Folia Phoniatrica et Logopaedica最新文献

Introduction: The purposes of this study were to multidimensionally assess the voice in patients with type 2 diabetes using perceptual and acoustic measurements, laryngeal imaging, and patient self-assessment and compare it with the healthy control group.

Methods: A total of 60 patients with type 2 diabetes were enrolled in this cross-sectional study, and a healthy group matched according to age and gender was recruited. The subjects underwent acoustic analysis using the Dysphonia Severity Index (DSI) and perceptual evaluation using the Persian version of the Consensus Auditory Perceptual Evaluation of Voice (ATSHA). Voice-related quality of life was assessed using the Voice Handicap Index (VHI).

Results: In both patient and control groups, 28 male and 32 female participants, with a mean age range of 47.35 ± 9.49 and 44.18 ± 9.39 years old, were included. The patient group had a higher mean for ATSHA parameters compared to the control group, and the difference between these two groups was significant (p < 0.05). The VHI scores for the patient group were significantly higher than those for the control group. The mean of DSI scores was lower in the patient group; however, this difference was not statistically significant (p > 0.05). There was a statistically significant correlation among the DSI, FBS, and HbA1C variables (p = 0.007, r = -0.346, and p = 0.008, r = -0.337).

Conclusions: The results confirm the presence of voice disorder symptoms in the patient group and their effects on their quality of life compared to the healthy group. These symptoms may result from changes in respiratory and muscle function, as well as changes in the phonetic mechanism of diabetes patients.

Introduction: Newborn cries exhibit a richness of melody and rhythmicity, yet their rhythmic features have been less studied.

Methods: In this study, we analyzed the amplitude modulation of 1,884 cries from 30 Chinese newborns.

Results: The group-averaged amplitude modulation spectrum revealed an evident increase in energy between 0.5 and 8 Hz, peaking around 2 Hz. The peak frequency for an individual child averaged at around 3 Hz (SD = 1.3 Hz), with the majority lying below 5 Hz.

Conclusion: This study is the first to demonstrate that newborn cries contain increased energy in slower rate amplitude modulation frequencies associated with prosodic feet and syllabic rhythms in speech, underscoring the important role of rhythmic information in early language acquisition.

Introduction: Controlled Oral Word Association Test (COWAT) is a common neuropsychological assessment tool used to evaluate an individual's semantic and phonemic verbal fluency. The defining feature of this test is the imposed time limit (typically 60 s per task) and the initial letter constraints. Evaluating the performance on COWAT has been challenging because numerous factors may complicate the interpretation of the obtained results. Although it has been widely used in clinical and research settings, it remains unclear whether COWAT performance primarily depends on the current cognitive activity level, the participants' age or the complexity and richness of vocabulary (which might be revealed via linguistic means, e.g., a relationship between pause length and word frequency).

Methods: The paper compares the performance of two age groups on the Russian version of COWAT test: students (M = 18.4, SD = 0.8) and senior academics (M = 60.6, SD = 5.2), all native speakers of Russian. Here, we develop the commonly used quantitative approach to processing data by adding the qualitative variables of word frequency and pause length.

Results: Our findings show that the cohort of senior academics tends to outperform the younger cohort, which might be conditioned by constant extensive cognitive engagement potentially preventing any cognitive decline. Second, associations between word frequency and pause length, mediated by certain factors, were observed in both cohorts studied, which call for a more in-depth and larger scale investigation.

Conclusion: The research opens new avenues for applying COWAT as a comprehensive diagnostic tool and a research method in both psychology and linguistics.

Objective: The present study explored the ways to prepare thickened liquids of different consistencies using lotus root starch (LRS) powder and evaluated their efficacy in treating post-stroke dysphagic patients.

Method: Thickened liquids matching the four consistency levels advocated by the International Dysphagia Diet Standardization Initiative (IDDSI) guidelines were prepared. To assess their clinical applicability, 76 post-stroke dysphagic patients were randomly divided into three groups: a xanthan gum (XG) group (n=26), an LRS group (n=26), and a control group (n=24). All groups received an intervention including swallow-related exercises and oral feeding training. The control group used regular foods (water, juice, congee, egg custard, and banana puree), while the XG and LRS groups used their respective thickened liquids. Swallowing performance was assessed before and after the intervention using the Standardized Swallowing Assessment (SSA), Penetration-Aspiration Scale (PAS), and gastric tube use duration and removal rate, incidence of adverse reactions, and cost of thickening associated with the three groups were obtained after intervention.

