시각적 피드백을 활용한 양압치료가 연인두 폐쇄부전 아동의 과대비성 감소에 미치는 효과 An Effect of Continuous Positive Airway Pressure Therapy utilizing Visual Feedback on Reduction of Hypernasality of Children with Velopharyngeal Incompetence.원문보기
본 연구는 시각적 피드백을 활용한 양압치료가 연인두 폐쇄부전 아동의 과대비성 감소에 미치는 효과를 알아보고자 실시하였다. 대상자는 인두피판술을 받은 후 과대비성 문제를 지닌 구개열 아동으로, 만 6∼8세 총 12명을 선정하였다. 실험은 1주에 3회씩 8주 동안 실시하였다. 양압치료는 공기 압력을 4.0cmH2O로하여 공기 압력이 분출되는 동안 과비음 치료 문형을 10분씩 반복적으로 읽도록 하였으며, 매주마다 0.5cmH2O씩 압력을 감소시키면서 치료하였다. 문형을 읽을 때 과대비성이 감소하고 있는 ...
본 연구는 시각적 피드백을 활용한 양압치료가 연인두 폐쇄부전 아동의 과대비성 감소에 미치는 효과를 알아보고자 실시하였다. 대상자는 인두피판술을 받은 후 과대비성 문제를 지닌 구개열 아동으로, 만 6∼8세 총 12명을 선정하였다. 실험은 1주에 3회씩 8주 동안 실시하였다. 양압치료는 공기 압력을 4.0cmH2O로하여 공기 압력이 분출되는 동안 과비음 치료 문형을 10분씩 반복적으로 읽도록 하였으며, 매주마다 0.5cmH2O씩 압력을 감소시키면서 치료하였다. 문형을 읽을 때 과대비성이 감소하고 있는 비성도 그래프를 실시간으로 제공하였다. 또한, 과대비성의 객관적인 수치를 평가하기 위해 Nasometer II를 사용하였으며, 비성도 평가 문형은 단순 지속 모음 /아, 이, 우/와 비강 자음을 전혀 포함하지 않은 문장이었다. 본 연구의 결과는 다음과 같았다. 첫째, 시각적 피드백을 활용한 양압치료와 일반 양압치료를 통해 비성도의 변화에 대해 알아본 결과 /아/ 발성시 일반 양압치료는 6% 감소하였으며, 시각적 피드백을 활용한 양압치료는 11% 감소하였다. /이/ 발성시 일반 양압치료는 7% 감소하였으며, 시각적 피드백을 활용한 양압치료는 18% 감소하였다. /우/ 발성시 일반 양압치료는 5% 감소하였으며, 시각적 피드백을 활용한 양압치료는 9% 감소하였다. 무비성 문장 발성시 일반 양압치료는 11% 감소하였으며, 시각적 피드백을 활용한 양압치료는 14% 감소하였다. 둘째, 시각적 피드백을 활용한 양압치료 집단과 일반 양압치료 집단의 치료 효과를 비교분석한 결과, /아/ 발성시 일반 양압치료 집단은 6.6% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 11.4% 감소하였다. /이/ 발성시 일반 양압치료 집단은 7% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 18% 감소하였다. /우/ 발성시 일반 양압치료 집단은 4.8% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 8.5% 감소하였다. 무비성 문장 발성시 일반 양압치료 집단은 11.5% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 14.1% 감소하였다. 본 연구를 실시한 결과, 일반 양압치료보다 시각적 피드백을 활용한 양압치료가 과대비성을 감소시키는데 더 효과적인 것으로 결론을 얻었다. 일반 양압치료법과 비교하여 시각적 피드백을 활용한 양압치료법은 양압을 통해 연인두 근육의 저항력을 직접적으로 강화시켜주는 동시에 구어 산출 시 즉각적으로 나타나는 결과에 대해 시각적으로 피드백을 받음으로써 동기 유발이 주어지기 때문에 과대비성 감소에 더 효과적인 결과를 보였을 것으로 추정된다.
