Effect of Speech Appliance to Prevent Levator Muscle Fatigule during Continuous Speech

he purposes of this study were to clarify' whether continuous speech may induce levator veli palatini muscle fatigue for speakers with velopharyngeal incompetence, and whether a speech appliance (Bulb-PLP) in place can decrease the muscle fatigue during speech. Four patients who underwent surge...

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Published inJournal of Japanese Cleft Palate Association Vol. 23; no. 4; pp. 273 - 281
Main Authors TACHIMURA, Takashi, FUJITA, Yoshinori, NOHARA, Kanji, WADA, Takeshi
Format Journal Article
LanguageJapanese
Published Japanese Cleft Palate Association 30.10.1998
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ISSN0386-5185
2186-5701
DOI10.11224/cleftpalate1976.23.4_273

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Abstract he purposes of this study were to clarify' whether continuous speech may induce levator veli palatini muscle fatigue for speakers with velopharyngeal incompetence, and whether a speech appliance (Bulb-PLP) in place can decrease the muscle fatigue during speech. Four patients who underwent surgery for cleft palate and required a speech appliance for improvement of their velopharyngeal incompetence, were selected as the subjects. Each subject was asked to pronounce more than 200 times /pu/ under both conditions of placement and removal of the speech appliance. A correlation coefficient between the number of pronunciations and values of smooth EMG activity of the levator muscle was calculated under each experimental condition. Absolute value of the correlation coefficient was significantly smaller under the placement condition than that under the removal condition for all subjects. Differential correlation coefficients between the two conditions were found to be statistically significant for three subjects out of four subjects. This result suggested that the levator muscle was likely to suffer from muscle fatigue with velopharyngeal incompetence left untreated and that a speech appliance in place can prevent muscle fatigue during speech. It is possible that the clinical effect of a speech appliance to improve velopharyngeal function is partly caused by its efficacy to decrease muscle fatigue.
AbstractList he purposes of this study were to clarify' whether continuous speech may induce levator veli palatini muscle fatigue for speakers with velopharyngeal incompetence, and whether a speech appliance (Bulb-PLP) in place can decrease the muscle fatigue during speech. Four patients who underwent surgery for cleft palate and required a speech appliance for improvement of their velopharyngeal incompetence, were selected as the subjects. Each subject was asked to pronounce more than 200 times /pu/ under both conditions of placement and removal of the speech appliance. A correlation coefficient between the number of pronunciations and values of smooth EMG activity of the levator muscle was calculated under each experimental condition. Absolute value of the correlation coefficient was significantly smaller under the placement condition than that under the removal condition for all subjects. Differential correlation coefficients between the two conditions were found to be statistically significant for three subjects out of four subjects. This result suggested that the levator muscle was likely to suffer from muscle fatigue with velopharyngeal incompetence left untreated and that a speech appliance in place can prevent muscle fatigue during speech. It is possible that the clinical effect of a speech appliance to improve velopharyngeal function is partly caused by its efficacy to decrease muscle fatigue.
