Article

OBJECTIVES: To evaluate the effect of a self-controlled vocal exercise in elderly
people with glottal closure insufficiency. DESIGN:
Parallel-arm, individual
randomized controlled trial. METHODS: Patients who visited one of 10 medical
centers under the National Hospital Organization group in Japan for the first
time, aged 60 years or older, complaining of aspiration or hoarseness, and
endoscopically confirmed to have glottal closure insufficiency owing to vocal
cord atrophy, were enrolled in this study. They were randomly assigned to an
intervention or a control group. The patients of the intervention group were
given guidance and a DVD about a self-controlled vocal exercise. The maximum
phonation time which is a measure of glottal closure was evaluated, and the
number of patients who developed pneumonia during the six months was compared
between the two groups. RESULTS: Of the 543 patients enrolled in this trial, 259
were allocated into the intervention group and 284 into the control; 60 of the
intervention group and 75 of the control were not able to continue the trial. A
total of 199 patients (age 73.9 +/-7.25 years) in the intervention group and 209
(73.3 +/-6.68 years) in the control completed the six-month trial. Intervention
of the self-controlled vocal exercise extended the maximum phonation time
significantly ( p < 0.001). There were two hospitalizations for pneumonia in the
intervention group and 18 in the control group, representing a significant
difference ( p < 0.001). CONCLUSION: The self-controlled vocal exercise allowed
patients to achieve vocal cord adduction and improve glottal closure insufficiency, which reduced the rate of hospitalization for pneumonia
significantly. CLINICAL TRIAL: gov Identifier-UMIN000015567.

Langue : ANGLAIS