Self-Perceived Vocal Symptoms and Discomfort in Amateur Church Singers

PURPOSE

To analyze self-perceived vocal symptoms and discomfort in amateur church singers and compare them between genders and church types.

METHODS

It was a quantitative cross-sectional study involving 99 amateur church singers aged between 18 and 59years. Data collection was carried out through the completion of a sociodemographic questionnaire, the Voice Symptom Scale (VoiSS), and the Vocal Tract Discomfort Scale (VTDS). The Mann-Whitney test was used for comparisons, and Spearman's correlation test was used for analyzing correlations between scale scores. The adopted significance level was 5% (P < 0.05).

RESULTS

There was a prevalence of females (71.7%), amateur singers from Protestant churches (73.7%), with a mean age of 27.5years. The average VoiSS total score was 22.6 points, the "limitation" domain was 12.3, the "emotional" domain was 2.55, and the "physical" domain was 7.7. The most self-perceived sensations in the VTDS were "dryness," "sore throat," and "itchiness" with mild to moderate intensity. There was a statistically significant difference between genders (P < 0.05) and a positive correlation from weak (r = 0.212) to strong magnitude (r = 0.660) between vocal symptoms and vocal tract discomfort. There was no statistically significant difference between types of churches.

CONCLUSION

Amateur singers self-report high levels of vocal symptoms, which impact limitation, emotional, and physical domains. Furthermore, they experience vocal tract discomfort sensations, with dryness being the most frequently reported, followed by sore throat and itching. No significant differences were found between the scale scores and church types. However, females reported a greater frequency and intensity of vocal tract discomfort sensations. The greater the self-reported vocal symptoms in this population, the higher their self-reported frequency and intensity of vocal tract discomfort sensations. These findings underscore the importance of addressing vocal health issues in amateur singers to enhance their overall well-being.

CPPS and Voice-Source Parameters: Objective Analysis of the Singing Voice

INTRODUCTION

In recent years cepstral analysis and specific cepstrum-based measures such as smoothed cepstral peak prominence (CPPS) has become increasingly researched and utilized in attempts to determine the extent of overall dysphonia in voice signals. Yet, few studies have extensively examined how specific voice-source parameters affect CPPS values.

OBJECTIVE

Using a range of synthesized tones, this exploratory study sought to systematically analyze the effect of fundamental frequency (fo), vibrato extent, source-spectrum tilt, and the amplitude of the voice-source fundamental on CPPS values.

MATERIALS AND METHODS

A series of scales were synthesised using the freeware Madde. Fundamental frequency, vibrato extent, source-spectrum tilt, and the amplitude of the voice-source fundamental were systematically and independently varied. The tones were analysed in PRAAT, and statistical analyses were conducted in SPSS.

RESULTS

CPPS was significantly affected by both fo and source-spectrum tilt, independently. A nonlinear association was seen between vibrato extent and CPPS, where CPPS values increased from 0 to 0.6 semitones (ST), then rapidly decreased approaching 1.0 ST. No relationship was seen between the amplitude of the voice-source fundamental and CPPS.

CONCLUSION

The large effect of fo should be taken into account when analyzing the voice, particularly in singing-voice research, when comparing pre and posttreatment data, and when comparing inter-subject CPPS data.

Impact of professional, recreational and nonsinging on temporomandibular disorders - a comparative study based on a self-assessment questionnaire

BACKGROUND

This study investigates the relationship between professional and recreational singing on temporomandibular disorders (TMDs) in women compared to a nonsinging control group.

METHODS

A total of 288 female subjects between the ages of 18 and 45 participated in the self-assessment questionnaire including demographic data, as well as questions on vocal practice and TMDs symptoms. Depending on the singing time per week, the (non)vocalists were assigned to the groups professional (n = 96), recreational (n = 96) and nonsingers (n = 96).

