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연축성 발성장애 환자의 Lax Vox 음성치료 효과

Effects of Lax Vox voice therapy in a patient with spasmodic dysphonia: A case report

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주제분류학제간연구

초록

Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased f0 and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

Abstract

Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased f0 and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

참고문헌 (14)

  1. Dargin, T. C., "Semi-occluded vocal tract exercises : aerodynamic and electroglottographic measurements in singers", Journal of Voice, 29(2), pp.155~164 (2015)
  2. Sovijärvi, A., "Fifth International Congress of Phonetic Sciences", pp.532~535 (1965), Karger
  3. "Lax Vox Voice Therapy Technique" (2013)[URL]
  4. Enflo, L., "Collision Threshold Pressure: A Novel Measure of Voice Function-Effect of vocal warm-up, Vocal loading and Reonance Tube phonation in water", pp.2013
  5. Granqvist, S., "Resonance tube phonation in water : high-speed imaging, electroglottographic and oral pressure observations of vocal fold vibrations-a pilot study", Logopedics Phoniatrics Vocology, 40(3), pp.113~121 (2015)
  6. Andrade, P. A., "The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises", Journal of Voice, 30(1), pp.36~41 (2016)
  7. Guzman, M., "Laryngeal and Pharyngeal Activity During Semioccluded Vocal Tract Postures in Subjects Diagnosed with Hyperfunctional Dysphonia", Journal of Voice, 27(6), pp.709~716 (2013)
  8. "Air pressure and contact quotient measures during different semioccluded postures in subjects with different voice conditions" (2016)[URL]
  9. Andrade, P. A., "Electroglottographic Study of Seven Semi-Occluded Exercises : LaxVox, Straw, Lip-Trill, Tongue-Trill, Humming, Hand-Over-Mouth, and Tongue-Trill Combined With Hand-Over-Mouth", Journal of Voice, 28(5), pp.589~595 (2014)
  10. Finitzo, T., "Spasmodic dysphonia, whether and where : results of seven years of research", Journal of Speech and Hearing Research, 32(3), pp.541~555 (1989)
  11. Roy, N., "Differential diagnosis of muscle tension dysphonia and spasmodic dysphonia", Current Opinion Otolaryngology & Head Neck Surgery, 18, pp.165~170 (2010)
  12. Blitzer, A., "Electromyographic findings in focal laryngeal dystonia(spastic dysphonia)", Annals of Otology, Rhinology, &Laryngology, 94, pp.591~594 (1985)
  13. Zwirner, P., "Effects of botulinum toxin therapy in patients with adductor spasmodic dysphonia : Acoustic, aerodynamic, and videoendoscopic findings", Laryngoscope, 102(4), pp.400~406 (1992)
  14. Stewart, C. F., "Adductor spasmodic dysphonia : standard evaluation of symptoms and severity", Journal of Voice, 11(1), pp.95~103 (1997)

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