Antonetti Angélica Emygdio da Silva, Vitor Jhonatan da Silva, Guzmán Marco, Calvache Carlos, Brasolotto Alcione Ghedini, Silverio Kelly Cristina Alves
Speech-Language Pathology and Audiology Department at Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brazil.
São Paulo Research Founding, Bauru, São Paulo, Brazil.
J Voice. 2023 Mar;37(2):215-225. doi: 10.1016/j.jvoice.2020.12.008. Epub 2021 Jan 4.
Semi-occluded vocal tract exercises (SOVTE) may improve the source and filter interaction by changing the acoustic characteristics and the impedance of the vocal tract, both in dysphonic and vocally healthy populations. However, there are a few studies that verify the effects of these exercises in a clinical trial. Thus, this study's purpose was to analyze the effectiveness of the SOVTE-Therapeutic Program (SOVTE-TP) in vocal quality and self-assessment, comparing it with Vocal Function Exercises.
Eighteen (eight men; 10 women), ages 18-50, with behavioral dysphonia participated in this randomized and blinded clinical trial. The participants were equally randomized into two groups: Experimental Group and Vocal Function Exercises Group. They were assessed at three moments: before the treatment, after finishing it, and one month after finishing the treatment--follow up. Acoustic measures (ie, fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, cepstral peak-smoothed, alpha ratio, and L1-L0), auditory-perceptual analysis, vocal fatigue index (VFI), self-perceived resonant voice, and vocal handicap index-30 (VHI-30) were measured at all assessment moments. For the two groups, the interventions happened twice per week (four weeks) and lasted 35 minutes. It was applied the repeated-measures ANOVA test (P< 0.05) and Tukey Test.
The acoustic measures and auditory-perceptual had no differences between the groups and moments, respectively, which means that SOVTE-TP did not cause any harm. The auditory-perceptual analysis showed a mild deviation of participants' vocal quality. All groups reduced the VFI and VHI-30 scores in M2 and kept these results at M3 also, the vocal economy sensation increased in M2, decreasing slightly in M3.
SOVTE-TP has positive effects regarding self-assessment (VFI, VHI, and resonant voice quality) on patients with mild behavioral dysphonia, and it provides the same effects as VFE.
半阻塞声道练习（SOVTE）可能通过改变声道的声学特性和阻抗来改善声源与滤波器的相互作用，无论是在发声障碍患者还是嗓音健康人群中。然而，只有少数研究在临床试验中验证了这些练习的效果。因此，本研究的目的是分析SOVTE治疗方案（SOVTE-TP）在嗓音质量和自我评估方面的有效性，并将其与嗓音功能练习进行比较。
18名（8名男性；10名女性）年龄在18至50岁之间的行为性发声障碍患者参与了这项随机双盲临床试验。参与者被平均随机分为两组：实验组和嗓音功能练习组。在三个时间点对他们进行评估：治疗前、治疗结束后以及治疗结束后一个月——随访。在所有评估时间点测量声学指标（即基频、抖动、闪烁、噪声谐波比、谐波峰值平滑、α比值和L1-L0）、听觉感知分析、嗓音疲劳指数（VFI）、自我感知的共振嗓音以及嗓音障碍指数-30（VHI-30）。两组的干预每周进行两次（共四周），每次持续35分钟。采用重复测量方差分析检验（P<0.05）和Tukey检验。
两组之间以及各时间点的声学指标和听觉感知分析均无差异，这意味着SOVTE-TP没有造成任何损害。听觉感知分析显示参与者的嗓音质量存在轻微偏差。所有组在M2时VFI和VHI-30评分均降低，在M3时也保持了这些结果，嗓音经济性感觉在M2时增加，在M3时略有下降。
SOVTE-TP对轻度行为性发声障碍患者的自我评估（VFI、VHI和共振嗓音质量）有积极影响，并且它提供了与VFE相同的效果。
