Study on the concordance of objective multi-parameters analysis and perceptual evaluation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Through exploring the concordance of objective multi-parameters analysis and perceptual evaluation, to establish an objective multi-parameters evaluation protocol of voice disorder and to make the evaluation of voice objectification and quantification.</p><p><b>METHODS</b>Voice samples from 271 patients (124 female and 147 male)with dysphonia and 69 control subjects with normal voice (37 female and 32 male)were recorded and assessed by a jury composed of 5 experts in phoniatrics from different hospitals. The jury was instructed to classify voice samples according to the G (grade) component of the GRBAS scale on a visual analogue scale secondarily transformed in a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. The voice samples were unified sentences and ordered randomly 3 times, the mean of 3 evaluation scores were the final results. The objective parameters, including fundamental frequency (F0), jitter, shimmer, fundamental frequency standard deviation (F0SD), normalized noise energy (NNE), harmonic-to-noise ratio (HNR) and maximal phonatory time (MPT), were measured on a 2-second sustained vowel/a/including its initial segment, using the software Dr. Speech for Windows. The data were analyzed using SPSS11.0.</p><p><b>RESULTS</b>All objective parameters except for F0 had high correlation with G and the variance tendency of these parameters values was coherent with the extent of voice disorder. And there were statistical differences between adjacent voice disorder groups. Male and female objective multi-parameters protocols were established respectively consisting of jitter, shimmer, F0SD, NNE, HNR and MPT using discriminant analysis (P < 0.05). The concordance between perceptual evaluation and objective multi-parameters evaluation was 81.6% in male and 83.2% in female. The concordance of evaluation of normal voice and severe voice disorder groups were better than that of mild and moderate voice disorder groups. All mis-grading voices were judged in the adjacent voice group.</p><p><b>CONCLUSIONS</b>The objective parameters of voice are able to reflect the characteristic of its perceptual evaluation and the concordance between perceptual evaluation and objective multi-parameters evaluation is good. The objective multi-parameters evaluation protocol we established could provide an objective and quantitative evaluation method for voice disorders.</p>

Effect of acupuncture and massage at tendon on F-wave of electromyogram in the patient of flexor spasm of the upper limb after operation of cervical spondylosis / 中国针灸

<p><b>OBJECTIVE</b>To explore the mechanism of acupuncture and massage at the tendon in treatment of the upper limb flexor spasm after cervical operation.</p><p><b>METHODS</b>Fifty-six cases were randomly divided into a treatment group (n = 30) treated with acupuncture and massage at the tendons, and a control group treated with traditional acupuncture and medication. Changes of F-wave, time limit and threshold value in electromyogram before and after treatment were investigated in the both groups.</p><p><b>RESULTS</b>Before treatment, the F-wave in the patient of the upper limb spasm post-cervical operation was characterized by high amplitude, long time limit and low threshold value, with no significant difference between the two groups (P > 0.05); after treatment, the amplitude lowered (P < 0.01), the time limit shortened (P < 0.001) in the treatment group and no significant changes were found in the control group (P > 0.05), but the amplitude of F-wave in the treatment group was significantly lower than that in the control group (P < 0.05). The threshold value significantly increased in the two groups, with the treatment group more significantly increased than the control group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture and massage at tendons can relieve the spasm through lowing the excitement in the cells of the anterior horn of the spinal cord, decreasing the amplitude and time limit of the F-wave, increasing the threshold value and reducing traction reflection.</p>