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1.
Aerodynamic measurements of patients with parkinson's disease   总被引:2,自引:0,他引:2  
Patients with Parkinson's disease commonly complain of voice dysfunction. Most of these complaints can be attributed to the known muscular control disorders that occur with Parkinson's disease. However, the manifestations of Parkinson's disease muscular dysfunction on parameters of phonation such as airflow, laryngeal resistance, and subglottal pressure necessary to sustain phonation have not been reported. The purpose of this study was to examine the aerodynamic characteristics of flow, laryngeal resistance, and phonation pressure threshold in a heterogeneous population of patients with Parkinson's disease who had varying voice complaints and to compare the data to similar studies for human subjects who have no voice complaints. The studies used a noninvasive method of detecting flow and acoustic signal from the lips, oral cavity and nose during phonation and used an external flow interruption technique to estimate subglottal pressure and phonation threshold pressure. About one third of the patients could not produce phonation at regular and loud intensities that were comfortable for normal subjects. The mean subglottal pressure (SGP) of patients with Parkinson disease who could produce 3 levels of intensity comparable to normal subjects was significantly higher than the mean SG-Ps for normal subjects for the same intensities of vocal production. The mean flow rates measured from patients with Parkinson's disease at the same 3 intensities of phonation was not significantly greater than in normal subjects. This indicated that the mean laryngeal resistance calculated for patients with Parkinson's disease was notably and significantly greater than mean laryngeal resistance calculated for normal subjects at the same intensity levels. The mean vocal efficiency (VE) for normal subjects was not significantly different than the mean VE for patients with Parkinson's disease, because greater pressure was used to generate similar flow and acoustic energy. These findings correlate with the perception of patients with Parkinson's disease that they are working harder to produce phonation. The observation of notably greater laryngeal resistance and phonation threshold pressure in patients with Parkinson's disease suggests that further studies of the glottic aperture in patients with Parkinson' disease may be useful for understanding how this common motor disorder disturbs phonation.  相似文献
2.
A phonetogram is a graph showing the sound pressure level (SPL) of softest and loudest phonation over the entire fundamental frequency range of a voice. A physiological interpretation of a phonetogram is facilitated if the SPL is measured with a flat frequency curve and if the vowel /a/ is used. It was found that in soft phonation, the SPL is mainly dependent on the amplitude of the fundamental, while in loud phonation, the SPL is mainly determined by overtones. The short-term SPL variation, i.e., the level variation within a tone, was about 5 dB in soft phonation and close to 2 dB in loud phonation. For two normal voices the long-term SPL variation, calculated as the mean standard deviation of SPL for day-to-day variation, was found to be between 2.4 and 3.4 dB in soft and loud phonation. Speakers who raise their loudness of phonation also tend to raise their mean voice fundamental frequency. Measures obtained from speaking at various voice levels were combined so that typical pathways could be introduced into the phonetogram. The average slope of these pathways was 0.3–0.5 st/dB for healthy subjects. Averaged phonetograms for male singers and male nonsingers did not differ significantly, but averaged phonetograms for female singers and female nonsingers did, in that the upper contour was higher for the female singers. Averaged phonetograms for female patients with non-organic dysphonia showed significantly lower SPL values in loudest phonation as compared to healthy female subjects, while no corresponding difference was seen for males in this regard. With respect to the SPL values for softest phonation, male dysphonic patients showed significantly higher SPL values than healthy male subjects, while no corresponding difference was seen in female subjects. The subglottal pressure mirrored these phonetogram differences between healthy and pathological voices. The averaged phonetograms of female patients after voice therapy showed an increased similarity with those of normal voices. For the male patients the averaged phonetogram did not change significantly after therapy.  相似文献
3.
The myoelastic-aerodynamic model of phonation implies that aerodynamic factors are crucial to the evaluation of voice function. Subglottal pressure and mean flow rate represent the vocal power source. If they can be related to the magnitude of the radiated sound power, they may provide an index of vocal efficiency. Methods of evaluating the aerodynamic characteristics associated with the ventilatory and laryngeal systems are critically discussed, and normative aerodynamic values for use in diagnosis and physiologic investigations are presented. Measurements having excellent time resolution of the glottal flow wave and of pressure changes in the vicinity of the larynx itself demonstrate the importance of study vocal tract acoustics.  相似文献
4.
