SYSTEMIC review outlines diagnosis and rehabilitation for dysphonia after spinal cord injury noting key tools and remaining gaps.
Why Dysphonia Matters After Spinal Cord Injury
Patients with spinal cord injury often develop dysphonia that can disrupt communication, limit social participation, and reduce quality of life. With no consensus guidelines available, investigators performed a systematic review to clarify what evidence exists for both assessment and rehabilitation, and to identify priorities for future research.
Across six databases plus reference list screening, 18 English language studies met inclusion criteria, representing 303 adults with acquired spinal cord injury. Participants were predominantly male, with a mean age of 39 years, and studies most often focused on cervical injury with mixed etiologies and impairment grades. Evidence quality ranged from randomized trials to observational studies and case reports, with overall risk of bias described as low to moderate.
Diagnosis And Rehabilitation for Dysphonia After Spinal Cord Injury
Assessment strategies were common but varied. Most studies used instrumental evaluations, frequently spirometry or plethysmography to characterize lung volumes, pressures, and flows. Acoustic analyses were also frequent, most often measuring maximum phonation time and sound pressure level. Perceptual assessment approaches were heterogeneous across studies, reflecting inconsistent tool selection and reporting. Patient reported outcomes appeared in two thirds of studies, commonly using the Voice Handicap Index in extended and short forms, including VHI 10.
On synthesis, the review supports a combined approach to evaluation that pairs spirometry with indirect laryngoscopy, acoustic and perceptual analyses, and VHI 10 to better capture both physiologic contributors and patient experience. Rehabilitation evidence was more limited and methodologically diverse. Reported approaches included speech valves for ventilated patients, glossopharyngeal breathing, abdominal binding, and neurologic music therapy. Among these, abdominal binding and neurologic music therapy showed the most consistent benefits across the available literature.
The authors conclude that dysphonia after spinal cord injury remains under studied, with substantial heterogeneity in methods and outcomes. They call for larger, higher quality studies with longer follow up to standardize diagnostic and rehabilitation protocols and to improve voice outcomes for this population.
Reference: Poggi B et al. Diagnosis and Rehabilitation of Dysphonia After Spinal Cord Injury: A Systematic Review. Neurology. 2026;106(6):e214689.
