Longitudinal Investigation of Factors Impacting the Development and Rehabilitation of Phonotrauma

影响声音外伤发生和康复的因素的纵向调查

• 批准号: 10738690
• 负责人: Laura Elizabeth Toles
• 金额: $ 18.09万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-14 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738690
• 关键词: Address; Adherence; Affect; Ambulatory Monitoring; Behavior; Behavioral; Benign; Decision Making; Development; Diagnosis; Disease; Dose; Early identification; Emotional Stress; Equipment and supply inventories; Etiology; Frequencies; Funding; Goals; Grain; Impulsivity; Individual; Investigation; Knowledge; Larynx; Lesion; Life; Literature; Measurement; Measures; Mediating; Methods; Monitor; Music; Nodule; Participant; Pathology; Patients; Pattern; Personality; Personality Assessment; Personality Traits; Personality inventories; Phase; Play; Polyps; Prevention; Procedures; Production; Prognosis; Recommendation; Recovery; Rehabilitation therapy; Research; Research Methodology; Risk; Risk Assessment; Risk Taking; Role; Signal Transduction; Social Dominance; Speed; Statistical Data Interpretation; Therapeutic; Time; Training; Voice; Voice Disorders; Work; career; clinically relevant; cohort; college; experience; high risk population; improved; improved outcome; kinematics; longitudinal analysis; pressure; prevent; programs; prospective; psychosocial; response; risk mitigation; skills; sound; stem; trait; vocal cord; voice therapy

PROJECT SUMMARY / ABSTRACT Voice behavior in daily life is assumed to be a primary factor in the development and persistence of phonotrauma (e.g., vocal fold nodules, polyps, etc.), which is one of the most prevalent behavioral voice disorders. The shortage of prospective, longitudinal investigations into the ambulatory voice behaviors in high-risk individuals limits the differentiation between factors that are causative versus compensatory to phonotrauma, and therefore impacts optimal risk-assessment, mitigation, and therapeutic decision-making. Recent work has found that individuals with phonotrauma had higher levels of personality traits related to social dominance and impulsivity and higher speaking vocal doses and increased speaking vocal intensity during voice use in daily life. Individuals without current vocal pathology had strong relationships between those same personality traits and vocal behaviors, suggesting that personality traits and speaking voice use in daily life could be robust factors in the development of phonotrauma and could play a role in the prognosis for recovery. The primary objective of this project is to determine the enduring role that personality traits and daily voice use have on the development of phonotrauma, changes in vocal fold kinematics, and on the ability to change damaging vocal behavior using prospective, longitudinal methods. Aim 1 seeks to identify personality and vocal behavior factors involved in the development of phonotrauma. This will be achieved through initial assessment using a personality trait inventory, ambulatory voice monitoring, and laryngeal assessment via high-speed videoendoscopy of vocally asymptomatic singers who are freshmen in a college voice concentration music program. We will conduct these assessment procedures bi-annually, beginning in the singer’s freshman year and ending at the conclusion of their junior year. Aim 2 will assess which ambulatory and vocal fold kinematic parameters are the most predictive of phonotrauma. Aim 3 will investigate the impact that personality has on compliance with therapeutic/behavioral recommendations in daily life through personality assessment and ambulatory monitoring before and after participation in voice therapy. These studies will be the first to use ambulatory monitoring to (1) prospectively observe factors related to the development of phonotrauma and (2) measure the impact that personality traits have on the ability to change individual vocal behaviors. It will also be the first to use high-speed videoendoscopy to observe development of phonotrauma over time. This project will support advancement of the PI’s long-term career objective, which is to implement a program that uses psychosocial and behavioral factors to improve the prevention and treatment of phonotrauma in high-risk populations. This career objective can only be achieved with adequate training in longitudinal research methods, advanced statistical analyses, and acquisition and analysis of high-speed videoendoscopy. Results from this study will build a framework to ultimately improve early identification of phonotrauma risk, develop risk mitigation strategies, and inform treatment approaches.

项目总结/摘要 日常生活中的语音行为被认为是语音创伤发展和持续的主要因素 (e.g.,声带小结、息肉等），这是最常见的行为性嗓音障碍之一。的 缺乏对高危人群动态嗓音行为的前瞻性、纵向研究 限制了对声音创伤的原因性因素与补偿性因素之间的区别，因此 影响最佳的风险评估、缓解和治疗决策。最近的研究发现， 语音创伤的个体具有更高水平的与社会支配和冲动相关的人格特质 以及在日常生活中使用声音时更高的说话声音剂量和增加的说话声音强度。个人 没有目前的声乐病理有很强的关系，这些相同的人格特质和声乐 行为，这表明个性特征和日常生活中说话的声音使用可能是影响 发展的声音创伤，并可能发挥作用的预后恢复。这项工作的主要目的是 项目是确定人格特质和日常语音使用对发展的持久作用， 声创伤，声带运动学的变化，以及使用 前瞻性纵向研究方法目的1旨在确定人格和声乐行为的因素参与了 语音创伤的发展。这将通过使用人格特质清单进行初步评估来实现， 动态语音监测，并通过高速视频内窥镜进行喉部评估， 无症状的歌手，他们是大学声音集中音乐课程的新生。我们将进行这些 评估程序每两年进行一次，从歌手的大一开始，到结束。 大三的时候目标2将评估哪些动态和声带运动学参数是最具预测性的 声音创伤目标3将调查人格对治疗/行为依从性的影响 通过性格评估和前后的动态监测， 参与声音治疗。这些研究将是第一个使用动态监测来（1）前瞻性 观察与语音创伤发展相关的因素;（2）测量人格特质对语音创伤发展的影响， 改变个体发声行为的能力。它也将是第一个使用高速视频内窥镜的医院 以观察随着时间的推移声创伤的发展。该项目将支持PI的长期发展 职业目标，这是实施一项计划，利用心理和行为因素，以提高 预防和治疗高危人群的声音创伤。这个职业目标只有在 在纵向研究方法、先进的统计分析和采集方面受过充分的培训， 高速视频内窥镜分析这项研究的结果将建立一个框架，以最终改善早期 识别声音创伤风险，制定风险缓解策略，并提供治疗方法。