{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:27:14Z","timestamp":1777930034738,"version":"3.51.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Speaking valves (SVs) restore phonation and may support airway protection in people with a tracheostomy, yet tolerance varies widely in neurological rehabilitation. We aimed to identify clinical factors associated with SV use and duration in a neurological rehabilitation setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 117 adults with neurological conditions and tracheostomy admitted to a rehabilitation center. Two internally validated multivariable models were developed: logistic regression for SV use (yes\/no) and a quasi-Poisson regression for target daytime SV duration (hours\/day), using routinely available bedside clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 117 patients, 64 (54.7%) used an SV during hospitalization. In the multivariable logistic model, higher level of consciousness (eMCS vs VS\/MCS; OR 6.26, 95% CI 1.53\u201323.14), a positive blue dye test (OR 0.05, 95% CI 0.01\u20130.30), and endotracheal suction requirement (vs spontaneous cough; OR 0.07, 95% CI 0.003\u20130.879) were independently associated with SV use. Model performance was strong (AUC 0.856; accuracy 79.5%). Among SV users, longer daytime duration for SV use was associated with younger age, greater inspiratory and expiratory muscle strength, higher consciousness level, mild dysphagia, spontaneous cough, and neuromuscular or spinal cord injury diagnoses. In contrast, moderate-to-abundant secretions were associated with fewer hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a single-center neurological rehabilitation cohort, SV adoption and sustained tolerance were associated with bedside indicators of neurological responsiveness, secretion management, swallowing safety, and respiratory muscle strength. Findings should be interpreted as predictive associations and warrant external validation in contemporary multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135261423945","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T16:49:34Z","timestamp":1771951774000},"page":"474-485","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Predictors of Speaking Valve Use in Neurological Patients: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-275X","authenticated-orcid":false,"given":"Mat\u00edas","family":"Otto-Y\u00e1\u00f1ez","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Salud, Funcionalidad y Actividad F\u00edsica (GISFAF), Kinesiolog\u00eda, Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Monge-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Los Coihues, Santiago, Chile"},{"name":"Blanquerna Universidad Ramon Llull, Facultad de Ciencias de la Salud, Programa de Doctorado Salud, Bienestar y Bio\u00e9tica, Barcelona, Espa\u00f1a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-4333","authenticated-orcid":false,"given":"Rodrigo","family":"Torres-Castro","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7218-6338","authenticated-orcid":false,"given":"Tamara","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Los Coihues, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erico","family":"Segovia","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Los Coihues, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-4309","authenticated-orcid":false,"given":"Diana C.","family":"S\u00e1nchez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-9574","authenticated-orcid":false,"given":"Roberto","family":"Vera-Uribe","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-3831","authenticated-orcid":false,"given":"Luis","family":"Vasconcello-Castillo","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4817-9364","authenticated-orcid":false,"given":"Vanessa","family":"Resqueti","sequence":"additional","affiliation":[{"name":"PneumoCardioVascular Lab\/HUOL, Hospital Universit\u00e1rio Onofre Lopes, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"},{"name":"Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4938-7018","authenticated-orcid":false,"given":"Guilherme","family":"Fregonezi","sequence":"additional","affiliation":[{"name":"PneumoCardioVascular Lab\/HUOL, Hospital Universit\u00e1rio Onofre Lopes, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"},{"name":"Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2126-6"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000523"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200311000-00021"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9737-3"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28440"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14113798"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06768"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0697"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08280-7"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2018.02.017"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-086415"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42466-025-00376-1"},{"issue":"01","key":"e_1_3_2_14_1","article-title":"Effect of speaking valves on tracheostomy decannulation","volume":"28","author":"Eichar B. W.","year":"2024","unstructured":"Eichar B. W., Kaffenberger T. M., McCoy J. L., Padia R. K., Muzumdar H., Tobey A. B. J. (2024). Effect of speaking valves on tracheostomy decannulation. International Archives of Otorhinolaryngology, 28(01), e157\u2013e164. https:\/\/doi.org\/10.1055\/s-0043-1767797","journal-title":"International Archives of Otorhinolaryngology"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001610"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10646-2"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-024-02762-w"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.62905\/001c.115440"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05500519"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-699X.2008.00100.x"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/09602010443000425"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_AJSLP-20-00331"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.913147"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2023.08.016"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04878"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202010-1282OC"},{"key":"e_1_3_2_27_1","first-page":"1","article-title":"Management of adults with a tracheostomy: An international survey of speech-language pathologists\u2019 practice","author":"Miles A.","year":"2025","unstructured":"Miles A., Wallace S. (2025). Management of adults with a tracheostomy: An international survey of speech-language pathologists\u2019 practice. International Journal of Speech-Language Pathology, 1\u201314. https:\/\/doi.org\/10.1080\/17549507.2025.2482865","journal-title":"International Journal of Speech-Language Pathology"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0698"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818803598"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13040616"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08206"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16815"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2020.09.003"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2018.11.006"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009595"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/nhs.70200"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2024.01.008"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004098"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2012.05.005"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181c30fb2"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2022516"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224357"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0267-3"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/25310429.2024.2411814"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0717-73482012000200004"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-05217-2"}],"container-title":["NeuroRehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538135261423945","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10538135261423945","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538135261423945","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:01:16Z","timestamp":1777680076000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10538135261423945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/10538135261423945"],"URL":"https:\/\/doi.org\/10.1177\/10538135261423945","relation":{},"ISSN":["1053-8135","1878-6448"],"issn-type":[{"value":"1053-8135","type":"print"},{"value":"1878-6448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]}}}