音声障害に対するIntensive Voice Therapyの試み
「はじめに」 音声治療は発声様式を適正化することで声帯振動の効率化を図り, 声帯粘膜への負担を最小限としながら最大限の発声を可能とさせる訓練法である. 音声治療の第一の適応は機能的問題である. これは呼吸, 発声, 共鳴の全過程で起こり得るものであるが, 疾患名として挙げれば声帯結節等の炎症性病変, および機能性発声障害(過緊張性発声障害, 変声障害等)の機能的問題を有する疾患が最もよい適応となる. 効果は限定的とされながらも, 声帯瘢痕や溝症のような硬化性病変, 反回神経麻痺等においてもその機能的問題に対し改善効果が症例報告で示されるなど音声治療は病因に関係なく広く用いられている. 発声訓練...
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| Published in | 喉頭 Vol. 33; no. 2; pp. 200 - 205 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本喉頭科学会
01.12.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-6127 2185-4696 |
| DOI | 10.5426/larynx.33.200 |
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| Abstract | 「はじめに」 音声治療は発声様式を適正化することで声帯振動の効率化を図り, 声帯粘膜への負担を最小限としながら最大限の発声を可能とさせる訓練法である. 音声治療の第一の適応は機能的問題である. これは呼吸, 発声, 共鳴の全過程で起こり得るものであるが, 疾患名として挙げれば声帯結節等の炎症性病変, および機能性発声障害(過緊張性発声障害, 変声障害等)の機能的問題を有する疾患が最もよい適応となる. 効果は限定的とされながらも, 声帯瘢痕や溝症のような硬化性病変, 反回神経麻痺等においてもその機能的問題に対し改善効果が症例報告で示されるなど音声治療は病因に関係なく広く用いられている. 発声訓練を単音, 単語, 短文, 日常会話といった各レベルでの達成を経ながら階層的に音声治療課題を向上させていく通常の音声治療は1人の臨床家が1回40～45分のセッションを1週間に1～2回のペースで8～12週間行うものとされている. |
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| AbstractList | 「はじめに」 音声治療は発声様式を適正化することで声帯振動の効率化を図り, 声帯粘膜への負担を最小限としながら最大限の発声を可能とさせる訓練法である. 音声治療の第一の適応は機能的問題である. これは呼吸, 発声, 共鳴の全過程で起こり得るものであるが, 疾患名として挙げれば声帯結節等の炎症性病変, および機能性発声障害(過緊張性発声障害, 変声障害等)の機能的問題を有する疾患が最もよい適応となる. 効果は限定的とされながらも, 声帯瘢痕や溝症のような硬化性病変, 反回神経麻痺等においてもその機能的問題に対し改善効果が症例報告で示されるなど音声治療は病因に関係なく広く用いられている. 発声訓練を単音, 単語, 短文, 日常会話といった各レベルでの達成を経ながら階層的に音声治療課題を向上させていく通常の音声治療は1人の臨床家が1回40～45分のセッションを1週間に1～2回のペースで8～12週間行うものとされている. |
| Author | 杉山, 庸一郎 平野, 滋 金子, 真美 |
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| DOI | 10.5426/larynx.33.200 |
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| References | 15） Hsieh MJ, Lan CC, Chen NH et al : Effects of high-intensity exercise training in a pulmonary rehabilitation programme for patients with chronic obstructive pulmonary disease. Respirology 12 : 381-388, 2007. 16） Gartner-Schmidt J : Flow phonation. Plural Publishing, San Diego, 2006. 2） Carding PN, Horsley IA, Docherty GJ : A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 13 : 72-104, 1999. 12） de Vos NJ, Singh NA, Ross DA et al : Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol A Biol Sci Med Sci 60 : 638-647, 2005. 17） Guzman M, Laukkanen AM, Krupa P et al : Vocal tract and glottal function during and after vocal exercising with resonance tube and straw. J Voice 27 : 523. e19-e34, 2013. 11） Wulf G, Shea CH : Principles derived from the study of simple skills do not generalize to complex skill learning. Psychon Bull Rev 9 : 185-211, 2002. 3） Gartner-Schmidt J, Gherson S, Hapner ER et al : The development of conversation training therapy : A concept paper. J Voice 30 : 563-573, 2016. 14） Abbass AA : Intensive short-term dynamic psychotherapy of treatment-resistant depression : a pilot study. Depress Anxiety 23 : 449-452, 2006. 1） Speyer R, Wieneke GH, Dejonckere PH : Documentation of progress in voice therapy : perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy. J Voice 18 : 325-340, 2004. 8） García JA, Moreno FJ, Reina R et al : Analysis of effects of distribution of practice in learning and retention of a continuous and a discrete skill presented on a computer. Percept Mot Skills 107 : 261-272, 2008. 9） Behlau M, Madazio G, Pacheco C et al : Intensive short-term voice therapy : The brazilian experience. Perspectives on Voice and Voice Disorders 24 : 98-103, 2014. 10） Stathopoulos E, Felson Duchan J : History and principles of exercise-based therapy : how they inform our current treatment. Semin Speech Lang 27 : 227-235, 2006. 7） Patel RR, Bless DM, Thibeault SL : Boot camp : a novel intensive approach to voice therapy. J Voice 25 : 562-569, 2011. 