences between continuous and discrete swallows. Continuous swallows were characterized by shorter maximal hyoid displacement, a shorter duration between the start of the swallow and the maximal displacement, a shorter total swallow duration, and lower peak velocity in both forward and backward hyoid movement. No significant difference was observed between the 5- and 10-ml swallows in hyoid movement amplitude, velocity, or duration. Conclusions: The quantification of hyoid kinematics in swallowing through the current USES recording protocol, combined with the semi-automatic extraction of hyoid function by applying a deep neural net and feature-finding algorithms, provides initial evidence to support its clinical utility in swallowing assessment. Further studies, including those of different clinical populations, to evaluate the sensitivity of the hyoid metrics in detecting changes to swallowing would support the clinical translation.Item The Compartmental Tongue(American Speech-Language-Hearing Association, 2024-07-03) Wrench, Alan A.Purpose: Tongue anatomy and function is widely described as consisting of four extrinsic muscles to control position and four intrinsic muscles to control shape. This myoarchitecture cannot, however, explain independent tongue body and blade movement nor accurately model the subtlety of observed lingual shapes. This study presents the case for a finer neuromuscular structure and functional description. Method: Using the theoretical framework of the partitioning hypothesis, evidence for neuromuscular compartments of each of the lingual muscles was discerned by reviewing studies of lingual anatomy, hypoglossal nerve staining, hypoglossal motoneuron axon tracing, muscle fiber type distribution, and electromyography. Muscle fibers of the visible human female were manually traced to produce a three-dimensional atlas of muscular compartments. A kinematic study was undertaken to determine the degree of independent movement between different parts of the tongue. A simple biomechanical model was used to demonstrate how synergistic groups of compartments can control sectors of the tongue. Results: Results indicated as many as 10 compartments of genioglossus, two each of superior and inferior longitudinal, eight of styloglossus, three of hyoglossus, and six each of transversus and verticalis, while palatoglossus may not have a significant role in tongue function. Kinematic analysis indicated independent control of five sectors of the tongue body, and biomechanical modeling demonstrated how this control may be achieved. Conclusion: Evidence is presented for a lingual structure based on neuromuscular compartments, which work together to position and shape sectors of the tongue and independently control tongue body and blade.Item Improving ultrasound post estimation accuracy by training on co-registered EMA data(University of Aizu, 2024-06-28) Balch-Tomes, Jonathan; Wrench, Alan A.; Scobbie, James M.; Macmartin, C.; Turk, A.This study aims to assess how accurately DeepLabCut [1], when applied to ultrasound tongue images, can estimate Electromagnetic Articulography (EMA) sensor positions. EMA provides objective measures of anterior tongue, jaw, and lip kinematics. DeepLabCut pose estimation is a powerful method of extracting keypoint positions from midsagittal ultrasound images of the tongue. It has an advantage over EMA in that it can be applied to the whole of the tongue from tip to root as well as the jaw and the hyoid. After correction for probe translation standard error in the estimation of keypoint positions compared to the corresponding EMA sensor positions was 1.2-1.5mm along the tongue contour and 0.5-0.9mm perpendicular to the tongue contour.Item Intrapersonal variability in hyoid movement during normal swallow(UKSRG 2024, 2024-02) Ma, Joan K-Y; Quezada, Gabriella; Wrench, Alan A.Item Using glossogram to investigate tongue movement in Ultrasound Evaluation of Swallowing(ESSD 2023, 2023-11) Ma, Joan K-Y; Wrench, Alan A.Item Ultrasound Evaluation of Swallowing in People with Neurological Diseases – A Pilot Study(ESSD 2023, 2023-11) Ma, Joan K-Y; Quezada, Gabriella; Allen, Jodi, E.; Mossey- Gaston, Corinne; Wrench, Alan A.Item Automated assessment of hyoid movement during normal swallow using ultrasound(Royal College of Speech and Language Therapists, 2022-03-14) Ma, Joan K-Y; Wrench, Alan A.Background The potential for using ultrasound by speech and language therapists (SLTs) as an adjunct clinical tool to assess swallowing function has received increased attention during the COVID-19 pandemic, with a recent review highlighting the need for further research on normative data, objective measurement, elicitation protocol and training. The dynamic movement of the hyoid, visible in ultrasound, is crucial in facilitating bolus