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构音障碍中的嗓音功能障碍:多维嗓音程序的应用

Voice dysfunction in dysarthria: application of the Multi-Dimensional Voice Program.

作者信息

Kent R D, Vorperian H K, Kent J F, Duffy J R

机构信息

Waisman Center, University of Wisconsin-Madison, Rm 435, 1500 Highland Avenue, Madison, WI 53705-2280, USA.

出版信息

J Commun Disord. 2003 Jul-Aug;36(4):281-306. doi: 10.1016/s0021-9924(03)00016-9.

Abstract

Phonatory dysfunction is a frequent component of dysarthria and often is a primary feature noted in clinical assessment. But the vocal impairment can be difficult to assess because (a). the analysis of voice disorder of any kind can be challenging, and (b). the voice disorder in dysarthria often occurs along with other impairments affecting articulation, resonance, and respiration. A promising assessment tool is multi-parameter acoustic analysis, such as the Multi-Dimensional Voice Program (MDVP). Part 1 of this paper recommends procedures and standards for the acoustic analysis of voice, including (1). selection of the sample to be analyzed, (2). signal quality requirements, (3). availability of normative data for both genders and different ages of speakers, (4). reliability of analysis, and (5). correlation of acoustic results with results from other methods of analysis. In Part 2, acoustic data are reviewed for the dysarthria associated with Parkinson disease (PD), cerebellar disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), unilateral hemispheric stroke, and essential tremor. Tentative profiles of voice disorder are described for these conditions. These profiles may serve as hypotheses for future research. Although several issues remain to be resolved in the acoustic analysis of voice disorder in dysarthria, steps can be taken now to promote the reliability, validity, and clinical utility of such analyses. (1). As a result of this activity, the participant will be able to describe ways in which an optimal multi-dimensional analysis of voice can be performed with modern acoustic analysis systems. (2). As a result of this activity, the participant will be able to apply multi-dimensional acoustic analysis of voice to individuals who have a dysarthria-related voice disorder. (3). As a result of this activity, the participant will be able to identify major sources of normative data on the Multi-Dimensional Voice Program.

摘要

发声功能障碍是构音障碍的常见组成部分,且常常是临床评估中所注意到的主要特征。但嗓音损害可能难以评估,原因如下:(a) 对任何类型的嗓音障碍进行分析都具有挑战性;(b) 构音障碍中的嗓音障碍常与影响发音、共鸣及呼吸的其他损害同时出现。一种很有前景的评估工具是多参数声学分析,如多维嗓音程序(MDVP)。本文第一部分推荐了嗓音声学分析的程序和标准,包括:(1) 待分析样本的选择;(2) 信号质量要求;(3) 针对不同性别和年龄的说话者的标准化数据的可得性;(4) 分析的可靠性;(5) 声学结果与其他分析方法结果的相关性。在第二部分中,回顾了与帕金森病(PD)、小脑疾病、肌萎缩侧索硬化症(ALS)、创伤性脑损伤(TBI)、单侧半球性中风及特发性震颤相关的构音障碍的声学数据。描述了这些病症的嗓音障碍初步概况。这些概况可作为未来研究的假设。尽管在构音障碍嗓音障碍的声学分析中仍有若干问题有待解决,但现在可以采取措施来提高此类分析的可靠性、有效性及临床实用性。(1) 通过此项活动,参与者将能够描述如何使用现代声学分析系统进行最佳的多维嗓音分析。(2) 通过此项活动,参与者将能够对患有与构音障碍相关嗓音障碍的个体应用嗓音的多维声学分析。(3) 通过此项活动,参与者将能够识别多维嗓音程序标准化数据的主要来源。

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