目的:患有声带结节的成年人会出现声音嘶哑,呼吸和声音疲劳,which,反过来,显着影响他们的声音参与以及活动。精心设计的语音治疗程序提高了生活质量和声音功能。这是一篇叙述性综述,对有关嗓音治疗干预在声带结节成人中的有效性的现有文献进行了系统的搜索。
方法:文章的数据库电子搜索使用了几个关键术语。使用了严格的纳入标准,并对研究进行了广泛的评估。这包括根据国家卫生和医学研究委员会的证据水平,评估,和批判性评估。
结果:30篇综述文章中有9篇符合入选标准,并报道了嗓音治疗干预对声带结节成年患者的积极作用。绝大多数审查的研究报告了多维语音测量结果数据,其中大多数包含视觉感知,听觉感知,声学和自我评估结果。无论接受直接或间接或两种语音治疗内容的组合,治疗后,发现几乎所有语音质量参数均有所改善。短期治疗(<3周)可能与更长的传统语音治疗计划一样有益,使用远程语音治疗可能是一种可实现的实用方法,可以提供治疗并增强对治疗的依从性。纳入研究的研究设计和证据水平较低(≤III-2),比较研究的偏倚风险中等。
结论:本叙述性综述不能总结嗓音治疗方案的一般有效性。进一步研究和了解治疗内容的具体参数(运动和技术)将改善语音结果测量。需要更多的研究来调查结束治疗后6个月语音治疗的益处是否可持续。然而,需要改进的证据来表明短期治疗与传统治疗方案一样有益。远程练习语音治疗可能是提供治疗并增强对治疗的依从性的可实现且实用的方式。
OBJECTIVE: An adult with vocal fold nodules can suffer from hoarseness, breathiness and vocal fatigue, which, in turn, significantly affects their vocal participation as well as activities. A well-designed voice therapy program improves the quality of life and vocal functionality. This is a narrative
review with a systematic search of the current literature about the effectiveness of voice therapy interventions in adults with vocal fold nodules.
METHODS: Several key terms were used for the database electronic search of articles. Strict inclusion criteria were used and a broad evaluation of the studies was performed. This included the level of evidence based on the National Health and Medical Research Council levels of evidence, assessment, and critical appraisal.
RESULTS: Nine out of 30 reviewed articles met the criteria of inclusion and reported positive effects of voice therapy intervention on adult patients with vocal fold nodules. The vast majority of the reviewed studies reported multidimensional voice measures outcome data, most of them containing visual-perceptual, auditory-perceptual, acoustic and self-assessment results. Regardless of receiving direct or indirect or a combination of both voice therapy contents, nearly all voice quality parameters were found to improve after treatment. Short-term treatment (< 3 weeks) may be as beneficial as longer traditional voice therapy programs, and using telepractice voice therapy may be an achievable and practical way of delivering treatment and enhance adherence to therapy. The study design and the evidence levels of the included studies were low (≤ III-2) and the risk of bias of the comparative studies was moderate.
CONCLUSIONS: This narrative
review cannot conclude the general effectiveness of voice therapy programs. Further research and understanding of what specific parameters (exercise and techniques) of a therapy\'s content will improve voice outcome measures. More studies are required to investigate whether or not voice therapy benefits are sustainable 6 months after ending the therapy. However, improved evidence is required to suggest that short period treatments are as beneficial as traditional therapy programs. Telepractice voice therapy may be an achievable and practical way of delivering treatment and enhance adherence to therapy.