Effects of Lax Vox Voice Therapy on Respiration and Phonation in Patients with Parkinson’s Disease

배경 및 목적: 파킨슨병은 운동기능에 영향을 미치는 중추신경계의 퇴행성 질환으로 자신의 음성을 자가 모니터링을 하지 못하여 음성의 강도와 음도 조절에 어려움을 보이는 감각장애이다. 반폐쇄성도훈련 중 Lax Vox는 튜브를 물에 넣어 발성하는 것으로 호흡, 공명, 발성의 상호작용에 초점을 맞추어 bio-feedback을 제공하는 총체적인 기법이다. 본 연구는 Lax Vox 음성치료가 파킨슨병 환자의 호흡 및 발성에 미치는 영향을 알아보고자 한다. 방법: 파킨슨병 환자 10명(남자 4명, 여자 6명)을 대상으로 Lax Vox 음성치료를 주 1회 간격으로 6주간 총 6회 실시하였다. 치료효과를 살펴보기 위해 음성치료 전후 공기역학적, 음향학적, 청지각적 평가, 전기성문파형 검사 및 한국어판 음성장애지수-10을 실시하였다. 결과: 음성치료 후 공기역학적, 음향학적 및 청지각적 평가 측정치와 음성장애지수가 유의하게 개선되었다. 특히, 폐활량, 음성 강도, 최대발성지속시간이 증가하였으며, 성문하압이 유의미하게 감소하였다. CPP와 음성범위프로파일, 발화 시 평균 강도가 유의하게 증가하였으며, sPPQ, vF0, shimmer, APQ, sAPQ, vAm가 감소하고, 한국어판 음성장애지수-10의 총점이 낮아졌다. 논의 및 결론: Lax Vox 음성치료는 파킨슨병 환자의 호흡 및 발성 능력에 긍정적인 효과가 있음을 확인하였으며, LSVT와 더불어 Lax Vox 음성치료는 파킨슨병 환자의 효과적인 치료법이 될 수 있음을 시사하였다.

Objectives: Parkinson’s disease (PD) is a degenerative disease of the central nervous system that mainly affects sensory and motor function. PD patients have difficulty in controlling their vocal pitch and loudness, and poor self-monitoring due to their sensory disorder. Among semi-occluded vocal tract exercises, Lax Vox is a holistic method that provides bio-feedback by focusing on the interaction of breathing, resonance, and phonation by tube phonation in water. The purpose of this study was to investigate the effect of Lax Vox voice therapy on respiration and phonation in patients with PD. Methods: Ten patients with PD (4 males and 6 females) underwent Lax Vox voice therapy six times a week for 6 weeks. To assess the effectiveness of Lax Vox voice therapy, aerodynamic, acoustic evaluation, GRBAS scale, electroglottography, and Korean Voice Handicap Index (KVHI)-10 were performed before and after voice therapy. Results: Significant improvement in aerodynamic, acoustic, auditory-perceptual rating measures, and KVHI-10 score was yielded following Lax Vox voice therapy. After treatment, significantly increased vital capacity (VC) and maximum phonation time (MPT); and reduced subglottal pressure (Psub) were observed. Cepstral peak prominence (CPP) was significantly increased and smoothed pitch perturbation quotient (sPPQ), vF0, shimmer, amplitude perturbation quotient (APQ), smoothed APQ (sAPQ), peak-amplitude variation (vAm) were significantly decreased after treatment. Moreover, Voice Range Profile (VRP) was extended and KVHI-10 scored significantly lower. Conclusion: Current outcomes confirmed that significantly positive effects were found in respiration and phonation change following Lax Vox voice therapy for patients with PD. Therefore, Lax Vox voice therapy, in addition to Lee Silverman Voice Treatment, can be useful for an effective treatment option in patients with PD.