Results: While all groups experienced a significant improvement after the intervention, as indicated by the SSA and PAS scores, the XG and LRS groups demonstrated significantly better outcomes than the control group. In addition, the XG and LRS patients had shorter gastric tube use, greater removal rate, and fewer incidence of adverse reactions than the controls. The cost of XG was greater than that of LRS powder for the intervention.

Conclusion: LRS powder can be used to prepare thickened liquids of different consistencies following the IDDSI framework. Its efficacy and safety in treating dysphagia are comparable to XG based thickeners. However, seeing its markedly lower cost, LRS powder can be considered a viable alternative to XG based commercial thickeners.

Introduction and objective: Human neonates are born with some control over their larynx, which is essential for breathing, swallowing and phonation. Laryngeal constriction phenomena were observed during not provoked crying of full-term infants. As preterm infants show alterations in lung development and functionality, the aim of the present study was to examine whether these infants generate laryngeal constriction phenomena during the first week of life.

Methods: Cry vocalizations (n = 562) of 11 healthy, preterm infants (6 females) were analyzed visually (frequency spectrograms and oscillograms) and auditorily. The analyses of the occurrence of laryngeal constriction phenomena and the duration of vocalization were conducted using the open-source software PRAAT.

Results: Constriction phenomena were found in the crying of all preterm infants. No significant sex differences were observed. There was a significant correlation between the occurrence of laryngeal constriction phenomena and gestational age (r = -0.81). Vocalizations containing constriction phenomena were significantly longer than those without constrictions.

Conclusion: The study showed laryngeal constrictions as a regular phenomenon in cry vocalizations of preterm infants during their first week of life. They seemed to be mainly used as a respiratory mechanism to increase end-expiratory lung volume and to improve alveolar gas exchange.

Introduction: The lack of a standardized evaluation method for cleft palate (CP) speech makes it difficult to exchange information at the domestic and global levels. We aimed to develop and validate a Japanese outcome tool for the perceptual assessment of speech in patients with CP.

Methods: The tool we developed was based on the Cleft Audit Protocol for Speech-Augmented (CAPS-A) with modifications to some speech parameters. We developed Japanese speech samples and parameters for the Japanese Cleft Speech Outcome Tool (CAPS-A-Japan [CAPS-A-JP]). This study was conducted in the Japancleft speech working group at the Japanese Cleft Palate Association. In phase 1, we constructed and developed the speech sampling protocol. In phase 2, after the revision of the definitions and criteria for several cleft speech characteristics and the speech sample, a total of 20 audio recordings were tested. In phase 3, criterion validity was assessed by comparing the CAPS-A-JP resonance outcomes reported for 40 cases with the outcomes of the clinical investigations. In phase 4, a listening experiment with six Japanese speech-language-hearing therapists was conducted twice to test the intra- and inter-rater reliabilities for 20 cases. Intra-class correlation coefficients (ICCs) were used to analyze reliability.

Results: The mean percentage agreement on criterion validity for resonance was 71% on high-pressure sentences but 54% on low-pressure sentences. The inter-rater reliability was rated moderate/good (ICC: 0.45-0.80), except for developmental immaturities/errors that were rated fair. The ICC was very low or incalculable for hyponasality and syllable error patterns because there were few cases of hyponasality and syllable errors. The intra-rater reliability was rated as good/very good. The ICC was very low or incalculable in hyponasality, nasal emission, and syllable error patterns.

Conclusions: The standardized outcome tool, CAPS-A-JP, was developed for the first time in Japan. Future research is required to optimize this tool based on the inclusion of a training protocol.

Introduction: The predominant alterations in voice of patients with multiple sclerosis (MS) are phonatory instability, vocal asthenia and roughness, shortness of breath, hypophonia, and hypernasality. However, research on alterations of acoustic parameters has few studies and disparate results. The objective of this study was to investigate voice disturbances in patients with MS, both with objective measures (analysis of biomechanical) and subjective measures (scales and questionnaires).