6） Roy N, Bless DM, Heisey D et al : Manual circumlaryngeal therapy for functional dysphonia : an evaluation of short- and long-term treatment outcomes. J Voice 11 : 321-331, 1997. 4） Speyer R, Weineke G, Hosseini EG et al : Effects of voice therapy as objectively evaluated by digitized laryngeal stroboscopic imaging. Ann Otol Rhinol Laryngol 111 : 902-908, 2002. 5） Gordon MT, Pearson L, Paton F et al : Predictive assessment of vocal efficiency (PAVE). A method for voice therapy outcome measurement. J Laryngol Otol 111 : 129-133, 1997. 13） Seynnes O, Fiatarone Singh MA, Hue O et al : Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders. J Gerontol A Biol Sci Med Sci 59 : 503-509, 2004. |
| References_xml | – reference: 6） Roy N, Bless DM, Heisey D et al : Manual circumlaryngeal therapy for functional dysphonia : an evaluation of short- and long-term treatment outcomes. J Voice 11 : 321-331, 1997. – reference: 2） Carding PN, Horsley IA, Docherty GJ : A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 13 : 72-104, 1999. – reference: 7） Patel RR, Bless DM, Thibeault SL : Boot camp : a novel intensive approach to voice therapy. J Voice 25 : 562-569, 2011. – reference: 4） Speyer R, Weineke G, Hosseini EG et al : Effects of voice therapy as objectively evaluated by digitized laryngeal stroboscopic imaging. Ann Otol Rhinol Laryngol 111 : 902-908, 2002. – reference: 12） de Vos NJ, Singh NA, Ross DA et al : Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol A Biol Sci Med Sci 60 : 638-647, 2005. – reference: 14） Abbass AA : Intensive short-term dynamic psychotherapy of treatment-resistant depression : a pilot study. Depress Anxiety 23 : 449-452, 2006. – reference: 3） Gartner-Schmidt J, Gherson S, Hapner ER et al : The development of conversation training therapy : A concept paper. J Voice 30 : 563-573, 2016. – reference: 8） García JA, Moreno FJ, Reina R et al : Analysis of effects of distribution of practice in learning and retention of a continuous and a discrete skill presented on a computer. Percept Mot Skills 107 : 261-272, 2008. – reference: 5） Gordon MT, Pearson L, Paton F et al : Predictive assessment of vocal efficiency (PAVE). A method for voice therapy outcome measurement. J Laryngol Otol 111 : 129-133, 1997. – reference: 15） Hsieh MJ, Lan CC, Chen NH et al : Effects of high-intensity exercise training in a pulmonary rehabilitation programme for patients with chronic obstructive pulmonary disease. Respirology 12 : 381-388, 2007. – reference: 16） Gartner-Schmidt J : Flow phonation. Plural Publishing, San Diego, 2006. – reference: 11） Wulf G, Shea CH : Principles derived from the study of simple skills do not generalize to complex skill learning. Psychon Bull Rev 9 : 185-211, 2002. – reference: 10） Stathopoulos E, Felson Duchan J : History and principles of exercise-based therapy : how they inform our current treatment. Semin Speech Lang 27 : 227-235, 2006. – reference: 1） Speyer R, Wieneke GH, Dejonckere PH : Documentation of progress in voice therapy : perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy. J Voice 18 : 325-340, 2004. – reference: 13） Seynnes O, Fiatarone Singh MA, Hue O et al : Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders. J Gerontol A Biol Sci Med Sci 59 : 503-509, 2004. – reference: 17） Guzman M, Laukkanen AM, Krupa P et al : Vocal tract and glottal function during and after vocal exercising with resonance tube and straw. J Voice 27 : 523. e19-e34, 2013. – reference: 9） Behlau M, Madazio G, Pacheco C et al : Intensive short-term voice therapy : The brazilian experience. Perspectives on Voice and Voice Disorders 24 : 98-103, 2014. |
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| SubjectTerms | intensive voice therapy 機能性発声障害 音声治療 |
| Title | 音声障害に対するIntensive Voice Therapyの試み |
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