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嗓音治疗对单侧声带麻痹嗓音结局的临床效果:两种基于嗓音特定功能训练(SOVT)的治疗方案的概念验证研究

Clinical Effects of Voice Therapy on Vocal Outcomes in Unilateral Vocal Fold Paralysis: Proof-of-Concept Study for Two SOVT-Based Treatment Protocols.

作者信息

Kissel Imke, Meerschman Iris, D'haeseleer Evelien, Papeleu Tine, Tomassen Peter, Claeys Sofie, Leyns Clara, Van Nuffelen Gwen, Van Lierde Kristiane

机构信息

Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.

Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.

出版信息

J Voice. 2024 Oct 11. doi: 10.1016/j.jvoice.2024.08.034.

Abstract

BACKGROUND

Studies on treatment efficacy in unilateral vocal fold paralysis (UVFP) often lack a predetermined treatment protocol, and little is known about the effects of specific vocal techniques on vocal outcomes and quality of life in UVFP patients. The purpose of this preliminary proof-of-concept study is to investigate the effects and feasibility of two intensive treatment protocols based on water-resistance therapy (WRT) and vocal function exercises (VFE).

METHODS

Ten participants with acute or chronic UVFP/paresis were recruited in the study and randomly assigned to the WRT or VFE group. Three of these participants presented with aphonia and could not complete the program as prescribed. The remaining participants completed an intensive therapy program with the assigned vocal technique. Before, during, and after the program, a multidimensional voice assessment was performed. Maximum phonation time, acoustic, perceptual, and patient-reported outcome measures (PROMs) were obtained.

RESULTS

WRT and VFE had positive clinical effects on instrumental and auditory-perceptual voice quality, glottal closure, and PROMs, but interindividual variability was high. Studies with larger sample sizes are necessary to confirm or refute these findings.

CONCLUSION

The WRT- and VFE-based therapy programs are both feasible and seem to elicit positive clinical changes in UVFP patients. Suggestions on how to improve the programs are provided, as well as considerations for implementation in clinical practice. Follow-up research is needed to examine the efficacy of both programs on group level.

摘要

背景

关于单侧声带麻痹(UVFP)治疗效果的研究往往缺乏预先确定的治疗方案,对于特定发声技巧对UVFP患者发声结果和生活质量的影响知之甚少。这项初步的概念验证研究的目的是调查基于抗水疗法(WRT)和发声功能锻炼(VFE)的两种强化治疗方案的效果和可行性。

方法

本研究招募了10名急性或慢性UVFP/轻瘫患者,并将他们随机分配到WRT组或VFE组。其中3名参与者出现失音,无法按规定完成该项目。其余参与者采用指定的发声技巧完成了强化治疗项目。在项目开始前、进行期间和结束后,进行了多维度的嗓音评估。获得了最长发声时间、声学、感知和患者报告结局指标(PROMs)。

结果

WRT和VFE对仪器测量和听觉感知的嗓音质量、声门闭合和PROMs有积极的临床效果,但个体差异很大。需要更大样本量的研究来证实或反驳这些发现。

结论

基于WRT和VFE的治疗方案都是可行的,并且似乎能在UVFP患者中引起积极的临床变化。文中提供了关于如何改进这些方案的建议,以及在临床实践中实施的考虑因素。需要进行后续研究以检验这两种方案在群体水平上的疗效。

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