Ribeiro Vanessa Veis, de Oliveira Amanda Gabriela, da Silva Vitor Jhonatan, Siqueira Larissa Thais Donalonso, Moreira Pamela Aparecida Medeiros, Brasolotto Alcione Ghedini, Silverio Kelly Cristina Alves
Speech Hearing and Language Disorders Department of the Bauru School of Dentistry, University of São Paulo-FOB/USP, Bauru, São Paulo, Brazil.
Speech Hearing and Language Disorders Department, State University of West-Central-UNICENTRO, Irati, Paraná, Brazil.
J Voice. 2019 Mar;33(2):256.e1-256.e16. doi: 10.1016/j.jvoice.2017.10.019. Epub 2018 Feb 1.
This study aims to propose and analyze the effect of a voice therapy program (VTP) in women with behavioral dysphonia.
This is a controlled, blinded, and nonrandomized cohort study. Participants of this study were 22 women with behavioral dysphonia divided into two groups: G1, 11 women with behavioral dysphonia who received the VTP, and G2, 11 women with behavioral dysphonia who did not receive any intervention. Before and after 6 weeks, the outcome variables evaluated in both groups were auditory-perceptual evaluation of the global degree of vocal quality (vowel /a/ and counting), instrumental acoustic parameters, Voice-Related Quality of Life, vocal and larynx symptoms, and musculoskeletal pain. The statistical analysis used the Wilcoxon, chi-square, and Mann-Whitney tests (P < 0.05).
After 6 weeks, we observed a significantly higher improvement in the general degree of vocal deviation in vowels, a reduced F0 and symptom of "fatigue while talking" in G1, and an increased "shoulder" pain intensity in G2. Both groups showed improvement in the socioemotional domain of Voice-Related Quality of Life. In addition, the comparison between the groups showed a significantly greater reduction in fundamental frequency and the "voice loss" symptom in G1 compared with G2.
The VTP using semioccluded vocal tract exercises obtained a positive effect on voice quality, symptoms, and musculoskeletal pain in women with behavioral dysphonia. The proposal, based on the taxonomy of voice therapy, seems to have promoted a phonatory balance, muscle relaxation, and improvement in the vocal resistance of this population.
本研究旨在提出并分析语音治疗方案（VTP）对行为性发声障碍女性的影响。
这是一项对照、盲法和非随机队列研究。本研究的参与者为22名行为性发声障碍女性，分为两组：G1组，11名接受VTP的行为性发声障碍女性；G2组，11名未接受任何干预的行为性发声障碍女性。在6周前后，两组评估的结局变量包括嗓音质量整体程度的听觉-感知评估（元音/a/和计数）、仪器声学参数、嗓音相关生活质量、嗓音和喉部症状以及肌肉骨骼疼痛。统计分析采用Wilcoxon检验、卡方检验和Mann-Whitney检验（P < 0.05）。
6周后，我们观察到G1组元音发声偏差的总体程度有显著更高的改善，F0降低且有“说话时疲劳”症状，而G2组“肩部”疼痛强度增加。两组在嗓音相关生活质量的社会情感领域均有改善。此外，两组比较显示，与G2组相比，G1组的基频和“声音嘶哑”症状有显著更大程度的降低。
使用半阻塞声道练习的VTP对行为性发声障碍女性的嗓音质量、症状和肌肉骨骼疼痛产生了积极影响。基于语音治疗分类法的方案似乎促进了该人群的发声平衡、肌肉放松和嗓音耐力的改善。
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