The effects of respiratory-based treatment for muscle tension dysphonia: a randomized controlled trial

基于呼吸的治疗对肌张力性发声障碍的效果：一项随机对照试验

• 批准号: 10047189
• 负责人: Soren Yvette Lowell
• 金额: $ 44.92万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10047189
• 关键词: Accounting; Acoustics; Address; Affect; Aftercare; Behavior; Biofeedback; Breathing; Clinic; Clinical; Control Groups; Coupled; Data; Disease; Dysphonia; Etiology; Evidence based treatment; Fatigue; Goals; Healthcare; Hoarseness; Laryngeal muscle structure; Larynx; Lead; Loudness; Measures; Muscle; Muscle Tension; Neurologic; Occupations; Outcome; Outcome Measure; Participant; Patients; Pattern; Periodicity; Physiological; Positioning Attribute; Production; Quality of life; Randomized; Randomized Controlled Trials; Recurrence; Reproducibility; Research; Social Interaction; Speech; Structure; System; Testing; Time; Training; Training Technics; Visual; Voice; Voice Disorders; Voice Quality; alternative treatment; base; biological systems; constriction; design; disability; effective therapy; evidence base; improved; innovation; lung volume; motor learning; respiratory; response; skill acquisition; sound; standard care; therapy design; treatment comparison; treatment effect; treatment group; trial design; vocal cord

Project Summary/Abstract Primary muscle tension dysphonia is a voice disorder that involves excessive and poorly coordinated muscle activity affecting multiple subsystems that are involved in speech production, in the absence of structural or neurologic abnormalities of the larynx. Primary muscle tension dysphonia (MTD) is one of the most common forms of voice disorders, accounting for at least 40% of patients seen in voice clinics. Perceptually the voice sounds hoarse and strained, with reduced loudness and pitch range, and people with MTD find speaking very effortful and fatiguing. The physiological abnormalities that characterize MTD are considered multifactorial, and include over-activity of muscles in and around the larynx, laryngeal constriction patterns, and abnormal speech breathing patterns. However, standard treatment approaches for MTD primarily address laryngeal function, including repositioning of laryngeal structures, reducing activity in the intrinsic and extrinsic laryngeal muscles, and altering vibratory patterns. Although voice improvement may follow these treatments, many people with MTD show recurrence of voice problems after only a few months, and some do not improve with treatment. These findings highlight the need for alternative treatments that address the respiratory contributions to MTD, with training targets that are based on the specific physiologic deficits of the respiratory subsystem, which directly affect the phonatory system. The goal of this project is to determine the effects of respiratory-based treatment focused on altering lung volume levels in people with MTD, and compare those effects to a control condition. A randomized group design will be implemented to determine the respiratory and acoustic effects of each condition using training techniques with established efficacy in motor learning. We will determine the effects of each condition immediately after and then 3 and 6 months after treatment completion to assess short- and long-term treatment effects. We propose that altering the levels at which speech breaths are initiated and ended (lung volume initiation and termination) while speaking will have a positive effect on related laryngeal behavior and voice. The proposed project has the potential to substantially advance the evidence-based treatment options for MTD, providing a vital step toward reducing the debilitating effects of this disorder.

项目概要/摘要 原发性肌张力性发声障碍是一种发声障碍，涉及肌肉过度和协调不良 在没有结构或结构的情况下，影响涉及语音产生的多个子系统的活动 喉部神经系统异常。原发性肌张力性发声障碍（MTD）是最常见的一种 各种形式的嗓音障碍，至少占嗓音诊所就诊患者的 40%。感觉上的声音 声音嘶哑且紧张，响度和音调范围减小，患有 MTD 的人发现说话非常困难 费力又劳累。 MTD 的生理异常被认为是多因素造成的，并且 包括喉部及其周围肌肉的过度活动、喉部收缩模式和异常言语 呼吸模式。然而，MTD 的标准治疗方法主要针对喉功能， 包括重新定位喉结构，减少喉内肌和外在肌的活动， 并改变振动模式。尽管这些治疗可能会改善声音，但许多患有 MTD 的人 仅仅几个月后，声音问题就复发了，而且有些问题在治疗后也没有改善。这些 研究结果强调需要寻找替代疗法来解决呼吸系统对 MTD 的影响，其中 基于呼吸子系统特定生理缺陷的训练目标，直接 影响发音系统。该项目的目标是确定基于呼吸的治疗的效果 专注于改变 MTD 患者的肺容量水平，并将这些影响与对照条件进行比较。一个 将实施随机分组设计，以确定每种情况对呼吸和声学的影响 使用在运动学习中已确定有效的训练技术。我们将确定每项的影响 治疗结束后立即以及治疗完成后 3 个月和 6 个月内的病情评估，以评估短期和长期 治疗效果。我们建议改变言语呼吸开始和结束的水平（肺 说话时的音量启动和终止）将对相关的喉部行为产生积极影响 嗓音。拟议的项目有可能大大推进基于证据的治疗方案 MTD，为减少这种疾病的衰弱影响迈出了重要的一步。