뇌졸중 환자 대상 흡인 음성의 음향변수 변동 = Acoustic parameter delta of an aspirated voice in stroke patients

다국어 초록 (Multilingual Abstract)

The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

목차 (Table of Contents)

• Abstract
• 1. 서론
• 2. 연구 방법
• 3. 결과
• 4. 논의 및 결론
• 참고문헌

참고문헌 (Reference)

1 최경효, "연하장애의 역학적 고찰" 대한연하장애학회 1 (1): 1-8, 2011

2 하정훈, "뇌졸중 후 연하장애의 중재적 치료" 대한연하장애학회 4 (4): 11-17, 2014

3 김보해, "노인에서의 구강인두 연하장애" 대한연하장애학회 6 (6): 49-53, 2016

4 Waito, A., "Voice-quality abnormalities as a sign of dysphagia: validation against acoustic and videofluoroscopic data" 26 : 125-134, 2011

5 Santos, K., "Vocal variability post swallowing in individuals with and without oropharyngeal dysphagia" 19 : 61-66, 2015

6 Hassan, H., "The value of bedside tests in dysphagia evaluation" 15 : 197-203, 2014

7 Malandraki, G., "The utility of pitch elevation in the evaluation of oropharyngeal dysphonia: Preliminary findings" 20 : 262-268, 2011

8 Ryu, J., "Prediction of laryngeal aspiration using voice analysis" 83 (83): 753-757, 2004

9 Groves-Wright, K., "Perception of wet vocal quality in identifying penetration/aspiration during swallowing" 53 : 620-632, 2010

10 Gonzailez-Fernandez, M., "Dysphagia in old-old women: Prevalence as determined according to self-report and the 3-ounce water swallowing test" 62 : 716-720, 2014

11 Shirazi, S., "Detection of swallows with silent aspiration using swallowing and breath sound analysis" 50 : 1261-1268, 2012

12 Teramoto, S., "Detection of aspiration and swallowing disorder in older stroke patients: simple swallowing provocation test versus water swallowing test" 81 : 1517-1519, 2000

13 권세희, "Change of Swallowing in Patients With Head and Neck Cancer After Concurrent Chemoradiotherapy" 대한재활의학회 40 (40): 1100-1107, 2016

14 Bruijn, M., "Associations between voice quality and swallowing function in patients treated for oral or oropharyngeal cancer" 21 (21): 2025-2032, 2013

15 Daniels, S., "Aspiration in patients with acute stroke" 79 : 14-19, 1998

16 Chang, H., "Acoustic voice analysis does not identify presence of penetration/aspiration as confirmed by videofluoroscopic swallowing study" 93 : 1991-1994, 2012