Jaeock Kim

Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial.

With age, physical functions decline, which influences respiratory performance. One of the physical changes associated with aging is sarcopenia, a reduction in muscle strength and power. Sarcopenia has been extensively studied in the elderly with regard to limb function but less with regard to respiratory function. Elderly individuals experience reduced muscle mass and strength in respiratory musculature, which may hinder the ability to generate adequate expiratory driving force for both ventilatory and nonventilatory activities. Increasing expiratory muscle strength may enhance an elderly individuals ability to generate and maintain the expiratory driving force critical to cough, speak, and swallow. Previous studies demonstrate that expiratory muscle strength training (EMST) improves ventilatory and nonventilatory functions. This paper discusses the potential impact that EMST can have on the rehabilitation of respiratory muscle decline, particularly in the elderly. This tutorial reviews an EMST paradigm, its physiological underpinnings, and its potential outcomes.

Effect of expiratory muscle strength training on elderly cough function

Age-related loss of muscle strength, known as sarcopenia, in the expiratory muscles, along with reductions in lung elastic recoil and chest wall compliance decreases the intrathoacic airway pressure as well as expiratory flow rates and velocity, greatly impacting an elderly persons ability to generate the forces essential for cough. This study examined the effects of a 4-week expiratory muscle strength training (EMST) program on maximum expiratory pressure (MEP) and cough function in 18 healthy but sedentary elderly adults. MEP significantly increased after the EMST program from 77.14+/-20.20 to 110.83+/-26.11cmH(2)O. Parameters measured during reflexive coughs produced by capsaicin challenge, indicated that compression phase duration significantly decreased (from 0.35+/-0.19 to 0.16+/-0.17s), peak expiratory flow rate decreased (from 4.98+/-2.18 to 8.00+/-3.05l/s) and post-peak plateau integral amplitude significantly increased (from 3.49+/-2.46 to 6.83+/-4.16l/ss) with the EMST program. EMST seems to be an effective program to increase the expiratory muscle strength in the sedentary elderly, which contribute to an enhanced cough function.

An Aerodynamic and Acoustic Analysis of the Breathy Voice of Thyroidectomy Patients

Thyroidectomy patients may have vocal paralysis or paresis, resulting in a breathy voice. The aim of this study was to investigate the aerodynamic and acoustic characteristics of a breathy voice in thyroidectomy patients. Thirty-five subjects who have vocal paralysis after thyroidectomy participated in this study. According to perceptual judgements by three speech pathologists and one phonetic scholar, subjects were divided into two groups: breathy voice group (n

Detection of voice changes due to aspiration via acoustic voice analysis

OBJECTIVE Aspiration can occur during swallowing. The present study investigated the feasibility of identifying aspiration risk (AR) via acoustic voice parameters. MATERIALS AND METHODS In total, 165 patients scheduled for a videofluoroscopic swallowing study (VFSS) were included. The patients were divided into two groups (AR and non-AR) based on their VFSS results. The AR group, which had ingested materials on or below the vocal folds, included 59 patients (42 males and 17 females). The non-AR group, which showed normal swallowing, included 106 patients (49 males and 57 females). The major cause of swallowing disorders was a stroke. A sustained vowel/a/for at least 3s was recorded before and after swallowing. Eight acoustic voice parameters were measured using PRAAT, including fundamental frequency, standard deviation of F0, jitter, relative average perturbation (RAP), shimmer, amplitude perturbation quotient (APQ), harmonic-to-noise ratio (HNR), and noise-to-harmonic ratio (NHR). Changes in each acoustic voice parameter before and after the VFSS were compared between the two groups with a repeated-measures mixed analysis of variance. RESULTS Only RAP showed a statistically significant interaction between group (non-AR and AR) and time (pre- and post-swallowing; p=0.030). RAP decreased after swallowing in the AR group; however, it increased in the non-AR group. Jitter and NHR increased in the non-AR group but decreased in the AR group after swallowing, but the difference was not statistically significant. CONCLUSIONS Our results suggest that the accumulation of pasty food in the vocal folds may modify vocal fold vibration and change voice quality in patients with penetration/aspiration. Several acoustic voice parameters, especially jitter, RAP, and NHR, were affected by AR. Thus, acoustic voice analysis may be helpful in making a diagnosis of AR as a supplementary tool for standard swallowing study including VFSS or fiberoptic examination.

Comparison of Acoustic Characteristics of Vowel and Stops in 3, 4 year-old Normal Hearing Children According to Parents` Deafness: Preliminary Study

The purpose of this study was to investigate how deaf parents influence the speech sounds of their normal-hearing children. Twenty four normal hearing children of deaf adults (CODA) and normal hearing parents (NORMAL) aged 3 to 4 participated in the study. The F1, F2, and the vowel triangle area in 7 vowels and the voice onset times (VOTs) and closure durations in 9 stops were measured. The results of the study are as follows. First, the F1 and F2 for all vowels were higher and the vowel triangle area was larger in CODA than in NORMAL although they were not statistically significant. Second, VOTs in for and in for , , and were longer in CODA than in NORMAL. Most stops in CODA appeared to be longer VOTs for most phonemes. Third, the manner and place of articulation in stops did not make a difference between CODA and NORMAL in VOTs and closed durations. CODA does not demonstrate the speech characteristics of deaf people, however, they seem to speak differently than NORMAL, which means CODA might be influenced by a different linguistic environment created by deaf parents in some way.