In order to evaluate feeding and swallowing functions in patients recruited by the Nutrition Support Team (NST), we investigated their underlying diseases, primary departments, age distribution, nutrition administration routes, and feeding and swallowing. The survey was conducted on 66 cases determined to be suffering from malnutrition based on screening of all hospitalized patients. The elderly aged 65 or over accounted for 86 percent of all cases. Neurological disorders were the most prevalent type of disease, affecting 29 percent of all cases. Oral feeding accounted for 40 percent, and supplemental nutrition for 60 percent of all cases. The incidence of aspiration was 66 percent. Forty-two percent of all cases did not involve oral administration. Feeding and swallowing functions were more seriously affected in cases of respiratory and neuromuscular diseases as compared with other diseases. Our findings suggest that in order to carry out safe oral nutrition, medical staff must evaluate the individual patient’s feeding and swallowing functions.
The present study was designed to investigate the phonological factors that facilitate speech fluency in children who stutter. Shimamori & Ito (2007, 2008) suggested that the transition from initial core vowels to the following phonemes might affect the occurrence of stuttering in Japanese. In the production of monosyllables, heavy syllables require a transition from core vowels to the following phonemes, whereas light syllables do not. If Shimamori & Ito’s hypothesis is valid, the frequency of stuttering on light syllables will be lower than that on heavy syllables in the production of monosyllables. The purpose of the present study was to investigate whether the frequency of stuttering on light syllables is lower than that of heavy syllables using monosyllabic production tasks. The participants were 30 elementary school children who stutter. The results demonstrated that the frequency of stuttering on light syllables was significantly lower than that of heavy syllables, as we expected. This outcome supported our hypothesis that a transition from initial core vowels to the following phonemes affects the occurrence of stuttering in Japanese.
Phonatory function tests objectively assess symptoms associated with voice disorders, such as difficulty vocalizing, inability to speak loudly and fatigue due to vocalizing. An aerodynamic phonatory function test applying the airway interruption method can simultaneously measure fundamental frequency, sound pressure level, mean flow rate and expiratory lung pressure. Expiratory lung pressure per mean flow rate indicates airway resistance during phonation and correlates with glottal resistance. Surgery to improve voice enhances laryngeal aerodynamics and thereby serves to normalize parameters. Phonatory function tests are extremely useful for assessing severity and therapeutic effects, and for monitoring the clinical course of patients with voice disorders. The high-speed video system currently under development for clinical applications is capable of assessing vocal cord vibrations to an accuracy of 1/2000 second. Here, we discuss image analysis methods that we investigated previously, i.e., glottal area waveform analysis, FFT analysis and kymographic analysis.
This article introduces prospective aspects of speech morphing technology in the future of voice therapy and its clinical applications. Speech morphing is based on a new speech analysis, modification and synthesis technology called TANDEM-STRAIGHT. Excitation source analysis procedures used in TANDEM-STRAIGHT are potentially able to handle irregular vocal fold vibration patterns found in voice disorders. Use of the new technology in the form of speech morphing will introduce a new strategy by showing the target voice of therapy or operations well in advance using the patient’s own voice.
The purpose of this paper was to clarify levels of evidence pertaining to the efficacy of voice therapies up to the present. I applied the existing literature about the efficacy of voice therapies since the 1980’s to the evidence levels proposed by Butler (2001). The results revealed a number of efficacy studies of therapeutic techniques exhibiting a high evidence level, and these were based on well-designed research. As the number of such studies based on well-designed research has now begun to increase, voice therapy is finally evolving from a simple art to an art with a science.
Voice disorders are very common in clinical practice. At the Saida Ear, Nose & Throat Clinic, in the past three years we examined 4,355 outpatient cases of voice disorders. We undertook voice analysis by examining the larynx by videostroboscope. The following approaches were performed successfully. 1. We performed the examinations using a videostroboscope, a new type of stroboscope attracting much attention that uses an LED as its light source. We compared this method against the conventional xenon-based equipment used until now, and concluded that LED-based stroboscopy has outstanding prospects. Diagnosis of voice disorders requires precise examination of the vocal folds. Stroboscopic examination is highly useful for observing vocal-fold vibrations in detail. When classifying vocal-fold diseases, differences between available examination methods and the use or non-use of stroboscopy must be considered. 2. In clinical practice, it is important to listen to the patient’s voice from a professional perspective, without relying on examination equipment. When analyzing the voice, consideration must be paid to the environment in which the patient uses his or her voice. 3. The newly developed system using a strain gage to check respiratory movement in real time was demonstrated as being effective for use in voice therapy. As examination results can be shown on the computer screen simultaneously, this visual feedback enables various types of voice training to be performed successfully.
Until now, vocal music training has been undertaken subjectively based on the experience of experts having long experience. Although respiratory coaching is very important for singing, understanding how the student is breathing during vocalization is quite difficult relying on visual means alone. Some voice coaches have attempted to overcome this diffculty by touching the student’s abdominal and thoracic areas. Even with this method, however, it has been difficult to gain full understanding of respiratory movement during singing. Moreover, there have been problems as to potential sexual harassment. A new coaching method enabling such understanding of respiratory movement by objective means has thus been eagerly awaited. A strain gage measures the degree of stretching based on changes in electrical resistance according to tensile level. A new strain-gage type system was developed that analyzes respiratory movement in real time using belts fixed around the abdominal and thoracic areas. Data is displayed on a computer screen in a form similar to an oscillograph, enabling objective observation of respiratory movement. The new system is seen to be highly effective for use in vocal coaching, as well as for training in conjunction with voice therapy.
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