transition and protection of the airway during a swallow and has shown promise as a biomarker of swallowing function.Item Beyond the edge: Markerless pose estimation of speech articulators from ultrasound and camera images using DeepLabCut(MDPI, 2022-02-02) Wrench, Alan A.; Balch-Tomes, JonathanAutomatic feature extraction from images of speech articulators is currently achieved by detecting edges. Here, we investigate the use of pose estimation deep neural nets with transfer learning to perform markerless estimation of speech articulator keypoints using only a few hundred hand-labelled images as training input. Midsagittal ultrasound images of the tongue, jaw, and hyoid and camera images of the lips were hand-labelled with keypoints, trained using DeepLabCut and evaluated on unseen speakers and systems. Tongue surface contours interpolated from estimated and hand-labelled keypoints produced an average mean sum of distances (MSD) of 0.93, s.d. 0.46 mm, compared with 0.96, s.d. 0.39 mm, for two human labellers, and 2.3, s.d. 1.5 mm, for the best performing edge detection algorithm. A pilot set of simultaneous electromagnetic articulography (EMA) and ultrasound recordings demonstrated partial correlation among three physical sensor positions and the corresponding estimated keypoints and requires further investigation. The accuracy of the estimating lip aperture from a camera video was high, with a mean MSD of 0.70, s.d. 0.56, mm compared with 0.57, s.d. 0.48 mm for two human labellers. DeepLabCut was found to be a fast, accurate and fully automatic method of providing unique kinematic data for tongue, hyoid, jaw, and lips.Item The impact of real-time articulatory information on phonetic transcription: Ultrasound-aided transcription in cleft lip and palate speech(Karger, 2019-05-24) Cleland, Joanne; Lloyd, Susan; Campbell, Linsay; Crampin, Lisa; Palo, Pertti; Sugden, Eleanor; Wrench, Alan A.; Zharkova, NataliaObjective: This study investigated whether adding an additional modality, namely ultrasound tongue imaging, to perception-based phonetic transcription impacted on the identification of compensatory articulations and on interrater reliability. Patients and Methods: Thirty-nine English-speaking children aged 3 to 12 with cleft lip and palate (CLP) were recorded producing repetitions of /aCa/ for all places of articulation with simultaneous audio and probe-stabilised ultrasound. Three types of transcriptions were performed: 1. Descriptive observations from the live ultrasound by the clinician recording the data; 2. Ultrasound-aided transcription by two ultrasound-trained clinicians; and 3. Traditional phonetic transcription by two CLP specialists from audio recording. We compared the number of consonants identified as in error by each transcriber and then classified errors into eight different subcategories. Results: Both the ultrasound-aided and traditional transcriptions yielded similar error-detection rates, however these were significantly higher than the observations recorded live in the clinic. Interrater reliability for the ultrasound transcribers was substantial (k=0.65), compared to moderate (k=0.47) for the traditional transcribers. Ultrasound-aided transcribers were more likely to identify covert errors such as double articulations and retroflexion than the audio-only transcribers. Conclusion: Ultrasound-tongue imaging is a useful complement to traditional phonetic transcription for CLP speech.Item Visualising speech: Using ultrasound visual biofeedback to diagnose and treat speech disorders in children with cleft lip and palate(NHS Greater Glasgow & Clyde and University of Strathclyde, Glasgow, 2017-09) Cleland, Joanne; Crampin, Lisa; Zharkova, Natalia; Wrench, Alan A.; Lloyd, Susan; Palo, PerttiChildren with cleft lip and palate (CLP) often continue to have problems producing clear speech long after the clefts have been surgically repaired, leading to educational and social disadvantage. Speech is of key importance in CLP from both a quality of life and surgical outcome perspective, yet assessment relies on subjective perceptual methods, with speech and language therapists (SLTs) listening to speech and transcribing errors. This is problematic because perception-based phonetic transcription is well known to be highly unreliable(Howard & Lohmander, 2011) especially in CLP, where the range of error types is arguably far greater than for other speech sound disorders. Moreover,CLP speech is known to be vulnerable to imperceptible error types, such as double articulations which can only be understood with instrumental techniques such as ultrasound tongue imaging (UTI). Incorrect transcription of these errors can result in misdiagnosis and subsequent inappropriate intervention which can lead to speech errors becoming deeply ingrained.