Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
J Voice. 2013 Mar;27(2):149-54. doi: 10.1016/j.jvoice.2012.10.002. Epub 2012 Dec 29.
Clinical application of mechanical interruption methods for measuring aerodynamic parameters has been hindered by relatively high intrasubject variability. To improve the intrasubject reliability, we evaluated the effect of auditory and visual feedback on subject performance when measuring aerodynamic parameters with the airflow interrupter.
Eleven subjects performed four sets of 10 trials with the airflow interrupter: no feedback (control); auditory feedback (tone matching subject's F0 played over headphones); visual feedback (real-time feedback of sound pressure level, frequency, and airflow); and combined auditory and visual feedback. Task order was varied across subjects. The effect of each feedback method on mean and coefficient of variation (CV) of subglottal pressure (Ps), mean flow rate (MFR), and laryngeal airway resistance (RL; Ps/MFR) compared with that of the control trials was determined using paired t tests. Feedback methods were compared against each other using one-way repeated measures analysis of variance.
Each feedback method significantly decreased CV of RL compared with that of the control trials (auditory feedback: P=0.005; visual feedback: P=0.008; and combined feedback: P<0.001). Auditory feedback (P=0.011) and combined feedback (P=0.026) also decreased CV of MFR. Mean MFR was significantly higher during trials with visual feedback compared with that of the auditory feedback.
Each feedback method improved the intrasubject consistency when measuring RL. Feedback appeared to have a greater effect on MFR than Ps. Although there is no clear optimal feedback method, each is preferable to not providing any feedback during trials. Evaluating new methods of visual feedback to further improve MFR and thus RL measurement would be valuable.
机械中断法测量空气动力学参数的临床应用受到个体内变异性较大的阻碍。为了提高个体内的可靠性，我们评估了在使用气流中断器测量空气动力学参数时，听觉和视觉反馈对受试者表现的影响。
11 名受试者进行了四组共 10 次试验，使用气流中断器：无反馈（对照）；听觉反馈（通过耳机播放与受试者 F0 匹配的音调）；视觉反馈（声压级、频率和气流的实时反馈）；以及听觉和视觉联合反馈。试验顺序在受试者之间变化。使用配对 t 检验确定每种反馈方法对声门下压（Ps）、平均流量（MFR）和喉气道阻力（RL；Ps/MFR）的平均值和变异系数（CV）的影响，并与对照试验进行比较。使用单向重复测量方差分析比较反馈方法之间的差异。
与对照试验相比，每种反馈方法均显著降低了 RL 的 CV（听觉反馈：P=0.005；视觉反馈：P=0.008；联合反馈：P<0.001）。听觉反馈（P=0.011）和联合反馈（P=0.026）也降低了 MFR 的 CV。与听觉反馈相比，视觉反馈试验中的平均 MFR 显著更高。
每种反馈方法都提高了测量 RL 时的个体内一致性。反馈似乎对 MFR 的影响大于对 Ps 的影响。虽然没有明确的最佳反馈方法，但与在试验中不提供任何反馈相比，每种方法都更可取。评估新的视觉反馈方法以进一步提高 MFR 从而改善 RL 测量将是有价值的。
