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团体语音治疗效果的多维评估

Multidimensional Assessment of the Effectiveness of Group Voice Therapy.

作者信息

Cantarella Giovanna, Torretta Sara, Ferruta Silvia, Ciabatta Annaclara, Manfredi Claudia, Pignataro Lorenzo, Dejonckere Philippe

机构信息

Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.

出版信息

J Voice. 2017 Nov;31(6):714-721. doi: 10.1016/j.jvoice.2017.02.004. Epub 2017 Mar 1.

Abstract

OBJECTIVE

Group voice therapy has been successfully used in patients with dysphonia, but there is little objectively documented evidence of its effects on voice quality and the self-perception of voice fatigue. The aim of this study was to investigate the effectiveness of group therapy in patients with functional dysphonia and minor anatomic vocal fold pathologies linked by appearance and history to voice use in an objective and multidimensional manner.

STUDY DESIGN

This is a prospective longitudinal study.

METHODS

Before and after treatment, 34 adult women underwent perceptual voice assessments using the grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) scale, Evaluation Vocale Assistée (EVA) system aerodynamic and acoustic assessments, and maximum phonation time measurements, and made subjective evaluations using the Voice Handicap Index. The pretreatment baseline values of the participants were obtained by means of two examinations separated by an interval of 1 week. The parameters belonging to each main dimension were clustered by means of Z-transformation, and the corresponding Z-scores were analyzed.

RESULTS

Group therapy was associated with a statistically significant improvement in the perceptual (P = 0.008), acoustic (P = 0.040), aerodynamic (P = 0.009 and <0.001), and self-evaluation parameters (P = 0.011).

CONCLUSIONS

Our findings provide evidence that group voice therapy can be associated with improvements in perceptual, acoustic, aerodynamic, and self-evaluated parameters in some patients with dysphonia. Controlled, randomized studies are needed in follow-up. This method of treatment may be a means of reducing the costs and waiting lists associated with rehabilitative treatment, and enhancing patients' motivation and compliance.

摘要

目的

小组发声疗法已成功应用于发声障碍患者,但关于其对嗓音质量和嗓音疲劳自我认知影响的客观记录证据较少。本研究的目的是以客观和多维度的方式调查小组疗法对功能性发声障碍以及外观和病史与发声相关的轻度解剖性声带病变患者的有效性。

研究设计

这是一项前瞻性纵向研究。

方法

在治疗前后,34名成年女性接受了嗓音感知评估,使用发声障碍等级、粗糙声、气息声、无力声和紧张声(GRBAS)量表、辅助嗓音评估(EVA)系统进行空气动力学和声学评估以及最大发声时间测量,并使用嗓音障碍指数进行主观评估。参与者的治疗前基线值通过间隔1周的两次检查获得。通过Z变换对属于每个主要维度的参数进行聚类,并分析相应的Z分数。

结果

小组疗法与感知(P = 0.008)、声学(P = 0.040)、空气动力学(P = 0.009和<0.001)以及自我评估参数(P = 0.011)在统计学上的显著改善相关。

结论

我们的研究结果表明,小组发声疗法可能会使一些发声障碍患者的感知、声学、空气动力学和自我评估参数得到改善。后续需要进行对照随机研究。这种治疗方法可能是一种降低康复治疗成本和减少等待名单的手段,并能提高患者的积极性和依从性。

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