The Application Of Semi-occluded Real-time Accent Method On Occupational Voice Users With Voice Disorders

Occupational voice users need to use their voice for a long time and with high intensity.Once their voice is misused or abused,it is easy to cause voice disorders,which are manifested in different degrees of functional decline in breathing,vocalization,and resonance,such as insufficient respiratory support,uncoordinated breathing and vocalization,abnormal loudness and pitch,abnormal sound quality,abnormal resonance sound quality,etc.According to the principles of therapy and the results of previous clinical verification,semi-occluded vocal tract exercises and the accent method can improve voice function,but their effects are limited.The integration of the two therapies may well target the characteristics of vocal disorders in occupational voice users.The purpose of this study is to explore a comprehensive voice therapy—semi-occluded real-time accent method,formulate treatment strategies through clinical experiments and use experiments for clinical validation,aiming to comprehensively and efficiently improve the vocal function of patients with vocal disorders in occupational voice users.The first experiment is a comparative study of the voice characteristics between occupational voice users with voice disorders and ordinary adults,comparing 30（26female and 4 male）vocal-disordered occupational users with an average age of31.13±8.49 years old with 30（26 females and 4 males）voice-disordered occupational users with an average age of 29.27±6.76 years old.The voice function level of ordinary adults was collected to refine the main vocal characteristics of occupational voice users with voice disorders,and to provide a reference for the formulation of subsequent treatment strategies.The results of the experiment shows that VC,MPT,MCA,HI,HF0,Jitter,Shimmer,NNE and CQP of the occupational voice user group are significant different from the general adult group（p<0.05）.Combined with the descriptive statistics,it shows that occupational voice users have problems with wrong breathing patterns,insufficient breathing support,poor coordination of breathing and vocalization,nervous vocalization,poor control of loudness and pitch,and insufficient use of resonant cavities.The second experiment bases on the above research results to formulate a semi-occluded real-time accent treatment strategy for occupational voice users with voice disorders,and through clinical experiments to verify the feasibility of the semi-occluded real-time accent treatment strategy.A total of 20 occupational voice users with voice disorders are selected in this study,and they are divided into a semi-occluded real-time accent method group and a blank control group,10 in each.The results show that the correct rate of breathing pattern increases from 0% to 100%（p=0.000<0.01）,and VC increases from 3856±1058 ml to 4165±1019 ml（p=0.005<0.01）,MPT increases from 11.84±3.11 s to 16.22±3.95 s（p=0.005<0.01）,and MCA increases from 17.00±6.06 s to 22.07±5.39 s（p=0.007<0.01）,showing that the respiratory support ability and the coordination ability of respiratory vocalization are significantly improved;NNE decreases from-7.82±3.96 d B to-16.37±4.06 d B（p=0.007<0.01）,and Jitter decreases from 0.70±0.71% to 0.18±0.18± 0.09 %（p=0.022<0.05）,Shimmer decreases from 4.27±1.44 % to 1.56±0.29%（p=0.005<0.01）,CQP decreases from 6.19±4.15% to 1.39±1.09%（p=0.005<0.01）,indicating that the voice quality is significantly improved,the vocal range is significantly broadened,and the control of breathing rhythm and the use of resonance chambers are improved.The innovation of this study is to propose a semi-obstructive real-time rereading treatment strategy suitable for occupational voice disorders.The key points of the strategy are as follows:（1）The rhythm of the accent method is the main line throughout the treatment process,following the functional characteristics and training framework of breathing,vocalization,and resonance,and gradually using adagio,andante,and allegro rhythm to improve the performance of speech muscles;（2）Extract the effective key techniques in semi-occluded vocal tract exercises,and use simple and convenient occluding tools and methods to provide long-term vocal tract occluding exercises for strengthening respiratory muscles;（3）Integrate semi-occluded factors and rhythm of the accent method,so that the vocal cords can perform voice training in a relaxed state,which improves the training efficiency and reduces the risk of vocal cord fatigue damage;（4）Using modern rehabilitation equipment to provide real-time audio-visual feedback to facilitate real-time self-monitoring of patients.