Methods: This is an experimental study with a total of 20 participants with MS. Voice samples were collected, and biomechanical correlates were analyzed through the Clinical Voice Systems program, Online Lab App. The VHI-30 (Voice Handicap Index) questionnaire, the GRBAS (grade, roughness, breathiness, asthenia, strain) scale, and the Hospital Anxiety and Depression Scale were used as subjective measures.

Results: Ninety-five percentages of participants feel and describe dysphonic difficulties. Self-perception of vocal disability correlated with auditory vocal perceptual analysis in the sample of women.

Conclusion: The biomechanical parameters showed alterations in the strength of the glottic closure, the efficiency index, and the structural imbalance index.

Introduction: Flexible endoscopic evaluations of swallowing (FEES) involve the administration of a variety of foods and liquids to assess outcomes related to pharyngeal residue, penetration, and aspiration. While the type and color of thin liquids used during FEES have been found to significantly affect FEES ratings, it is unknown if similar effects are observed with pureed foods. Therefore, the aims of this study were to assess the effects of puree type (applesauce vs. pudding) and color (natural, blue, green) on ratings of pharyngeal residue, penetration, and aspiration during FEES.

Methods: Pharyngeal residue, penetration, and aspiration were assessed in 37 consecutive outpatient adults undergoing FEES. Patients were presented with two types of puree: 5 mL applesauce and 5 mL pudding. Each puree type was presented once with either blue or green food coloring added to it by a clinician. Each puree type was also presented once with no clinician-added food coloring ("natural"). The order of presentation was randomized between patients and all data were blindly analyzed by pairs of independent raters using the Visual Analysis of Swallowing Efficiency and Safety (VASES). Multilevel statistical models were used to examine the effects of puree type and color on oropharyngeal residue, hypopharyngeal residue, and Penetration-Aspiration Scale scores (PAS).

Results: Pudding trials were associated with higher oropharyngeal residue ratings compared to applesauce trials. Blue-colored applesauce was associated with higher oropharyngeal and hypopharyngeal residue ratings when compared to natural applesauce. Lastly, green-colored applesauce and green-colored pudding were both associated with higher hypopharyngeal residue ratings compared to natural applesauce and natural pudding, respectively.

Conclusion: This study identified statistically significant effects of puree type and color and ratings of pharyngeal residue ratings, but not penetration or aspiration, as seen during FEES. These data suggest that clinicians and researchers should consider standardizing the type and color of pureed food used during FEES.

Introduction: Nasalance is an acoustic representation of perceived nasality with proven clinical and research utility. Its validity is contingent on appropriate speech sample sets and distinct normative databases based on known impact factors such as language and phonetic environment, but little is known about the potential effects of lexical tone on nasalance. Its use in international cross-linguistic studies necessitates definition and added considerations of speech sampling protocol.

Methods: Part I: a methodological review was undertaken using PRISMA (2020), the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist for evaluating the risk of bias, and calculation of effect sizes and/or visual displays using tables showing the grouping of similar data for the synthesis of findings. Part II: a pilot study explored the effect of lexical tone on nasalance in Cantonese, a lexical tone language.

Results: Part I: a total of 17 studies met the inclusion criteria. In addressing possible confounders and minimizing the risk of bias, 13 studies were assigned an overall quality rating of acceptable (+) and the remaining 4, a high rating (++). For the 9-word string, there was a (non-clinical) difference of 3-5% between Swedish and Brazilian-Portuguese, and a moderate effect size for age (d = 0.49); for the consonant-vowel syllables set, clinical differences across languages were identified for adults and between 5 and 10% for children and adolescents. Part II: the pilot study showed a significant effect of lexical tone on nasalance, where nasalance for the high-level tone 1 was significantly higher than that for high-rising tone 2, low-rising tone 5, and low-falling tone 4.

Discussion: There is a need for further evidence from other languages, including tonal languages, to better define the evidence and speech methodology of international cross-linguistic nasalance studies.