본 연구는 시각적 피드백을 활용한 양압치료가 연인두 폐쇄부전 아동의 과대비성 감소에 미치는 효과를 알아보고자 실시하였다. 대상자는 인두피판술을 받은 후 과대비성 문제를 지닌 구개열 아동으로, 만 6∼8세 총 12명을 선정하였다. 실험은 1주에 3회씩 8주 동안 실시하였다. 양압치료는 공기 압력을 4.0cmH2O로하여 공기 압력이 분출되는 동안 과비음 치료 문형을 10분씩 반복적으로 읽도록 하였으며, 매주마다 0.5cmH2O씩 압력을 감소시키면서 치료하였다. 문형을 읽을 때 과대비성이 감소하고 있는 비성도 그래프를 실시간으로 제공하였다. 또한, 과대비성의 객관적인 수치를 평가하기 위해 Nasometer II를 사용하였으며, 비성도 평가 문형은 단순 지속 모음 /아, 이, 우/와 비강 자음을 전혀 포함하지 않은 문장이었다. 본 연구의 결과는 다음과 같았다. 첫째, 시각적 피드백을 활용한 양압치료와 일반 양압치료를 통해 비성도의 변화에 대해 알아본 결과 /아/ 발성시 일반 양압치료는 6% 감소하였으며, 시각적 피드백을 활용한 양압치료는 11% 감소하였다. /이/ 발성시 일반 양압치료는 7% 감소하였으며, 시각적 피드백을 활용한 양압치료는 18% 감소하였다. /우/ 발성시 일반 양압치료는 5% 감소하였으며, 시각적 피드백을 활용한 양압치료는 9% 감소하였다. 무비성 문장 발성시 일반 양압치료는 11% 감소하였으며, 시각적 피드백을 활용한 양압치료는 14% 감소하였다. 둘째, 시각적 피드백을 활용한 양압치료 집단과 일반 양압치료 집단의 치료 효과를 비교분석한 결과, /아/ 발성시 일반 양압치료 집단은 6.6% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 11.4% 감소하였다. /이/ 발성시 일반 양압치료 집단은 7% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 18% 감소하였다. /우/ 발성시 일반 양압치료 집단은 4.8% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 8.5% 감소하였다. 무비성 문장 발성시 일반 양압치료 집단은 11.5% 감소하였으며, 시각적 피드백을 활용한 양압치료 집단은 14.1% 감소하였다. 본 연구를 실시한 결과, 일반 양압치료보다 시각적 피드백을 활용한 양압치료가 과대비성을 감소시키는데 더 효과적인 것으로 결론을 얻었다. 일반 양압치료법과 비교하여 시각적 피드백을 활용한 양압치료법은 양압을 통해 연인두 근육의 저항력을 직접적으로 강화시켜주는 동시에 구어 산출 시 즉각적으로 나타나는 결과에 대해 시각적으로 피드백을 받음으로써 동기 유발이 주어지기 때문에 과대비성 감소에 더 효과적인 결과를 보였을 것으로 추정된다.
This study was performed in order to explore an effect of continuous positive airway pressure therapy utilizing visual feedback on reduction of hypernasality of children with velopharyngeal incompetence. The subjects of this experiment were children with cleft palate having a problem of hypernasalit...
This study was performed in order to explore an effect of continuous positive airway pressure therapy utilizing visual feedback on reduction of hypernasality of children with velopharyngeal incompetence. The subjects of this experiment were children with cleft palate having a problem of hypernasality after having undergone pharyngeal flap surgery and total 12 children aged full 6-8 years old were selected. Experiment was performed for 8 weeks based on 3 times a week. In CPAP therapy focusing on reinforcing velopharyngeal closing muscle by sending certain amount of air flow to nasal cavity while children with cleft palate are speaking, the subjects were directed to read sentence pattern for hypernasality therapy repeatedly every 10 minutes while air pressure set at 4.0cmH2O is gushed out and therapeutic procedure was performed by reducing air pressure by 0.5cmH2O. Nasalance gragh in which hypernasality is reduced when reading sentence pattern was provided in real time. In addition, in order to evaluate objective value of hypernasality, Nasometer II was used and sentence pattern evaluating nasalance did not include /a, i, u/ which were simple sustained vowels and nasal consonant at all. The result of this study is as follows: First, as a result of investigating change of nasalance through continuous positive airway pressure therapy utilizing visual feedback and general CPAP therapy, at the time of vocalization of /a/ sound, general CPAP therapy was reduced by 6% and CPAP therapy utilizing visual feedback was reduced by 11%. At the time of vocalization of /i/ sound, general CPAP therapy was reduced by 7% and CPAP therapy utilizing visual feedback was reduced by 18%. At the time of vocalization of /u/ sound, general CPAP therapy was reduced by 5% and CPAP therapy utilizing visual feedback was reduced by 9%. At the time of vocalization of non-nasalance sentence, general CPAP therapy was reduced by 11% and CPAP therapy utilizing visual feedback was reduced by 14%. Second, as a result of comparative analysis for therapeutic effects of CPAP therapy group utilizing visual feedback and general CPAP therapy group, at the time of vocalization of /a/ sound, general CPAP therapy group was reduced by 6.6% and CPAP therapy group utilizing visual feedback was reduced by 11.4%. At the time of vocalization of /i/ sound, general CPAP therapy was reduced by 7% and CPAP therapy group utilizing visual feedback was reduced by 18%. At the time of vocalization of /u/ sound, general CPAP therapy group was reduced by 4.8% and