Phonetics and Speech Sciences (말소리와 음성과학)

Korean Society of Speech Sciences (한국음성학회)
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Acoustic parameter delta of an aspirated voice in stroke patients

뇌졸중 환자 대상 흡인 음성의 음향변수 변동

  • 강영애 (충남대학교병원 이비인후과) ;
  • 지성주 (충남대학교병원 재활의학과) ;
  • 구본석 (충남대학교병원 이비인후과) ;
  • 조철우 (창원대학교 메카트로닉스대학 전기전자제어공학부)
  • Received : 2017.07.28
  • Accepted : 2017.09.13
  • Published : 2017.09.30
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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.

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References

  1. Bruijn, M., Rinkel, R., Cnossen, I., Witte, B., Langendijk, J., Leemans, C., & Verdonck-de Leeuw, I. (2013). Associations between voice quality and swallowing function in patients treated for oral or oropharyngeal cancer. Support Care Cancer, 21(7), 2025-2032. https://doi.org/10.1007/s00520-013-1761-3
  2. Kim, B., & Jung, E. (2016). Oropharyngeal dysphagia in the elderly. Journal of the Korean Dysphagia Society, 6, 49-53. (김보해.정은재 (2016). 노인에서의 구강인두 연하장애. 대한연하장애학회지, 6, 49-53.)
  3. Chang, H., Torng, P., Wang, T., & Chang, Y. (2012). Acoustic voice analysis does not identify presence of penetration/aspiration as confirmed by videofluoroscopic swallowing study. Archives of Physical Medicine and Rehabilitation, 93, 1991-1994. https://doi.org/10.1016/j.apmr.2012.05.028
  4. Choi, K. (2011). Epidemiology of dysphagia. Journal of the Korean Dysphagia Society, 1, 1-8. (최경효 (2011). 연하장애의 역학적 고찰. 대한연하장애학회지, 1, 1-8.)
  5. Daniels, S., Brailey, K., Priestly, D., Herrington, L., Weisberg, L., & Foundas, A. (1998). Aspiration in patients with acute stroke. Archives of Physical Medicine and Rehabilitation, 79, 14-19. https://doi.org/10.1016/S0003-9993(98)90200-3
  6. Gonzailez-Fernandez, M., Humbert, L., Winegrad, H., Cappola, A., & Fried, L. (2014). Dysphagia in old-old women: Prevalence as determined according to self-report and the 3-ounce water swallowing test. Journal of American Geriatrics Society, 62, 716-720. https://doi.org/10.1111/jgs.12745
  7. Groves-Wright, K., Boyce, S., &　Kelchner, L. (2010). Perception of wet vocal quality in identifying penetration/aspiration during swallowing. Journal of Speech, Language, and Hearing Research, 53, 620-632. https://doi.org/10.1044/1092-4388(2009/08-0246)
  8. Hah, J., & Chang, H. (2014). Interventional management of post-stroke dysaphagia. Journal of the Korean Dysphagia Society, 4, 11-17. (하정훈.장현 (2014). 뇌졸중 후 연하장애의 중재적 치료. 대한연하장애학회지, 4, 11-17.)
  9. Hassan, H., & Aboloyoun, A. (2014). The value of bedside tests in dysphagia evaluation. Egyptian Society of Ear, Nose, Throat & Allied Sciences, 15, 197-203. https://doi.org/10.1016/j.ejenta.2014.07.007
  10. Kweon, S., Koo, B., & Jee, S. (2016). Change of swallowing in patients with head and neck cancer after concurrent chemoradiotherapy. Annals of Rehabilitation Medicine, 40(6), 1100-1107. https://doi.org/10.5535/arm.2016.40.6.1100
  11. Malandraki, G., Hind, J., Gangnon, R., Logemann, J., & Robbins, J. (2011). The utility of pitch elevation in the evaluation of oropharyngeal dysphonia: Preliminary findings. American Journal of Speech-Language Pathology, 20, 262-268. https://doi.org/10.1044/1058-0360(2011/10-0097)
  12. Ryu, J., Park, S., & Choi, K. (2004). Prediction of laryngeal aspiration using voice analysis. American Journal of Physical Medicine & Rehabilitation, 83(10), 753-757. https://doi.org/10.1097/01.PHM.0000140798.97706.A5
  13. Santos, K., Scheeren, B., Maciel, A., & Cassol, M. (2015). Vocal variability post swallowing in individuals with and without oropharyngeal dysphagia. International Archives of Otorhinolaryngology, 19, 61-66.
  14. Shirazi, S., Buchel, C., Daun, R., Lenton, L., & Moussavi, Z. (2012). Detection of swallows with silent aspiration using swallowing and breath sound analysis. Medical & Biological Engineering & Computing, 50, 1261-1268. https://doi.org/10.1007/s11517-012-0958-9
  15. Teramoto, S., & Fukuchi, Y. (2000). Detection of aspiration and swallowing disorder in older stroke patients: simple swallowing provocation test versus water swallowing test. Archives of Physical Medicine and Rehabilitation, 81, 1517-1519. https://doi.org/10.1053/apmr.2000.9171
  16. Waito, A., Bailey, G., Molfenter, S., Zoratto, D., & Steele, C. (2011). Voice-quality abnormalities as a sign of dysphagia: validation against acoustic and videofluoroscopic data. Dysphagia, 26, 125-134. https://doi.org/10.1007/s00455-010-9282-4