RESULTS

The TMDs prevalence in professional singers (42%) was higher than that in recreational singers (31%) and noticeably higher than that in nonsingers (25%). The Fisher-Freeman-Halton exact test showed that the differences between the groups were not noticeable (p = .053) but could be formulated as tendencies. The professionals suffered much more from restricted jaw movement (p = .004; OR = 2.718; 95% CI = 1.409-5.242), temporomandibular joint sounds (p < .009; OR = 2.267; 95% CI = 1.264-4.064) and temporomandibular pain (p = .010; OR = 2.333; 95% CI = 1.264-4.308) than nonsingers.

CONCLUSIONS

Singing might have an enhancing effect on the appearance of TMDs. In particular, professional singers suffered more from self-reported TMDs than recreational singers and nonsingers. In addition to the high level of physical workload if participating in professional singing, the psychosocial impact should be investigated more in further studies. No new treatment strategies resulted from this study, as the etiological significance of singing is still unclear. Knowledge about risk factors for multifactorial TMDs can help practitioners and patients prevent and treat TMDs.

Global Inventory and Similarity Rating of Singing Voice Assessment Terms Used at English Speaking Academic Institutions

The choice of terms to describe and assess the singing voice is an essential part of vocal pedagogy. However, previous work suggested that singing terminology used in academia may be somewhat ambiguous. To address this issue, the authors a) compiled a comprehensive inventory of singing voice assessment terms used by English-speaking academic institutions worldwide and b) with the help of 22 highly experienced singing voice teachers, grouped the most prevalent terms based on their conceptual similarity. Only about a fifth of all targeted institutions provided materials and information online. Overall, a total of 292 different terms were found in the 64 available sources. This surprisingly large number of terms could be reduced by approximately 61% through lexical grouping. In the resulting data set, only 24 of the 114 terms occurred in at least 20% of the online sources, suggesting a rather low current density of information as well as little to no systematic and coordinated use of terms across institutions. The singing voice expert's similarity rating of the 24 most prevalent terms revealed a non-uniform distribution, suggesting that only some of these terms can be used interchangeably. Overall, these findings hint at the underlying complexity of voice assessment on a descriptive and qualitative level, highlighting the need for further research in this area.

Exploring the role of singing, semantics, and amusia screening in speech-in-noise perception in musicians and non-musicians

Sentence repetition has been the focus of extensive psycholinguistic research. The notion that music training can bolster speech perception in adverse auditory conditions has been met with mixed results. In this work, we sought to gauge the effect of babble noise on immediate repetition of spoken and sung phrases of varying semantic content (expository, narrative, and anomalous), initially in 100 English-speaking monolinguals with and without music training. The two cohorts also completed some non-musical cognitive tests and the Montreal Battery of Evaluation of Amusia (MBEA). When disregarding MBEA results, musicians were found to significantly outperform non-musicians in terms of overall repetition accuracy. Sung targets were recalled significantly better than spoken ones across groups in the presence of babble noise. Sung expository targets were recalled better than spoken expository ones, and semantically anomalous content was recalled more poorly in noise. Rerunning the analysis after eliminating thirteen participants who were diagnosed with amusia showed no significant group differences. This suggests that the notion of enhanced speech perception-in noise or otherwise-in musicians needs to be evaluated with caution. Musicianship aside, this study showed for the first time that sung targets presented in babble noise seem to be recalled better than spoken ones. We discuss the present design and the methodological approach of screening for amusia as factors which may partially account for some of the mixed results in the field.

The need for robust critique of arts and health research: the treatment of the Gene Cohen et al. (2006) paper on singing, wellbeing and health in subsequent evidence reviews

BACKGROUND

This paper considers weaknesses in a study by Cohen et al. (2006) on the impacts of community singing on health. These include high demand characteristics, lack of attention to attrition, flawed statistical analysis, and measurement. Nevertheless, the study is uncritically cited, in evidence reviews, with findings taken at face value.

METHODS

Google Scholar, SCOPUS and BASE citation functions for Cohen et al. identified 32 evidence reviews in peer-reviewed journals. Eleven of these reviews, published between 2010 and 2023, focused on creative arts interventions.

