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ORIGINAL RESEARCH

Investigation of Voice Change in Stroke Individuals in the Subacute Period Compared to the Acute Period
İnme Geçiren Bireylerin Subakut Dönemde Akut Döneme Göre Ses Değişiminin İncelenmesi
Received Date : 18 Sep 2023
Accepted Date : 02 Oct 2023
Available Online : 06 Oct 2023
Doi: 10.24179/kbbbbc.2023-99536 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2023;31(4):213-22.
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study was to compare the results of voice assessment in stroke survivors with the results of voice assessment in the subacute period and to examine spontaneous voice changes. Material and Methods: The study was carried out with 37 (22 males, 15 females) individuals with a mean age of 66,65±9,63 years. Acoustic and aerodynamic voice assessments [maximum phonation time (MPT) and s/z ratio] were performed. Voice Handicap Index- 10 (VHI-10), and Voice-Related Quality of Life (V-RQOL) were applied. All assessments were performed within 1 week and 1 month after the stroke. Results: MPT was 6.279±3.544 in the acute period and 7.461±4.875 in the subacute period. There was no statistically significant difference in aerodynamic measurement results or V-ROQL in the subacute period compared to the acute period (p>0.05). The fundamental frequency value increased statistically significantly in women, men, and all participants. VHI-10 decreased statistically significantly (p<0.05) in all participants. Conclusion: To the best of our knowledge, this is the first study to evaluate the voice of stroke patients in the acute phase using both subjective and objective methods. It was found that the MPT of stroke patients was limited, and the Shimmer values of acoustic parameters were above normal limits. In the subacute phase, it was observed that phonation durations were still low and Shimmer values tended to increase. Therefore, acoustic, aerodynamic, and specific voice evaluations, especially maximum phonation durations, should be performed in stroke patients in the acute period.
ÖZET
Amaç: Bu çalışmanın amacı, inme geçiren hastalarda ses değerlendirme sonuçlarını subakut dönemdeki ses değerlendirme sonuçları ile karşılaştırmak ve spontan ses değişikliklerini incelemektir. Gereç ve Yöntemler: Çalışma yaş ortalaması 66,65±9,63 yıl olan 37 (22 erkek, 15 kadın) birey ile gerçekleştirildi. Akustik ve aerodinamik ses değerlendirmeleri [maksimum fonasyon süresi (MFS) ve s/z oranı] yapıldı. Ses Handikap İndeksi-10 [Voice Handicap Index-10 (VHI-10)] ve Sesle İlgili Yaşam Kalitesi Ölçeği (SİYKÖ) uygulandı. Tüm değerlendirmeler hastalar inme geçirdikten 1 hafta içinde ve 1 ay sonraki dönemde tekrar yapıldı. Bulgular: MFS akut dönemde 6,279±3,544 ve subakut dönemde 7,461±4,875 idi. Akut döneme kıyasla subakut dönemde aerodinamik ölçüm sonuçlarında veya SİYKÖ’de istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Temel frekans değeri kadınlarda, erkeklerde ve tüm katılımcılarda istatistiksel olarak anlamlı şekilde arttı. Tüm katılımcılarda VHI-10 istatistiksel olarak anlamlı şekilde azaldı (p<0,05). Sonuç: Bildiğimiz kadarıyla bu çalışma, akut fazda inme hastalarının sesini hem subjektif hem de objektif yöntemler kullanarak değerlendiren ilk çalışmadır. İnme hastalarının maksimum fonasyon süresinin sınırlı olduğu ve akustik parametrelerin Shimmer değerlerinin normal sınırların üzerinde olduğu bulunmuştur. Subakut fazda ise fonasyon sürelerinin hâlâ düşük olduğu ve Shimmer değerlerinin artma eğiliminde olduğu görülmüştür. Bu nedenle akut dönemde, inme hastalarında başta maksimum fonasyon süreleri olmak üzere akustik, aerodinamik ve spesifik ses değerlendirmeleri yapılmalıdır.
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