Ramig L O, Dromey C
Department of Communication Disorders and Speech Science University of Colorado at Boulder, USA.
J Speech Hear Res. 1996 Aug;39(4):798-807. doi: 10.1044/jshr.3904.798.
The purpose of this study was to document changes in aerodynamic and glottographic aspects of vocal function in patients with Parkinson disease who received two forms of high effort treatment. Previous reports (Ramig, Countryman, Thompson, & Horii, 1995) have documented increased sound pressure level (SPL) following treatment that trained phonation and respiration (Lee Silverman Voice Treatment: LSVT), but not for treatment that trained respiration only (R). In order to examine the mechanisms underlying these differences, measures of maximum flow declination rate (MFDR) and estimated subglottal pressure (Psub) were made before and after treatment. A measure of relative vocal fold adduction (EGGW) was made from the electroglottographic signal during sustained vowel phonation. Sound pressure level data from syllable repetition, sustained vowel phonation, reading, and monologue tasks were also analyzed to allow a more detailed understanding of treatment-related change in several contexts. Consistent with increases in SPL, significant increases in MFDR, estimated Psub, and EGGW were measured posttreatment in patients who received the LSVT. Similar changes were not observed following R treatment. These findings suggest that the combination of increased vocal fold adduction and subglottal pressure is a key in generating posttreatment increases in vocal intensity in idiopathic Parkinson disease (IPD).
本研究的目的是记录接受两种高强度治疗形式的帕金森病患者发声功能在空气动力学和喉图方面的变化。先前的报告（拉米格、康特里曼、汤普森和堀井，1995年）记录了接受发声和呼吸训练治疗（李·西尔弗曼嗓音治疗：LSVT）后声压级（SPL）的增加，但仅接受呼吸训练治疗（R）后声压级未增加。为了研究这些差异背后的机制，在治疗前后测量了最大气流下降率（MFDR）和估计的声门下压力（Psub）。在持续元音发声期间，从电声门图信号中测量相对声带内收（EGGW）的指标。还分析了音节重复、持续元音发声、朗读和独白任务中的声压级数据，以便更详细地了解几种情况下与治疗相关的变化。与声压级增加一致，接受LSVT治疗的患者治疗后MFDR、估计的Psub和EGGW显著增加。R治疗后未观察到类似变化。这些发现表明，声带内收增加和声门下压力增加的组合是特发性帕金森病（IPD）患者治疗后发声强度增加的关键。
