A Study of Ventilatory Homeostasis and Phonatory Behavior During Aerobic Exercise

有氧运动中通气稳态和发声行为的研究

• 批准号: 8454075
• 负责人: Aaron Scott Ziegler
• 金额: $ 3.12万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2013-01-22
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8454075
• 关键词: Acoustics; Activities of Daily Living; Address; Adult; Aerobic; Aerobic Exercise; Affect; Air; Area; Athletic; Behavior; Blood gas; Breathing; Carbon Dioxide; Child; Clinical Research; Communication; Competence; Dancing; Data; Development; Employment; Energy Transfer; Environmental air flow; Evaluation; Exercise; Fire - disasters; Frequencies; Future; Gases; Goals; Homeostasis; Human; Impairment; Individual; Injury; Investigation; Knowledge; Laboratories; Laryngeal Injury; Larynx; Law Enforcement; Literature; Maintenance; Measures; Mechanics; Metabolic; Military Personnel; Occupations; Output; Oxygen Consumption; Phonation; Physical Education; Police; Police officer; Population; Production; Quality of life; Reading; Regulation; Rehabilitation therapy; Research; Respiratory physiology; Rest; Risk; Safety; Series; Source; Speech; Stress; Suggestion; Tidal Volume; Tissues; Training; Voice; Workload; experience; expiration; fitness; glottis; human subject; impression; instructor; interest; meetings; phrases; physical model; physiologic stressor; pressure; primary outcome; respiratory; secondary outcome; sound; teacher; vocal cord; vocalization

DESCRIPTION (provided by applicant): The prevailing model of physical injury indicates the primary traumatic agent in injury is the transfer of energy in amounts exceeding local tissue thresholds. Of interest for the present study is mechanical energy transfer in vocal fold (VF) injury during phonation. One important source of such injury is perpendicular VF impact stress (force/area), which in turn is partially regulated by VF adduction and phonatory subglottal pressure (PS) [32, 33]. A gap in the literature, which this project addresses, regards the effects of high respiratory drive (HRD) - i.e., increased ventilation due to blood-gas level changes during aerobic activity [1] - on adduction and PS, and thus VF injury risk in human subjects. Of particular interest are individuals required to phonate loudly during aerobic activity (HRD), such as military drill instructors, firefighters, physical education teachers, and others. Existing data indicate that when voice output is free to vary under HRD, expiratory flow increases [22, 24], presumably in conjunction with relatively abducted vocal folds. Thus, the risk of injury should be minimal. However, data indicate individuals in the foregoing occupations actually have elevated risk for phonotrauma [2-12], which is thought to be associated with increased VF adduction, PS and impact stress. The general hypothesis pursued in this study is that in a laboratory setting requiring loud voice during HRD, VF adduction as well as estimated PS will increase rather than decrease, thus increasing the risk of VF injury. Further, respiratory homeostasis (maintenance of optimum blood-gas concentrations), as measured by minute ventilation and blood-gas levels, will be compromised in that scenario. Conversely, when voice output is free to vary under HRD, respiratory homeostasis will be better preserved, but voice output will be compromised, as measured by decreased adduction and PS, thus decreasing injury risk. Stated differently, this project investigates a proposed competition between the vocal folds' function as a gateway to blood-gas regulation versus oscillating sound source. The study utilizes a physiologic stressor, aerobic exercise, to investigate laryngeal behavior during HRD as a window into the mechanisms of phonotrauma in physically active voice users. Specific Aims are: SA 1: To investigate the influence of (a) vocal goal and (b) exercise workload on respiratory function. The hypothesis is that "loud" phonation will disproportionately interfere with ventilatory homeostasis during an aerobic exercise challenge as compared with "spontaneous" phonation. SA 2: To investigate the influence of (a) vocal goal and (b) exercise workload on laryngeal function. The hypothesis is that with increasing HRD, "loud" phonation will result in a disproportional increase in VF adduction and estimated PS, and thus injury risk, compared to "spontaneous" phonation. The project's significance lies with its investigation of mechanisms of VF injury in general and of occupationally induced VF injury associated with HRD in particular. PUBLIC HEALTH RELEVANCE: The proposed research will characterize the effects of aerobic activity, a physiologic stressor, and vocal goal on respiratory and laryngeal function using non-invasive measures in human subjects. The knowledge gained from this research will guide the development of future large-scale clinical studies to elucidate the effects of different approaches to vocal and cardiorespiratory training in the rehabilitation of physically active voice users with voice problems.

描述（由申请人提供）：体外损伤的主要模型表明受伤中的主要创伤药是能量的转移，其量超过了局部组织阈值。本研究感兴趣的是发声过程中声带（VF）损伤中的机械能传递。这种损伤的一个重要来源是垂直VF撞击应力（力/面积），进而由VF内收和语音次数下压力（PS）部分调节[32，33]。该项目解决的文献差距是高呼吸驱动器（HRD）的影响 - 即有氧活性期间血液气水平变化引起的通气增加[1]对内收和PS，因此人类受试者的VF损伤风险。特别有趣的是在有氧活动（HRD）（例如军事演习教练，消防员，体育老师等）中大声调音所需的人。现有数据 表明当语音输出在HRD下自由变化时，呼气流量会增加[22，24]，大概与相对绑架的声带相结合。因此，受伤的风险应该很小。但是，数据表明，上述职业中的个体实际上具有较高的Phonotrauma风险[2-12]，这被认为与增加的VF内收，PS和撞击应力有关。这项研究中提出的一般假设是，在实验室环境中，在HRD期间需要大声的声音，VF内收并估计的PS会增加而不是减少，从而增加了VF损伤的风险。此外，在这种情况下，通过微小通气和血液气体水平来衡量的呼吸稳态（维持最佳血液浓度）将受到损害。相反，当语音输出在HRD下自由变化时，呼吸稳态将得到更好的保存，但是通过减少和PS来衡量，语音输出将受到损害，从而降低了损伤风险。换句话说，该项目调查了声带的功能之间提出的竞争，这是通往血液气体调节的门户与振荡声源。这项研究利用生理压力源，有氧运动来研究HRD期间的喉行为，作为在物理上活跃的语音使用者中使用Phonotrauma机制的窗口。具体目的是：SA 1：研究（a）人声目标和（b）锻炼工作量对呼吸功能的影响。假设是，与“自发”发音相比，在有氧运动挑战期间，“响亮”的发音会不成比例地干扰通气稳态。 SA 2：研究（a）声音目标和（b）锻炼工作量对喉功能的影响。假设是，随着HRD的增加，与“自发”发音相比，随着HRD的增加，“响亮”的发音将导致VF内收和估计的PS，从而造成损伤风险的不可估量增加。该项目的意义在于其对VF伤害机制的调查，总体上和 尤其是与HRD相关的职业诱导的VF损伤。 公共卫生相关性：拟议的研究将表征有氧活性，生理压力源以及人声目标对呼​​吸和喉部功能的影响，并使用人类受试者中的非侵入性测量方法。从这项研究中获得的知识将指导未来大规模临床研究的发展，以阐明不同方法的影响 与声音和心肺训练一起恢复身体活跃的语音使用者 语音问题。