Guzman Marco, Acuña Gabriela, Pacheco Fernanda, Peralta Francisca, Romero Constanza, Vergara Cecilia, Quezada Camilo
Department of Otolaryngology, Las Condes Clinic, Santiago, Chile; Department of Communication Sciences, University of Chile, Santiago, Chile.
Department of Communication Sciences, University of Chile, Santiago, Chile.
J Voice. 2018 Nov;32(6):770.e1-770.e9. doi: 10.1016/j.jvoice.2017.08.021. Epub 2017 Dec 19.
The present study reports the effects of double source of vibration semioccluded vocal tract exercises (SOVTEs) on subjective and objective variables in subjects with voice complaints.
Eighty-four participants with voice complaints were randomly assigned to one of four treatment groups: (1) water resistance therapy, (2) tongue trills, (3) lip trills, and (4) raspberry (tongue and lip trills at the same time). Before and after voice therapy, participants underwent aerodynamic, electroglottographic, and acoustic assessments. Measures for the Vocal Tract Discomfort Scale (VTDS), self-assessment of resonant voice quality, and sensation of muscle relaxation were also obtained. Three assessment sessions were conducted: (1) before the therapy session (Pre), (2) immediately after the voice therapy session (Post 1), and (3) 1 week after home practice (Post 2).
Significant differences between baseline (Pre) and both post measures were found for the perception of muscle relaxation and resonant voice quality. No significant differences between Post 1 and Post 2 for any exercises were observed. This indicates that all voice exercises improved subjective self-perceived voice quality immediately after exercises and that improvement remained stable after 1 week of practice. Water resistance therapy and raspberry attained the highest effect. A significant decrease for all exercises was also observed for VTDS values after 1 week of practice. Although some significant changes were observed in objective variables, no clear patterns could be detected.
SOVTEs with secondary source of vibration may reduce vocal symptoms related to physical discomfort in subjects with voice complaints. Objective variables apparently do not fully reflect subjective positive outcomes, or they are not sensitive enough to capture changes. No significant differences between four observed SOVTEs were observed.
本研究报告了双源振动半闭塞声道练习(SOVTEs)对有嗓音问题受试者主观和客观变量的影响。
84名有嗓音问题的参与者被随机分配到四个治疗组之一:(1)抗阻训练,(2)舌尖颤音练习,(3)唇颤音练习,(4)树莓音练习(舌尖和唇颤音同时进行)。在嗓音治疗前后,参与者接受了气动、电声门图和声学评估。还获得了声道不适量表(VTDS)、共振嗓音质量自我评估和肌肉放松感觉的测量值。进行了三次评估:(1)治疗前(Pre),(2)嗓音治疗后立即(Post 1),(3)在家练习1周后(Post 2)。
在肌肉放松感知和共振嗓音质量方面,发现基线(Pre)与两个治疗后测量值之间存在显著差异。未观察到任何练习在Post 1和Post 2之间有显著差异。这表明所有嗓音练习在练习后立即改善了主观自我感知的嗓音质量,并且在练习1周后改善情况保持稳定。抗阻训练和树莓音练习效果最佳。练习1周后,所有练习的VTDS值也显著降低。尽管在客观变量中观察到了一些显著变化,但未发现明确的模式。
具有二次振动源的SOVTEs可能会减轻有嗓音问题受试者与身体不适相关的嗓音症状。客观变量显然不能完全反映主观的积极结果,或者它们不够敏感,无法捕捉到变化。在观察到的四种SOVTEs之间未观察到显著差异。