• 대한후두음성언어의학회지
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• 제26권1호
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• pp.21-24
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• 2015

Voice therapy after post-thyroidectomy dysphonia is designed to improve glottal closure without supraglottic hyperfunction by development of abdominal support for breathing and intrinsic muscle strengthening exercises. Regarding voice therapy of unilateral vocal fold paresis/paralysis, several techniques such as head positioning, digital manipulation, pushing and pulling method are used for trial or temporary therapy. And the holistic voice therapy such as LSVT, Accent method, VFE are useful for hypofunctional voice disorders. These may be effective interventions as a temporary improvement until normal voice recovers or may provide the essentials for long-term rehabilitation.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.13-18
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• 2020

Background and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization. Materials and Methods The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2. Results In acoustic analysis, Jitter, vF₀, vAm, Shimmer, NHR, and VTI were significantly decreased. F₀ was increased after voice therapy for women. 'Grade', 'Rough,' and 'Breathy' were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased. Conclusion VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.39-45
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• 2000

Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p＜0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p＜0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

• 음성과학
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• 제9권3호
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• pp.77-86
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• 2002

The purpose of this study was to investigate the effects of Sea Dong-Il's technique on voice quality in patients with vocal nodules and phonasthenia (vocal fatigue). Ten patients (4 nodules and 6 vocal fatigue) participated in the study. Each subject was assessed acoustically (Fo, Jitter, Shimmer, NNE) in the first and last session. Dr. Speech (version 3.4, Tiger-DRS) was used to compare acoustic parameters of pre-and post-treatment. Sea Dong-Il's technique consisted of breathing exercise, relaxation exercise, and phonation exercise. The results were as follows: First, Sea Dong- Il's technique tended to be effective on improving voice quality in patients with phonasthenia and vocal nodules. Second, the nature of improvements were as follows: there was a significant difference between pre-and post-treatment in shimmer (p < .01) and NNE (p < .001), while there was no significant difference between pre-and post-treatment in Fo and Jitter. Finally, given the fact that the number of subjects was only 10, the jitter might have shown a significant difference if more subjects participated in the experiment.

• 재활복지
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• 제22권1호
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• pp.157-168
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• 2018

본 연구는 반폐쇄성도훈련에 기반을 둔 성대에어로빅치료(Vocal Aerobic Treatment: VAT)가 소프라노 성악가 음성개선에 미치는 영향을 알아보고자 하였다. 연구대상은 성대결절로 음성문제를 호소하는 소프라노 성악가 1명으로 연구를 진행하였다. 연구방법은 치료 전 후 음향학적평가와 주관적 음성평가를 실시하여 측정값을 비교하였으며, 성대에어로빅치료는 주 2회 총 32회기동안 진행하였다. 음향학적 평가는 MDVP (multi-dimensional voice program)와 VRP (voice range profile)를 사용하여 음도, 음질, 음역을 평가하였으며, 주관적 음성평가는 SVHI (singing voice handicap index)로 주관적인 음성만족도를 평가하였다. 음도 평가 결과 치료 후 소프라노 가수에 적절한 기본주파수(Fo)를 유지하였다. 음질평가 결과 주파수변동률(Jitter), 진폭변동률(Shimmer), 배음대소음비(NHR) 수치가 치료 전보다 감소하였다. 음역평가결과 음역의 범위가 넓어졌으며 반음의 개수가 30개에서 35개로 증가하였다. 주관적 음성평가는 설문 보고 후 획득한 총 점수를 문항수로 나눈 결과 3.6점에서 0.6점으로 감소하였으며, 본인이 느끼는 음성문제의 정도가 경미하다고 보고하였다. 이러한 결과를 정리해보면 성대에어로빅치료는 성악가 음성개선에 효과적인 것으로 사료된다. 그러나 본 연구는 소프라노 성악가 1명을 대상으로 한 성대에어로빅치료의 치료 효과에 관한 사례연구로 향후 더 많은 성악가를 대상으로 효과에 대한 연구가 이루어져야 할 것이다. 또한 성악가뿐만 아니라 다양한 직업적 음성사용자를 위한 음성관리 및 음성치료프로그램에 관한 후속 연구가 필요할 것이다.

• 말소리와 음성과학
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• 제11권3호
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• pp.69-76
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• 2019

본 연구는 성대에어로빅치료법(vocal aerobic treatment, VAT)이 음성장애 환자의 음성 개선에 미치는 효과에 대해 알아보았다. 연구대상은 후두스트로보스코피, 음성검사 상 음성장애로 진단된 20명(남 13명, 여 7명)이었다. 음향학적 평가는 CSL(computerized speech lab)의 MDVP(Multi-Dimensional Voice Program)와 VRP(Voice Range Profile)를 통해 평가하였다. 공기역학적 평가는 PAS(Phonatory Aerodynamic System)를 통해 평가하였다. MDVP를 통해 치료 전 후 기본주파수(Fo), 주파수변동률(Jitter), 진폭변동률(Shimmer), 소음대배음비(NHR)의 변화를 측정하였고, VRP에서는 치료 전 후 주파수 범위(Fo range), 강도범위(Energy range)를 측정하였다. PAS에서는 치료 전 후 폐활량(FVC), 최대연장발성시간(PHOT), 평균호기류율(MEAF), 성문하압(MPAP), 음성효율성(AEFF)의 변화를 알아보았다. 후두스트로보스코피에서는 치료 전 후 양측 성대의 규칙성, 대칭성, 점막파동, 진폭 변화 소견을 알아보았다. 음성치료는 총체적 음성치료 접근법 중 하나인 VAT 프로그램을 환자별로 주 1회 실시하였다. 환자별 평균 치료 회기는 6.5회였다. 연구결과, MDVP에서는 Jitter, Shimmer, NHR이 통계적으로 유의하게 감소하였다(p<.001, p<.01, p<.05). VRP 결과, 주파수 범위에서 Hz와 Semitones이 치료 후 유의미하게 향상하였다(p<.01, p<.05). PAS 결과, FVC, PHOT에서 유의미한 향상이 나타났다(p<.01, p<.001). 후두스트로보스코피 결과 치료 후 기능적 음성장애, 인후두역류질환, 양성성대점막질환군에서 성대소견이 정상범주에 해당하였다. 따라서 VAT 프로그램은 음성장애환자의 음향학적 공기역학적 후두스트로보스코피 측면에서의 음성 개선에 효과적인 것으로 나타났다. 차후 연구에서는 동일 집단의 음성장애 환자에게 VAT 적용 연구가 필요하다고 생각된다. 또한 객관적인 음성 개선뿐만 아니라 주관적 음성 개선을 알아볼 필요가 있다. 나아가 직업적 음성사용자를 대상으로 VAT 효과에 대한 적용연구가 필요가 있다.