Throat Clearing, Coughing, and Alternative Behaviors

摘要 慢性清仓行为在整个人群中很普遍 有嗓音障碍。清喉和咳嗽被认为是对人的辱骂。 并且通常是在声音治疗期间被减少的目标。这些虐待行为包括 通常取而代之的是较少的滥用清理动作，包括：软性喉咙清理， 无声咳嗽，吞咽困难，吞咽困难，并有液体丸剂。尽管流行率 清算行为和减少该行为的使用的方法是众所周知的， 关于这些行为的“危害性”及其危害，缺乏科学证据。 与水合作用的关系。同样，还没有完成调查的研究 向患者传授替代技术作为代偿策略。另外， 清除粘液的有害行为和替代行为的有效性 而如何让患者从这种感觉中解脱出来仍是未知的。 这项研究的长期目标是确定特定药物的疗效 嗓音障碍患者的发声卫生治疗的组成部分 提高处理效率。提议开始实现的具体目标有两个 这是一个长期目标。第一个目标是比较生物力学、生理成分 发声、发声、软喉清、硬喉清、无声咳嗽、硬咳 在正常语音的参与者内部和之间咳嗽。这一目标将集中在内部 受试者在这些行为中的平均速度差异。第二个目标是 比较粘液聚集和感觉清除前后的评分 六清中，软喉清、硬喉清、无声咳、硬 咳嗽，用力吞咽，用力吞咽，并用液体丸剂。这两个目标的结果都将是 与补水措施有关。这些目标将通过一个研究计划来实现 利用频闪检查、高速视频内窥镜和新的图像处理 技巧。普通话人士和嗓音障碍者将参加 这项研究允许进行比较。预计这项研究的结果 将通过增加我们对行为的普遍了解而与公共健康相关 与嗓音病理有关。这项研究的结果应该提供更多的 与病人护理方法直接相关的知识。叙述性 408万名嗓音障碍患者习惯使用 滥用清算行为，这被认为是最普遍的 发声虐待，并与造成声带损伤有关。通过利用数字高速 视频内窥镜、频闪检查、水合分析和图像分析技术，这 研究将提供有关声带动力学和运动学的客观数据 与这些行为相关的运动和振动，以及关于替代行为的数据 在声带卫生教育和发声治疗中经常提倡的行为，以及 有害和改善性清理行为与心理健康水平的关系 水合作用。预计这项研究的结果将与公众相关 通过增加我们对通常与声音相关的行为的知识来保持健康 病理学，并与病人护理方法直接相关。

Summary Chronic clearing behaviors are prevalent throughout the population of persons with voice disorders. Throat clearing and coughing have been deemed vocally abusive and are typically targeted to be reduced during voice therapy. The abusive behaviors are commonly replaced with less abuse clearing maneuvers inclusive of: soft throat clear, silent cough, hard swallow, and hard swallow with a fluid bolus. Although the prevalence of clearing behaviors and methods to diminish the use of the behaviors are well-known, there is a lack of scientific evidence as to the 'harmfulness' of these behaviors and their relationship with hydration. Likewise, no research has been accomplished investigating the alternative techniques taught to patients as compensatory strategies. Additionally, the effectiveness of both harmful and alternative clearing behaviors to displace mucus and to provide the patient with relief from the sensation remains unknown. The long-term aim of this research is to determine the efficacy of specific components in vocal hygiene therapy for patients with voice disorders which will increase treatment efficiency. There are two specific aims proposed to begin to reach the long-term goal. The first aim is to compare biomechanical, physiological components of phonation, phonation onset, soft throat clear, hard throat clear, silent cough, and hard cough within and between normophonic participants. This aim will focus on within participant differences of average velocity during these behaviors. The second aim is to compare pre- and post-clearing ratings of mucus aggregation and sensation removal among six clearing behaviors, soft throat clear, hard throat clear, silent cough, hard cough, hard swallow, and hard swallow with a fluid bolus. The result of both aims will be related to hydration measures. The aims will be accomplished through a research plan utilizing stroboscopy, high-speed videoendoscopy, and novel image processing techniques. Normophonic speakers and persons with voice disorders will participate in this research to allow for comparisons. It is expected that the outcome of this research will be relevant to public health by increasing our knowledge of behaviors commonly associated with voice pathology. The results of this study should provide increased knowledge to relate directly to methods of patient care. Narrative Four million and eighty thousand persons with voice disorders use habitual abusive clearing behaviors, which are considered one of the most prevalent forms of vocal abuse and linked to causing vocal fold lesions. By utilizing digital high-speed videoendoscopy, stroboscopy, hydration analysis and image analysis techniques, this research will provide objective data on the dynamics and kinematics of vocal fold movement and vibration associated with these behaviors, as well as data on alternative behaviors often advocated for in vocal hygiene education and voice therapy, and the relationship of both deleterious and ameliorative clearing behaviors with level of hydration. It is expected that the outcome of this research will be relevant to public health by increasing our knowledge of behaviors commonly associated with voice pathology and relating directly to methods of patient care.