呼吸练习联合手法治疗对传统歌手肌肉紧张性发声障碍的效果：一项盲法随机对照试验。

The effect of breathing exercises combined with manual therapy on muscle tension dysphonia in traditional singers: a blinded randomized controlled trial.

机构信息

Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Eur Arch Otorhinolaryngol. 2022 Jun;279(6):2989-2996. doi: 10.1007/s00405-021-07237-y. Epub 2022 Jan 30.

DOI:10.1007/s00405-021-07237-y

PMID:35094120

Abstract

BACKGROUND

Muscle tension dysphonia (MTD) is common in traditional singers and can lead to serious complications, but there is inconclusive evidence about how MTD should be treated in singers as professional voice users. This study was conducted to investigate the effects of breathing exercises combined with manual therapy versus breathing exercises and manual therapy on voice quality in traditional singers suffering from MTD.

METHODS

In this blinded randomized clinical trial, 60 patients with MTD were randomly allocated to four groups: (1) breathing exercises, (2) manual therapy, (3) combined intervention (CI) and (4) control. Patients received treatments for 13 sessions, once per week. Treatment effects were assessed in terms of primary outcome measures: (1) breathing performance, measured by maximum phonation time (MPT) and (2) laryngeal function, measured by Stroboscopy Evaluation Rating Form (SERF). Secondary outcome measure was patient's self-perceived voice handicap, measured by Persian version of Singing Voice Handicap Index (SVHIp). All outcome variables were measured before and after treatment. The between group comparisons on MPT and SVHIp score were investigated using analysis of covariance (ANCOVA). The Kruskal-Wallis non-parametric test was used for between group comparisons of SERF items.

RESULTS

Three treatment groups had improved regarding breathing performance, laryngeal function and voice handicap over the time (P < 0.01). The improvements achieved in all outcomes were significantly greater in the CI group than those of the breathing exercises, manual therapy and control groups.

CONCLUSIONS

This randomized controlled trial showed that the combination of breathing exercises and manual therapy significantly improved the laryngeal function, breathing performance and voice handicap in traditional singers suffering from MTD.

TRIAL REGISTRATION

IRCT2015102524686N1.

摘要

背景

肌肉紧张性发声障碍（MTD）在传统歌手中很常见，可能导致严重的并发症，但对于作为专业嗓音使用者的歌手，MTD 应如何治疗，目前尚无定论。本研究旨在探讨呼吸练习联合手法治疗与呼吸练习和手法治疗对患有 MTD 的传统歌手的嗓音质量的影响。

方法

在这项盲法随机临床试验中，将 60 名 MTD 患者随机分为四组：（1）呼吸练习组、（2）手法治疗组、（3）联合干预组（CI）和（4）对照组。患者每周接受一次治疗，共 13 次。治疗效果以主要结局指标评估：（1）呼吸功能，用最长发声时间（MPT）测量；（2）喉功能，用频闪喉镜评估评分表（SERF）测量。次要结局指标为患者的自我感知嗓音障碍，用 Persian 版歌唱嗓音障碍指数（SVHIp）测量。所有结局变量在治疗前后均进行测量。采用协方差分析（ANCOVA）比较 MPT 和 SVHIp 评分的组间差异。采用 Kruskal-Wallis 非参数检验比较 SERF 各项目的组间差异。