• Phonetics and Speech Sciences
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• v.2 no.4
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• pp.165-171
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• 2010

Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT$^{(R)}$, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

• Physical Therapy Korea
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• v.10 no.2
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• pp.85-98
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• 2003

The purpose of this study was to investigate the changes of the activities of daily living (ADL) by the motor learning program for upper extremity in stroke patients. The subjects were sixty-two members who were treated at the department of occupational therapy. The ADL were measured with Functional Independence Measure (FIM). The result's were as fol1ows; 1. The ability to perform daily activities after treatment was significantly increased independent of age, gender, cause, affected side and speech disability (p<.01). The differences between the pre-treatment and the post-treatment was no significant correlation to sex, cause, affected side and duration of treatment, but the speech disability was significant. Therefore the pre-treatment scores and post-treatment scores were significantly different. 2. The variation of the pre-treatment and the post-treatment in the detail item to the performance of daily life of the stroke patients through the upper extremity motor learning program was significantly increased in self-care, sphincter control, locomotion, mobility, communication and social cognition (p<.01) Consequently, The motor learning program for upper extremity significantly improved the performance level of all ADL areas in stroke patients.

• Phonetics and Speech Sciences
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• v.4 no.4
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• pp.147-154
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• 2012

The purpose of this study is to examine the effect of voice improvement when vocal training, which relaxes the vocal contact, is applied to children with vocal nodules. Subjects included 20 5- to 12-year-old boys with vocal nodules in Otolaryngology and for whom voice therapy had been advised. The vocal therapy was conducted for 40 minutes per a week for a total of eight times. Results were evaluated by videostroboscopy, auditory-perceptual evaluation of GRBAS Scale, aerodynamic test, and acoustic analysis before and after therapy. As a result, first, the size of vocal nodules was reduced and the unstable pattern of vocal contact was improved. Glottic closure was increased and Phase symmetry was decreased during vocal vibration. Mucosal wave was increased and muscle tension of the larynx was reduced. Second, auditory-perceptual evaluation showed that subjects' overall quality of voice improved. GRBAS Scale Evaluation showed that the characteristics of the subjects' voice which were rough, breathy, and strained and breathy were reduced after therapy. Third, the measurements of acoustic parameters showed a statistically significant improvement. The fundamental frequency of the subejects' voice was increased and values of Jitter and Shimmer, NHR, [H1-H2] decreased. Fourth, the maximum phonation time of children was increased. These results imply that vocal relaxation training conducted in this study has a very positive effect to improve the voice of children with vocal nodules.

• Speech Sciences
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• v.11 no.4
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• pp.101-120
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• 2004

Vocal nodule is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy. However, the existing therapeutic methods about vocal nodule are in great demand. The purpose of this study was to evaluate the effect of therapeutic methods between Accent method and SK-MVTT (Seong-Tae Kim's multiple voice therapy technique), which was designed by the author. We identified 40 females, who diagnosed having vocal nodules, aged from 21 to 52 years (mean age: 40 years). Twenty females were treated by the SK-MVTT and the other 20 females the Accent method. All subjects received 12 sessions of treatment, and were evaluated after finishing the 6th and the 12th session. The results showed that the SK-MVTT produced a better results compared to the Accent method. The SK-MVTT was better especially at the initial stage of voice therapy compared to the Accent method. In this study, we can suggest that SK-MVTT may be useful in improving the voice qualities of vocal nodule patients. However, more data should be collected and evaluated before it can widely be used in other clinics.

• Phonetics and Speech Sciences
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• v.2 no.2
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• pp.117-121
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• 2010

The This study aimed to evaluate the effects of the voice therapy we operated to the patients with age-related dysphonia. Thirty four participants who were diagnosed as age-related dysphonia in laryngoscopic finding from January, 2009 to December, 2009 completed the study. The participants were aged from 60 to 82 years old with a mean age of 70.6. All participants had received the abdominal breath technique, SKHPIP with laughter, and basic vocal training with description of their problem, the length of which ranged from four sessions to twelve sessions. We executed the videostroboscopy to compare the aspect of voicing change and the perceptual assessment, voice range profile, acoustic and aerodynamic measures to identify change of voice. Participants had glottal gap due to incomplete glottic closure during voicing on the pretest. After they took the voice therapy, the glottic gap became narrow and rough and breathy voice was reduced. There were significant difference in acoustic and aerodynamic measures. Jitter, Shimmer, MFR were reduced and MPT, Psub were increased(p<.05). Participants' pitch range and intensity range were increased on the posttest performance after taking voice therapy. Especially, most of them were showed that pitch range was increased significantly in high frequency area. The results of this investigation indicate that the voice therapy using abdominal breath, SKHPIP, and exercise together is effective for the patients who have age-related dysphonia to improve their voice quality. We recommend to apply this technique to functional voice disorders who are showed glottal gap.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.9 no.2
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• pp.114-128
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• 2002

