Kerala Journal of
Physical Medicine and Rehabilitation

KIMS Al Shifa Super Specialty Hospital, Perinthalmanna, Kerala, India

Dr. Shahin K E MD PMR,

Specialist, In-Charge,

Department of Physical Medicine and Rehabilitation, KIMS Al Shifa Super Specialty Hospital, Perinthalmanna, Kerala, India
Email: drshahin.ke@kimsalshifa.com.

Shahin K E. Above Cuff Vocalisation in Tracheostomised Patients. KJPMR. 2026;25(2):18-20.

Above-Cuff Vocalisation (ACV) is an emerging communication rehabilitation technique that enables selected tracheostomised patients to speak while maintaining cuff inflation. Communication impairment in critically ill and ventilator-dependent patients contributes to psychological distress, reduced autonomy, and impaired participation in rehabilitation. By restoring airflow through the larynx, ACV may improve communication, patient engagement, and rehabilitation outcomes.
This narrative review discusses the physiological basis, clinical applications, safety considerations, and multidisciplinary implementation of ACV, with emphasis on its relevance to Physical Medicine and Rehabilitation (PM&R). Current evidence suggests that ACV is feasible and generally safe in appropriately selected patients when performed by trained multidisciplinary teams. ACV represents a promising adjunct in tracheostomy rehabilitation and early neurorehabilitation, although further research is needed to establish standardised protocols and long-term functional outcomes.