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Preliminary Study of Semi-Intensive Voice Therapy for Functional Voice Disorders


背景:功能性嗓音異常的個案是最常被轉介來接受嗓音治療,在接受完整的嗓音治療後,病人可以恢復之前的用聲及提高生活品質,然而治療期間太長使得病人常取消預約,甚至中斷治療,都使治療成效大打折扣。有別於傳統或歐美密集型治療頻率,本研究依照本國國情所設計一週兩次的嗓音治療頻率,並探討此半密集型嗓音治療是否可以有效地恢復病人之前的用聲及生活品質,並且縮短治療的期間。方法:本研究為前瞻性的研究,經由耳鼻喉科醫師診斷納入15位功能性嗓音異常的個案,在治療前、後分別進行聽知覺、聲學、氣動學及嗓音相關生活品質問卷等主觀及客觀評估。結果:個案在治療後的整體嗓音異常、粗糙聲、無力與拉緊聲均有顯著改善,聲學評估中在持續發長音之基礎頻率(F0)、頻率擾動係數(jitter%)、振幅擾動係數(shimmer%)和噪音諧音比率(noise to harmonic ratio)方面也都有顯著的改善,而嗓音相關生活品質問卷嚴重度也從中度顯著地改善到輕度。此外也發現受試者對治療的滿意度高且退出率低。結論:一週兩次的半密集型嗓音治療,有實質的療效且能被台灣職場文化接受,期望此初步研究結果可以提供臨床醫療人員作為參考依據,未來仍需更多個案及更長時間追蹤,以瞭解接受此治療方式及頻率的延續效果及需要改善之處。

Parallel abstracts

Background: Patients diagnosed with functional dysphonia often resulted in variable treatment outcomes because of poor treatment attendance. Previous studies have proposed that intensive voice treatment may improve client adherence; however, in Taiwan, it is difficult in practicing these intensive modalities for these patients who are high work demands and minimal support for sick leave. To investigate the clinical outcomes of functional dysphonia following sub-intensive voice treatment, including perceptual, acoustic, aerodynamic parameters, and self-questionnaires. Methods: Fifteen patients with functional dysphonia participated in the study. Voice recordings, acoustic, aerodynamic, and voice related-quality of life assessments were recorded before and after voice treatment. In addition to a vocal hygiene education session, all participants received eight sessions of direct voice therapy. This sub-intensive treatment consisted of two 40 minutes treatment sessions per week over four weeks. Results: After voice therapy the grade of overall voice quality, roughness, weakness of voice, and strain in auditory perceptual judgment, values for jitter%, shimmer% and noise to harmonic ratio of sustain vowel /a/ were significantly improved. The fundamental frequency of sustain vowel /a/ and speaking voice, and the scores of voice related-quality of life were significantly increased after therapy. High satisfaction and attendance rates were also found. Conclusions: Semi-intensive treatment is a potentially viable service delivery option for functional dysphonia and warrants further larger scale investigation.


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