Lessac-Madsen共鸣嗓音治疗对年轻健康日本女性最大发声时间及其与声学特征关联的短期效果

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中文摘要

健康个体因嗓音滥用而面临发生嗓音障碍的风险，这促使了预防措施的开发。我们假设，通常为有嗓音问题者开具的共鸣嗓音练习，可能对无嗓音障碍者的发声表现产生积极影响。本研究纳入39名健康女大学生，参与一次包含Lessac-Madsen共鸣嗓音治疗（LMRVT）入门的实验性课程。LMRVT包括嗓音肌肉放松练习以及重复以鼻辅音/m/开头的单词。评估方面，我们在LMRVT干预前后记录了最大发声时间（MPT）、持续单元音发声和段落朗读任务。结果显示，干预后MPT显著延长，而在多重比较校正后，没有声学特征显示显著的组水平变化。在多元回归分析中，我们检验了声学变化是否与ΔMPT的个体差异相关。这些分析一致发现，反映高频区域共鸣增加的Hammarberg指数降低，是持续元音发声和段落朗读任务中ΔMPT的显著相关因素。段落朗读任务的多元回归分析还显示元音空间面积有减小的趋势。随后进行了一项探索性贝叶斯结构方程模型（BSEM），以表征ΔMPT与声学测量之间的共享变异，假设“嗓音经济性”为与干预相关变化有关的潜在因子。ΔHammarberg指数在嗓音经济性因子上显示出最强的负向载荷，该因子在各任务中与ΔMPT一致相关。这些发现表明，入门性共鸣嗓音练习可能改善健康个体的MPT，并且Hammarberg指数可能是MPT改善个体差异的候选声学相关因素。

英文摘要

Healthy individuals carry a risk of developing voice disorders from vocal abuse, prompting the development of preventive measures. We hypothesized that resonant voice exercises, typically prescribed for individuals with vocal problems, might positively affect phonatory performance in those without existing voice disorders. Here, 39 healthy female university students participated in an experimental session featuring an introductory Lessac-Madsen Resonant Voice Therapy (LMRVT). The LMRVT consisted of vocal musculature relaxation exercises and the repetition of words initiated by the nasal consonant /m/. For assessment, we recorded maximum phonation time (MPT), sustained single-vowel phonation, and a passage-reading task before and after the LMRVT intervention. The results demonstrated a significant prolongation of MPT following the intervention, whereas no acoustic feature showed a significant group-level change after correction for multiple comparisons. In multiple regression analyses, we tested whether acoustic changes were associated with individual differences in ΔMPT. These analyses consistently identified a reduction in the Hammarberg Index, reflecting increased high-frequency regional resonance, as a significant correlate of ΔMPT in both sustained-vowel phonation and passage-reading tasks. The multiple regression analysis for the passage-reading task also showed a trend for a decrease in vowel-space area. An exploratory Bayesian structural equation modeling (BSEM) was then conducted to characterize the shared variation among ΔMPT and the acoustic measures, assuming "vocal economy" as a latent factor related to the intervention-associated change. The ΔHammarberg Index showed the strongest negative loading on the vocal economy factor, which was consistently associated with ΔMPT across tasks. These findings suggest that introductory resonant voice exercises may improve MPT in healthy individuals and that the Hammarberg Index may be a candidate acoustic correlate of individual differences in MPT improvement.