he purposes of this study were to clarify' whether continuous speech may induce levator veli palatini muscle fatigue for speakers with velopharyngeal incompetence, and whether a speech appliance (Bulb-PLP) in place can decrease the muscle fatigue during speech. Four patients who underwent surgery for cleft palate and required a speech appliance for improvement of their velopharyngeal incompetence, were selected as the subjects. Each subject was asked to pronounce more than 200 times /pu/ under both conditions of placement and removal of the speech appliance. A correlation coefficient between the number of pronunciations and values of smooth EMG activity of the levator muscle was calculated under each experimental condition. Absolute value of the correlation coefficient was significantly smaller under the placement condition than that under the removal condition for all subjects. Differential correlation coefficients between the two conditions were found to be statistically significant for three subjects out of four subjects. This result suggested that the levator muscle was likely to suffer from muscle fatigue with velopharyngeal incompetence left untreated and that a speech appliance in place can prevent muscle fatigue during speech. It is possible that the clinical effect of a speech appliance to improve velopharyngeal function is partly caused by its efficacy to decrease muscle fatigue. 口蓋裂術後鼻咽腔閉鎖不全症例において,スピーチエイドの装着・非装着により発音活動時の口蓋帆挙筋疲労の程度が異なるかを検討した。Bulb-PLP装着時・非装着時において200回以上の/pu/音節の連続表出を命じ,表出開始からの順序に応じた口蓋帆挙筋活動を擬似的な時系列資料として扱い,表出順と筋活動値との問の回帰式を条件ごとに求めて筋活動の時系列変化を調べた。実験は口蓋裂術後鼻咽腔閉鎖不全症例で,Bulb-PLPの装着のもとに言語治療を継続的に受けた4症例を対象にした。その結果,非装着時,装着時ともに,表出回数の増加に対する筋活動値の変化は,低下する場合や増加する場合と様々であった。しかしながら,全ての症例における非装着時の回帰係数の絶対値は装着時よりも大きく,回帰係数の差の検定の結果,4名中3名において係数の差は有意であり,その傾向は装着期間の短い例では顕著でなかった。すなわち,スピーチエイド非装着時の口蓋帆挙活動は,鼻咽腔が良好に閉鎖されている時の筋活動よりも変動が大きく,連続活動によって関連筋が疲労しやすいことを示しており,さらにスピーチエイドの鼻咽腔閉鎖機能賦活効果の背景には,会話等の連続音の表出に鼻咽腔閉鎖機能の関連筋の疲労に対する抑制効果が関与する可能性が示された。
Author FUJITA, Yoshinori
NOHARA, Kanji
TACHIMURA, Takashi
WADA, Takeshi
Author_FL 野原 幹司
舘村 卓
藤田 義典
和田 健
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  fullname: WADA, Takeshi
  organization: Division for Oral and Facial Disorders, Osaka University Faculty Dentistry
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スピーチエイドの鼻咽腔閉鎖機能賦活効果の生理学的背景
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References 1)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド装着にともなう発音時口蓋帆挙筋活動の変化. 日口蓋誌, 22: 22-31, 1997.
6)舘村 卓, 和田 健: 栓塞子付き口蓋挙上装置(Bulb-PLP: Bulb attached Palatal Lift Prosthesis)の考案. 日口蓋誌, 13: 253-261, 1988.
15) Oberg, T: Muscle fatigue and calibration of EMG measurements. J. Electromyogr.. Kinesiol., 5: 239-243, 1995.
2)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド装着による鼻咽腔閉鎖機能の予備能形成. 音声言語医学, 38: 337-343, 1997.
5)舘村 卓, 和田 健, 原 久永, 他: 粉液型光重合リライニングレジンを用いた咽頭部作製法による栓塞子付き口蓋挙上装置. 歯界展望, 80: 147-155, 1992.
16) Bigland-Ritchie, B., Johansson, R., Lippold, OJC., et al.: Contractile speed and EMG changes during fatigue of sustained maximal voluntary contraction. J. Neurophysiol. 50: 313-324, 1983.
9) Tachimura, T., Hara, H., Koh H., at al.. Effect of temporary closure of Oronasal fistula on levator veli palatini muscle activity. Cleft Palate-Craniofacial J., 34: 505 -511, 1997.
17) Moritani, T., Muro, M., Kijima, A., et al.: Electromechanical changes during electrically induced and maximal voluntary contractions: surface and intramuscular EMG responses during sustained maximal voluntary contraction. Exp. Neurol., 88: 484-499, 1985.
7)舘村 卓, 和田 健, 原 久永, 他: 発音補正装置装着時における口蓋帆挙筋活動に対する口腔内圧および鼻腔漏出気流量の影響. 日口蓋誌, 16: 180-189, 1991.
14) Moritani, T., Muro, M., and Nagat, A: Intramuscular and surface electromyogram changes duting muscle fatigue. J. Appl. Physiol., 60: 1179-1185, 1986.
13)原 久永, 舘村 卓, 高 英保, 他: 持続的鼻腔内陽圧負荷装置を用いた鼻咽腔閉鎖機能賦活法(CPAP療法)のnasalanceによる評価. 日口蓋誌, 23: 28-35, 1998.
3)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド着脱にともなう鼻咽腔閉鎖機能の変化-blowing 時口蓋帆挙筋活動の変化-. 日口蓋誌, 21: 28-34, 1996.
8) Tachimura, T., Hara, H., Wada, T.: Oral air pressure and nasal air flow rate on levator veli palatini muscle activity in patients wearing a speech appliance. Cleft Palate-Craniofacial J., 32: 382-389, 1995.
4 ) Kuehn, DP and Moon JB: Levator veli palatini muscle activity in relation to intraoral air pressure variation in cleft palate subjects. Cleft Palate Craniofac. J., 32: 376-381, 1995.
10) Kuehn, DP and Moon JB: Levator veli palatini muscle activity in relation to intraoral air pressure variation. J. Speechand Hear. Res., 37: 1260-1270, 1994.
11) Kuehn, DP: New therapy for treating hypernasal speech using continuous positive airway pressure (C PAP). Plast. Reconstr. Surg., 88: 959-969, 1991.
