Zilan Zhu, Jarrad H Van Stan, Hamzeh Ghasemzadeh, Ahsan J Cheema, Jeremy Wolfberg, Robert E Hillman, Annie B Fox, Daryush D Mehta
{"title":"非声部创伤性声带功能亢进患者亚组语音治疗后简化的发声效率指标正常化。","authors":"Zilan Zhu, Jarrad H Van Stan, Hamzeh Ghasemzadeh, Ahsan J Cheema, Jeremy Wolfberg, Robert E Hillman, Annie B Fox, Daryush D Mehta","doi":"10.1044/2025_AJSLP-25-00040","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to determine whether simplified vocal efficiency (VE) metrics could accurately identify changes after voice therapy in individuals with nonphonotraumatic vocal hyperfunction (NPVH). This study analyzes treatment-related changes for traditional VE-vocal intensity (square of sound pressure) over aerodynamic power-and three simplified VE ratios: (a) sound pressure level over aerodynamic power (SPL/AP), (b) SPL over subglottal pressure (SPL/Ps), and (c) SPL over airflow (SPL/AFLOW).</p><p><strong>Method: </strong>Retrospective data from 108 adults (80 females, 28 males) diagnosed with primary muscle tension dysphonia (associated with NPVH) and 208 vocally healthy adults (181 females, 27 males). Study participants produced repeated consonant-vowel utterances in comfortable and loud conditions before and after voice therapy, with acoustic SPL and aerodynamic measurements (Ps and AFLOW) derived. Pre- to posttherapy VE changes were analyzed using mixed-design analysis of variance models. In an exploratory analysis, patients were divided into three subgroups based on their pretherapy VE measures to investigate treatment effects within NPVH subgroups.</p><p><strong>Results: </strong>Pre- to posttherapy VE changes were not observed for the NPVH group as a whole. A subsequent subgroup analysis revealed treatment effects within female patients with NPVH exhibiting lower and higher than typical pretherapy VE metrics. SPL/Ps exhibited a treatment effect in both loudness conditions and migration toward normative ranges following therapy. Posttherapy changes were observed to varying degrees in both loudness conditions for traditional VE and simplified VE metrics of SPL/AP and SPL/AFLOW.</p><p><strong>Conclusions: </strong>VE ratios, especially SPL/Ps, demonstrate potential as metrics for evaluating the outcome of voice therapy in individuals with NPVH and aid in stratifying individuals with NPVH into subgroups compared to vocally healthy values. Further investigations are warranted to investigate the role of VE metrics in the assessment, treatment, and prevention of NPVH.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"2846-2863"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452819/pdf/","citationCount":"0","resultStr":"{\"title\":\"Simplified Vocal Efficiency Metrics Normalize Following Voice Therapy in Subgroups of Patients With Nonphonotraumatic Vocal Hyperfunction.\",\"authors\":\"Zilan Zhu, Jarrad H Van Stan, Hamzeh Ghasemzadeh, Ahsan J Cheema, Jeremy Wolfberg, Robert E Hillman, Annie B Fox, Daryush D Mehta\",\"doi\":\"10.1044/2025_AJSLP-25-00040\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The purpose of this study is to determine whether simplified vocal efficiency (VE) metrics could accurately identify changes after voice therapy in individuals with nonphonotraumatic vocal hyperfunction (NPVH). This study analyzes treatment-related changes for traditional VE-vocal intensity (square of sound pressure) over aerodynamic power-and three simplified VE ratios: (a) sound pressure level over aerodynamic power (SPL/AP), (b) SPL over subglottal pressure (SPL/Ps), and (c) SPL over airflow (SPL/AFLOW).</p><p><strong>Method: </strong>Retrospective data from 108 adults (80 females, 28 males) diagnosed with primary muscle tension dysphonia (associated with NPVH) and 208 vocally healthy adults (181 females, 27 males). Study participants produced repeated consonant-vowel utterances in comfortable and loud conditions before and after voice therapy, with acoustic SPL and aerodynamic measurements (Ps and AFLOW) derived. Pre- to posttherapy VE changes were analyzed using mixed-design analysis of variance models. In an exploratory analysis, patients were divided into three subgroups based on their pretherapy VE measures to investigate treatment effects within NPVH subgroups.</p><p><strong>Results: </strong>Pre- to posttherapy VE changes were not observed for the NPVH group as a whole. A subsequent subgroup analysis revealed treatment effects within female patients with NPVH exhibiting lower and higher than typical pretherapy VE metrics. SPL/Ps exhibited a treatment effect in both loudness conditions and migration toward normative ranges following therapy. Posttherapy changes were observed to varying degrees in both loudness conditions for traditional VE and simplified VE metrics of SPL/AP and SPL/AFLOW.</p><p><strong>Conclusions: </strong>VE ratios, especially SPL/Ps, demonstrate potential as metrics for evaluating the outcome of voice therapy in individuals with NPVH and aid in stratifying individuals with NPVH into subgroups compared to vocally healthy values. Further investigations are warranted to investigate the role of VE metrics in the assessment, treatment, and prevention of NPVH.</p>\",\"PeriodicalId\":49240,\"journal\":{\"name\":\"American Journal of Speech-Language Pathology\",\"volume\":\" \",\"pages\":\"2846-2863\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452819/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Speech-Language Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1044/2025_AJSLP-25-00040\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-25-00040","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/13 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
Simplified Vocal Efficiency Metrics Normalize Following Voice Therapy in Subgroups of Patients With Nonphonotraumatic Vocal Hyperfunction.
Purpose: The purpose of this study is to determine whether simplified vocal efficiency (VE) metrics could accurately identify changes after voice therapy in individuals with nonphonotraumatic vocal hyperfunction (NPVH). This study analyzes treatment-related changes for traditional VE-vocal intensity (square of sound pressure) over aerodynamic power-and three simplified VE ratios: (a) sound pressure level over aerodynamic power (SPL/AP), (b) SPL over subglottal pressure (SPL/Ps), and (c) SPL over airflow (SPL/AFLOW).
Method: Retrospective data from 108 adults (80 females, 28 males) diagnosed with primary muscle tension dysphonia (associated with NPVH) and 208 vocally healthy adults (181 females, 27 males). Study participants produced repeated consonant-vowel utterances in comfortable and loud conditions before and after voice therapy, with acoustic SPL and aerodynamic measurements (Ps and AFLOW) derived. Pre- to posttherapy VE changes were analyzed using mixed-design analysis of variance models. In an exploratory analysis, patients were divided into three subgroups based on their pretherapy VE measures to investigate treatment effects within NPVH subgroups.
Results: Pre- to posttherapy VE changes were not observed for the NPVH group as a whole. A subsequent subgroup analysis revealed treatment effects within female patients with NPVH exhibiting lower and higher than typical pretherapy VE metrics. SPL/Ps exhibited a treatment effect in both loudness conditions and migration toward normative ranges following therapy. Posttherapy changes were observed to varying degrees in both loudness conditions for traditional VE and simplified VE metrics of SPL/AP and SPL/AFLOW.
Conclusions: VE ratios, especially SPL/Ps, demonstrate potential as metrics for evaluating the outcome of voice therapy in individuals with NPVH and aid in stratifying individuals with NPVH into subgroups compared to vocally healthy values. Further investigations are warranted to investigate the role of VE metrics in the assessment, treatment, and prevention of NPVH.
期刊介绍:
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.