A Study of Ventilatory Homeostasis and Phonatory Behavior During Aerobic Exercise

有氧运动中通气稳态和发声行为的研究

基本信息

批准号：
8454075
负责人：
Aaron Scott Ziegler
金额：
$ 3.12万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-01 至 2013-01-22
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8454075
关键词：
Acoustics Activities of Daily Living Address Adult Aerobic Aerobic Exercise Affect Air Area Athletic Behavior Blood gas Breathing Carbon Dioxide Child Clinical Research Communication Competence Dancing Data Development Employment Energy Transfer Environmental air flow Evaluation Exercise Fire - disasters Frequencies Future Gases Goals Homeostasis Human Impairment Individual Injury Investigation Knowledge Laboratories Laryngeal Injury Larynx Law Enforcement Literature Maintenance Measures Mechanics Metabolic Military Personnel Occupations Output Oxygen Consumption Phonation Physical Education Police Police officer Population Production Quality of life Reading Regulation Rehabilitation therapy Research Respiratory physiology Rest Risk Safety Series Source Speech Stress Suggestion Tidal Volume Tissues Training Voice Workload experience expiration fitness glottis human subject impression instructor interest meetings phrases physical model physiologic stressor pressure primary outcome respiratory secondary outcome sound teacher vocal cord vocalization

项目摘要

DESCRIPTION (provided by applicant): The prevailing model of physical injury indicates the primary traumatic agent in injury is the transfer of energy in amounts exceeding local tissue thresholds. Of interest for the present study is mechanical energy transfer in vocal fold (VF) injury during phonation. One important source of such injury is perpendicular VF impact stress (force/area), which in turn is partially regulated by VF adduction and phonatory subglottal pressure (PS) [32, 33]. A gap in the literature, which this project addresses, regards the effects of high respiratory drive (HRD) - i.e., increased ventilation due to blood-gas level changes during aerobic activity [1] - on adduction and PS, and thus VF injury risk in human subjects. Of particular interest are individuals required to phonate loudly during aerobic activity (HRD), such as military drill instructors, firefighters, physical education teachers, and others. Existing data indicate that when voice output is free to vary under HRD, expiratory flow increases [22, 24], presumably in conjunction with relatively abducted vocal folds. Thus, the risk of injury should be minimal. However, data indicate individuals in the foregoing occupations actually have elevated risk for phonotrauma [2-12], which is thought to be associated with increased VF adduction, PS and impact stress. The general hypothesis pursued in this study is that in a laboratory setting requiring loud voice during HRD, VF adduction as well as estimated PS will increase rather than decrease, thus increasing the risk of VF injury. Further, respiratory homeostasis (maintenance of optimum blood-gas concentrations), as measured by minute ventilation and blood-gas levels, will be compromised in that scenario. Conversely, when voice output is free to vary under HRD, respiratory homeostasis will be better preserved, but voice output will be compromised, as measured by decreased adduction and PS, thus decreasing injury risk. Stated differently, this project investigates a proposed competition between the vocal folds' function as a gateway to blood-gas regulation versus oscillating sound source. The study utilizes a physiologic stressor, aerobic exercise, to investigate laryngeal behavior during HRD as a window into the mechanisms of phonotrauma in physically active voice users. Specific Aims are: SA 1: To investigate the influence of (a) vocal goal and (b) exercise workload on respiratory function. The hypothesis is that "loud" phonation will disproportionately interfere with ventilatory homeostasis during an aerobic exercise challenge as compared with "spontaneous" phonation. SA 2: To investigate the influence of (a) vocal goal and (b) exercise workload on laryngeal function. The hypothesis is that with increasing HRD, "loud" phonation will result in a disproportional increase in VF adduction and estimated PS, and thus injury risk, compared to "spontaneous" phonation. The project's significance lies with its investigation of mechanisms of VF injury in general and of occupationally induced VF injury associated with HRD in particular. PUBLIC HEALTH RELEVANCE: The proposed research will characterize the effects of aerobic activity, a physiologic stressor, and vocal goal on respiratory and laryngeal function using non-invasive measures in human subjects. The knowledge gained from this research will guide the development of future large-scale clinical studies to elucidate the effects of different approaches to vocal and cardiorespiratory training in the rehabilitation of physically active voice users with voice problems.

描述（由申请人提供）：普遍的身体损伤模型表明，损伤的主要创伤因素是超过局部组织阈值的能量转移。本研究感兴趣的是发声期间声带（VF）损伤中的机械能转移。这种损伤的一个重要来源是垂直 VF 冲击应力（力/面积），而该应力又部分受到 VF 内收和发声声门下压力 (PS) 的调节 [32, 33]。该项目解决的文献中的一个空白是关于高呼吸驱动 (HRD)（即有氧活动期间血气水平变化导致的通气增加 [1]）对内收和 PS 的影响，从而导致室颤损伤风险在人类受试者中。特别令人感兴趣的是在有氧运动 (HRD) 期间需要大声发声的个人，例如军事训练教练、消防员、体育教师等。现有数据表明当声音输出在 HRD 下自由变化时，呼气流量增加 [22, 24]，可能与相对外展的声带有关。因此，受伤的风险应该是最小的。然而，数据表明，从事上述职业的人实际上患音伤的风险较高[2-12]，这被认为与心室颤动内收、PS 和冲击应力的增加有关。本研究的一般假设是，在 HRD 期间需要大声说话的实验室环境中，VF 内收以及估计的 PS 将增加而不是减少，从而增加 VF 损伤的风险。此外，在这种情况下，通过每分钟通气量和血气水平测量的呼吸稳态（维持最佳血气浓度）将受到损害。相反，当声音输出在 HRD 下自由变化时，呼吸稳态将得到更好的保持，但声音输出将受到损害（通过内收和 PS 减少来衡量），从而降低受伤风险。换句话说，该项目研究了声带作为血气调节门户的功能与振荡声源之间的拟议竞争。该研究利用生理压力源（有氧运动）来研究 HRD 期间的喉部行为，以此作为了解身体活跃的发声使用者的语音损伤机制的窗口。具体目标是： SA 1：研究 (a) 发声目标和 (b) 运动负荷对呼吸功能的影响。假设是，与“自发”发声相比，在有氧运动挑战期间，“大声”发声会不成比例地干扰通气稳态。 SA 2：研究 (a) 发声目标和 (b) 运动负荷对喉功能的影响。假设随着 HRD 的增加，与“自发”发声相比，“大声”发声将导致 VF 内收和估计 PS 不成比例地增加，从而导致受伤风险。该项目的意义在于研究室颤损伤的一般机制和职业诱发的室颤损伤尤其与 HRD 相关。公共健康相关性：拟议的研究将采用非侵入性措施来描述有氧活动、生理应激源和发声目标对人类受试者呼吸和喉功能的影响。从这项研究中获得的知识将指导未来大规模临床研究的发展，以阐明不同方法的效果声音和心肺训练，以帮助身体活跃的声音使用者康复语音问题。