12)舘村 卓, 原 久永, 高 英保, 他: 鼻咽腔閉鎖機能に対する持続的鼻腔内陽圧負荷(CPAP: Continuous Positive Air Pressure)の効果-口蓋帆挙筋活動に対する口腔内圧・鼻腔内圧の影響-. 日口蓋誌, 19: 111-119, 1994.
References_xml – reference: 13)原 久永, 舘村 卓, 高 英保, 他: 持続的鼻腔内陽圧負荷装置を用いた鼻咽腔閉鎖機能賦活法(CPAP療法)のnasalanceによる評価. 日口蓋誌, 23: 28-35, 1998.
– reference: 17) Moritani, T., Muro, M., Kijima, A., et al.: Electromechanical changes during electrically induced and maximal voluntary contractions: surface and intramuscular EMG responses during sustained maximal voluntary contraction. Exp. Neurol., 88: 484-499, 1985.
– reference: 3)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド着脱にともなう鼻咽腔閉鎖機能の変化-blowing 時口蓋帆挙筋活動の変化-. 日口蓋誌, 21: 28-34, 1996.
– reference: 1)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド装着にともなう発音時口蓋帆挙筋活動の変化. 日口蓋誌, 22: 22-31, 1997.
– reference: 16) Bigland-Ritchie, B., Johansson, R., Lippold, OJC., et al.: Contractile speed and EMG changes during fatigue of sustained maximal voluntary contraction. J. Neurophysiol. 50: 313-324, 1983.
– reference: 7)舘村 卓, 和田 健, 原 久永, 他: 発音補正装置装着時における口蓋帆挙筋活動に対する口腔内圧および鼻腔漏出気流量の影響. 日口蓋誌, 16: 180-189, 1991.
– reference: 10) Kuehn, DP and Moon JB: Levator veli palatini muscle activity in relation to intraoral air pressure variation. J. Speechand Hear. Res., 37: 1260-1270, 1994.
– reference: 12)舘村 卓, 原 久永, 高 英保, 他: 鼻咽腔閉鎖機能に対する持続的鼻腔内陽圧負荷(CPAP: Continuous Positive Air Pressure)の効果-口蓋帆挙筋活動に対する口腔内圧・鼻腔内圧の影響-. 日口蓋誌, 19: 111-119, 1994.
– reference: 2)舘村 卓, 高 英保, 原 久永, 他: スピーチエイド装着による鼻咽腔閉鎖機能の予備能形成. 音声言語医学, 38: 337-343, 1997.
– reference: 6)舘村 卓, 和田 健: 栓塞子付き口蓋挙上装置(Bulb-PLP: Bulb attached Palatal Lift Prosthesis)の考案. 日口蓋誌, 13: 253-261, 1988.
– reference: 14) Moritani, T., Muro, M., and Nagat, A: Intramuscular and surface electromyogram changes duting muscle fatigue. J. Appl. Physiol., 60: 1179-1185, 1986.
– reference: 5)舘村 卓, 和田 健, 原 久永, 他: 粉液型光重合リライニングレジンを用いた咽頭部作製法による栓塞子付き口蓋挙上装置. 歯界展望, 80: 147-155, 1992.
– reference: 15) Oberg, T: Muscle fatigue and calibration of EMG measurements. J. Electromyogr.. Kinesiol., 5: 239-243, 1995.
– reference: 4 ) Kuehn, DP and Moon JB: Levator veli palatini muscle activity in relation to intraoral air pressure variation in cleft palate subjects. Cleft Palate Craniofac. J., 32: 376-381, 1995.
– reference: 9) Tachimura, T., Hara, H., Koh H., at al.. Effect of temporary closure of Oronasal fistula on levator veli palatini muscle activity. Cleft Palate-Craniofacial J., 34: 505 -511, 1997.
– reference: 11) Kuehn, DP: New therapy for treating hypernasal speech using continuous positive airway pressure (C PAP). Plast. Reconstr. Surg., 88: 959-969, 1991.
– reference: 8) Tachimura, T., Hara, H., Wada, T.: Oral air pressure and nasal air flow rate on levator veli palatini muscle activity in patients wearing a speech appliance. Cleft Palate-Craniofacial J., 32: 382-389, 1995.
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Snippet he purposes of this study were to clarify' whether continuous speech may induce levator veli palatini muscle fatigue for speakers with velopharyngeal...
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jstage
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StartPage 273
SubjectTerms cleft palate
fatigue
levator veli palatini
speech appliance
velopharyngeal incompetence
スピーチエイド
口蓋帆挙筋
口蓋裂
筋疲労
鼻咽腔閉鎖不全症
Title Effect of Speech Appliance to Prevent Levator Muscle Fatigule during Continuous Speech
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