Dietsch Angela M, Krishnamurthy Rahul, Young Kelsey, Barlow Steven M
Department of Special Education and Communication Disorders, University of Nebraska-Lincoln.
Center for Brain, Biology and Behavior, University of Nebraska-Lincoln.
J Speech Lang Hear Res. 2024 Mar 11;67(3):729-739. doi: 10.1044/2023_JSLHR-23-00381. Epub 2024 Feb 7.
Expiratory muscle strength training (EMST) is increasingly being used to treat voice, cough, and swallowing deficits in a wide range of conditions. However, a multitude of aero-resistive EMST models are commercially available, and the absence of side-by-side comparative data interferes with clinicians' ability to assess which model is best suited to a particular client's needs. The primary aim of this research was to test and compare the pressure and flow parameters of six currently available EMST models to help inform clinical decision making.
We identified and tested five devices of each of six different EMST models to generate benchmark data for minimum trigger pressures across settings. The reliability was tested within each device and between five devices of the same model across settings using coefficient of variation.
All six models required higher pressures to initiate flow at the highest setting compared to the lowest setting, as expected. Detailed descriptive statistics for each model/setting combination include average flow-triggering pressure for each model/setting and the variability across trials within a device and across devices of the same model. From these, ranked order of the least to most stable EMST model was derived.
Systematic testing of several commercially available expiratory resistance training devices yielded clinical benchmarks and reliability data to aid clinicians in selecting an appropriate therapy device and regimen for a client based on their available airflow and air pressure as well as reliability of the device. These findings allow clinicians to directly compare key parameters across EMST devices.
呼气肌力量训练（EMST）越来越多地用于治疗多种病症中的嗓音、咳嗽和吞咽功能障碍。然而，市面上有多种气动阻力型EMST模型，且缺乏并排比较数据，这妨碍了临床医生评估哪种模型最适合特定患者的需求。本研究的主要目的是测试和比较六种现有EMST模型的压力和流量参数，以辅助临床决策。
我们识别并测试了六种不同EMST模型中的每一种的五个设备，以生成不同设置下最小触发压力的基准数据。使用变异系数在每个设备内部以及同一模型的五个设备之间跨设置测试可靠性。
正如预期的那样，与最低设置相比，所有六种模型在最高设置下启动气流都需要更高的压力。每个模型/设置组合的详细描述性统计数据包括每个模型/设置的平均气流触发压力以及设备内部和同一模型的不同设备之间试验的变异性。据此得出了从最不稳定到最稳定的EMST模型的排名顺序。
对几种市售呼气阻力训练设备进行系统测试，得出了临床基准和可靠性数据，以帮助临床医生根据患者的可用气流和气压以及设备的可靠性，为患者选择合适的治疗设备和方案。这些发现使临床医生能够直接比较不同EMST设备的关键参数。