In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.799-814
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• 2001

This study was performed to investigate the clinical pictures and rehabilitation service patterns of stroke patients in cities of kimchon(kumi), jinju. pohwang, jeonju and jeju from January 1,2001 to march. Authors developed structured questionnaire, and distributed it to each physical therapist. Total number of distributed questionnaire was 400, and 301 questionnaire were col looted and analysed finally.1. The occurrence rate of hemorrhagic stroke(60.5%) was higher than that of ischemic stroke(39.5%). The highest incidence of the stroke was noted in the group of 50 years and ratio of male to female 1.3 : 1. 2. The several warning sign is motor deficit(42.5%). headache. dizziness, vomitting(31.9%) and difficulty speaking or understanding(10.6%). 3. The most important contributing factor of stroke was hypertension both hemorrhagic(50.0%) and ischemic stroke(40.3%). 4. In the painful stroke patients(53.2%). the major problems were shoulder pain(51.3%) and shoulder-hand syndrom(31.3%). 5. In hemorrhagic stroke. the seasonal preference was autumn and summer. In ischemic stroke. the seasonal preference was autumn and winter. 6. In the surgery, hemorrhgic stroke(44.5%) was higher than that of ischemic stroke(20.2%). 7 The major impairment were motor deficit(95.3%), psychological deficits(24.4%), hearing and speech deficit(23.4%). vision deficit(14.7%) and perception deficit(12.7%). 8. The rehabilitation services for stroke patients were physical therapy(98.0%), occupational therapy(41.5%), oriental therapy(35.1%), speech therapy(17.5%) and psychological therapy(7.4%). 9. The start of rehabilitation service was different according to surgery. 36.5% of patients started physical therapy in 4 week and 32.0% of patients started in 8 week later in surgery and 53.1% of patients started physical therapy in 2 week in not surgery( P<0.05). 10. The highest frequency of rehabilitation service was six times per week.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.73-76
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• 2010

Purpose: There are several surgical methods for correcting a velopharyngeal insufficiency (VPI) but in some cases, it is not possible to achieve complete recovery of the velopharyngeal function. This paper introduces a new therapy for treating hypernasality without further surgery using continuous positive airway pressure (CPAP). Methods: CPAP therapy was applied to seven VPI patients for eight weeks from April of 2007 to September of 2009. All patients underwent palatoplasty for the cleft palate and six patients underwent palatal lengthening for VPI before CPAP therapy. A speech pathologist performed an auditory perceptual evaluation to evaluate the improvement in hypernasality after 8-week CPAP therapy. Results: Six patients showed an improvement in hypernasality after CPAP therapy according to the auditory perceptual evaluation. One patient with severe hypernasality responded to the early part of therapy but the hypernasality did not improve after therapy. Conclusion: CPAP therapy might be effective in reducing the hypernasality in patients with VPI by providing resistance training to strengthen the velopharyngeal closure muscles. In particular, CPAP therapy could be more effective for patients who show mild to moderate hypernasality after surgery.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.211-212
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• 2007

Stroke makes several physical deficits. Dysarthria is one of the most difficult problems in conventional medicine because of the weakness of neuromotor control. The purpose of this study is to find the acoustic characteristics of acupuncture therapy effects on post-stroke dysarthria. Seven patients with stroke(infarction or hemorrhage) were selected by CT or MR imaging. The authors applied acupuncture therapy by inserting needles into 8 acupuncture points, ipsilateral ST4, ST6 and contralateral LI4, ST36 on facial palsy side, and CV23, CV24, bilateral "Sheyu" for 4 weeks. Speech sample were composed of five simple vowels /a,e,i,o,u/ and meaningless polysyllabic words CVCVC(C: stops, affricated, fricative sounds, v: /e/). .VOT, total duration of each speech samples and vowel formant (F1&F2) were analyzed on Spectrogram. The results are as follows: 1. VOT of bilabial and velar stops was decreased post treatment. The VOT of bilabial glottalized pre and post treatment were statistically significant (p < 0.05). 2. Total duration of polysyllabic words was decreased post treatment. Decrement of total duration containing the bilabial was statistically significant (p<0.05). 3. First formant of round vowel /o/ pre and post treatment was statistically significant (p<0.05).

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.39-44
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• 2005

Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.