Previous studies have indicated that the diaphragm may contribute to the accomplishment of the quick and precise subglottal pressure changes required during singing. The present investigation compares data collected from simultaneously recorded electromyograms from breathing muscles and transdiaphragmatic pressure during singing as well as during nonsense and emphatic speech.  相似文献
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6.
Normative measures of open quotient, speed quotient, maximum flow declination rate (MFDR), and subglottal pressure were determined for 75 children between the ages of 6 years 0 months and 10 years 11 months. The participants produced a sustained /a/ at low, comfort, and high pitches for a minimum of 5 seconds, and five to seven repetitions of /pa/ at low, comfort, and high pitches. No statistically significant differences were found in the mean measures of any aerodynamic variables (open quotient, speed quotient, maximum flow declination rate, subglottal pressure) between the frequency levels (low, comfort, high pitches). Also, no strong evidence (P > .05) exists that age or sex effect differed between the frequency levels (low, comfort, high) for any of the aerodynamic measures. For /a/ response tasks, mean open quotient measures increased slightly from low to comfort frequency and from comfort to high frequency. Mean speed quotient measures showed minimal differences between low and comfort frequency, with decreased mean measures for high frequency. Mean MFDR measures increased from low to comfort frequency and from comfort to high frequency. Mean subglottal pressure measures increased slightly from low to comfort frequency and from comfort to high frequency.  相似文献
7.
Although subglottal pressures in conversational speech are relatively easily measured and thus known, the higher values that sometimes occur in singing (especially in tenors) have received little attention in the literature. Still more unusual is the opportunity to measure a large-scale change over decades in the application of pressure in singing production. This study compares measurements of subglottal pressure in a tenor/singing teacher (JS) at two points in his career: in his early thirties, when he was a subject in HS's dissertation study on the efficiency of voice production; and recently, in his fifties, in connection with JS's forthcoming book on the history of the pedagogy of Bel Canto. Although a single case study, its points of special interest include the high values initially measured (up to100 cm H2O) and the reduction of this figure by more than 50% in the maximal values of the recent measurements. The study compares these values with those of other singers in the same laboratory (both with esophageal balloon and directly, with a catheter passed through the glottis) and in the literature, as well as discusses in detail the problems pertaining to the measurement (repeatability, correcting for lung volume, etc.).

As a sophisticated subject, JS makes some pertinent observations about the changes in his use of subglottal pressure.  相似文献

8.
Rapid subglottal pressure changes related to the glottal cycles influence the aerodynamics of phonation. Various methods to measure these have been developed, but are not practical for routine phoniatric use. For that reason, a noninvasive measurement tool is necessary. This article presents a technique that uses a microphone positioned at the skin of the jugular fossa to record the signal which arises in the subglottal spaces and is transmitted through the soft tissue to the surface of the skin. Using the program Glottal Segmentation of Voice and Speech, jugular microphone recordings from two healthy subjects were compared with simultaneously recorded direct intratracheal measurements during the same phonation. A systematic error arising from the transmission properties of the microphone and the soft tissue leads to phase and amplitude deviations. These must be taken into account and require correction. This correction procedure leads to high correlations and a good agreement between the two signals. Even without this correction the jugular microphone measurements proved to be useful as a diagnostic and a therapeutic tool in cases where chest resonance specific processes appear affected. In addition, they offer material for research purposes. Although based on a small number of subjects, the new method shows a good validity; testing on a larger number of subjects will probably strengthen the validity.  相似文献
9.
10.
Sustained high notes, diminishing gradually from the loudest to the softest phonation within a maneuver called messa di voce, are examined in two contrasting professional tenor voices. Signals of the sound pressure level, electroglottograph, and mean esophageal pressure are recorded, and similar maneuvers by the same subjects are examined stroboscopically. The lyric voice is found to make a gradual diminuendo while maintaining nearly constant posture of the vocal tract together with a phase of complete closure in the glottal cycle. The robust voice, by contrast, passes abruptly from a production of high subglottal pressure and a high closed quotient to one of low pressure and incomplete closure, and the transition is marked by a sudden opening of the previously constricted laryngeal collar. It is proposed that the mode of soft voice production demonstrated by the robust voice be recognized as a distinct register of the singing voice.  相似文献
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