CPAP therapy group utilizing visual feedback was reduced by 8.5%. At the time of vocalization of non-nasalance, general CPAP therapy group was reduced by 11.5% and CPAP therapy group utilizing visual feedback was reduced by 14.1%. As a result of this study, it was concluded that CPAP therapy utilizing visual feedback was more effective in reducing hypernasality than general CPAP therapy. It is assumed that comparing with general CPAP therapy, as CPAP therapy utilizing visual feedback directly reinforces resistance of velopharyngeal muscle through positive airway pressure and is motivated as it visually receives feedback for the result being immediately represented at the time of speech production at the same time, it may represent more effective result for the reduction of hypernasality.
This study was performed in order to explore an effect of continuous positive airway pressure therapy utilizing visual feedback on reduction of hypernasality of children with velopharyngeal incompetence. The subjects of this experiment were children with cleft palate having a problem of hypernasality after having undergone pharyngeal flap surgery and total 12 children aged full 6-8 years old were selected. Experiment was performed for 8 weeks based on 3 times a week. In CPAP therapy focusing on reinforcing velopharyngeal closing muscle by sending certain amount of air flow to nasal cavity while children with cleft palate are speaking, the subjects were directed to read sentence pattern for hypernasality therapy repeatedly every 10 minutes while air pressure set at 4.0cmH2O is gushed out and therapeutic procedure was performed by reducing air pressure by 0.5cmH2O. Nasalance gragh in which hypernasality is reduced when reading sentence pattern was provided in real time. In addition, in order to evaluate objective value of hypernasality, Nasometer II was used and sentence pattern evaluating nasalance did not include /a, i, u/ which were simple sustained vowels and nasal consonant at all. The result of this study is as follows: First, as a result of investigating change of nasalance through continuous positive airway pressure therapy utilizing visual feedback and general CPAP therapy, at the time of vocalization of /a/ sound, general CPAP therapy was reduced by 6% and CPAP therapy utilizing visual feedback was reduced by 11%. At the time of vocalization of /i/ sound, general CPAP therapy was reduced by 7% and CPAP therapy utilizing visual feedback was reduced by 18%. At the time of vocalization of /u/ sound, general CPAP therapy was reduced by 5% and CPAP therapy utilizing visual feedback was reduced by 9%. At the time of vocalization of non-nasalance sentence, general CPAP therapy was reduced by 11% and CPAP therapy utilizing visual feedback was reduced by 14%. Second, as a result of comparative analysis for therapeutic effects of CPAP therapy group utilizing visual feedback and general CPAP therapy group, at the time of vocalization of /a/ sound, general CPAP therapy group was reduced by 6.6% and CPAP therapy group utilizing visual feedback was reduced by 11.4%. At the time of vocalization of /i/ sound, general CPAP therapy was reduced by 7% and CPAP therapy group utilizing visual feedback was reduced by 18%. At the time of vocalization of /u/ sound, general CPAP therapy group was reduced by 4.8% and CPAP therapy group utilizing visual feedback was reduced by 8.5%. At the time of vocalization of non-nasalance, general CPAP therapy group was reduced by 11.5% and CPAP therapy group utilizing visual feedback was reduced by 14.1%. As a result of this study, it was concluded that CPAP therapy utilizing visual feedback was more effective in reducing hypernasality than general CPAP therapy. It is assumed that comparing with general CPAP therapy, as CPAP therapy utilizing visual feedback directly reinforces resistance of velopharyngeal muscle through positive airway pressure and is motivated as it visually receives feedback for the result being immediately represented at the time of speech production at the same time, it may represent more effective result for the reduction of hypernasality.
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