RESULTS

We demonstrate limitations in the Cohen et al. research which undermine the conclusions they reach regarding the health benefits of group singing. Subsequent evidence reviews take the findings at face value and offer little critical commentary.

DISCUSSION

We consider what is needed to improve evidence reviews in the field of creative arts and health research.

CONCLUSIONS

A more robust approach is needed in reviewing research evidence in the field of arts and health. The Cohen et al. paper is not suitable for inclusion in future evidence reviews.

Vocal Dose and Vocal Demands in Contemporary Musical Theatre

OBJECTIVE

To document and quantify vocal dose and student-singers' self-assessment during rehearsals for a contemporary musical theater production.

METHODS/DESIGN

Six student singers fastened the sensor from the KayPentax APM 3200 dosimeter to the lower neck to capture neck vibration data during their preparation for the musical Wonderland by Frank Wildhorn. Data were collected during 8-hour periods, at four different stages throughout the rehearsal process: beginning (music and choreography learning phase), middle (staging phase), and end (running the entire show/dress rehearsal phase), plus a post-production day once the production had concluded to establish a baseline vocal load. Students concurrently completed the EASE questionnaire1 after each data collection day.

RESULTS

The EASE score (Appendix 1) and demographics/perceptual questionnaire (Appendix 2) revealed that all subjects (three males and three females) found the singing role vocally and physically demanding but only two found the roles to be emotionally challenging. The musical score demanded a higher usage of chest register (judged perceptually) than mixed register from lead singers. All subjects' maximum fundamental frequency range exceeded the pitch range required by the score. The mean daily vibration dose (distance dose, as computed with Kay Pentax Software) of the three individual female singers' during rehearsals, 5,203 meters, was higher than the mean daily dose of the three male singers, 3,766 meters. The subjects' self-ratings on the EASE were not correlated with the distance dose.

CONCLUSIONS

A review of Wonderland's score and perceptual judgment of the singers' performances revealed extensive use of chest register, with belting and mix vocal strategies being the predominant stylistic choices. Students described the singing roles' vocal and physical requirements as more challenging than the character's emotional components. This pilot study provides information on the vocal dose for lead and ensemble singers in rehearsal for a Contemporary Musical Theatre production. Singers and voice professionals may find dosimetry a valuable tool for monitoring the vocal dose during rehearsals and performances.

The Effect of Singers' Masks on the Impulse Dispersion of Aerosols During Singing

BACKGROUND

During the Covid-19 pandemic, singing activities were restricted due to several super-spreading events that have been observed during rehearsals and vocal performances. However, it has not been clarified how the aerosol dispersion, which has been assumed to be the leading transmission factor, could be reduced by masks which are specially designed for singers.

MATERIAL AND METHODS

Twelve professional singers (10 of the Bavarian Radio-Chorus and two freelancers, seven females and five males) were asked to sing the melody of the ode of joy of Beethoven's 9th symphony "Freude schöner Götterfunken, Tochter aus Elisium" in D-major without masks and afterwards with five different singers' masks, all distinctive in their material and proportions. Every task was conducted after inhaling the basic liquid from an e-cigarette. The aerosol dispersion was recorded by three high-definition video cameras during and after the task. The cloud was segmented and the dispersion was analyzed for all three spatial dimensions. Further, the subjects were asked to rate the practicability of wearing the tested masks during singing activities using a questionnaire.

RESULTS

Concerning the median distances of dispersion, all masks were able to decrease the impulse dispersion of the aerosols to the front. In contrast, the dispersion to the sides and to the top was increased. The evaluation revealed that most of the subjects would reject performing a concert with any of the masks.

CONCLUSION

Although, the results exhibit that the tested masks could be able to reduce the radius of aerosol expulsion for virus-laden aerosol particles, there are more improvements necessary to enable the practical implementations for professional singing.

Vocal Self-Perception of Singers During COVID-19 Pandemic

OBJECTIVE

to compare the self-perception of vocal fatigue and use of singing voice during the COVID-19 pandemic between professional and amateur singers and to relate this self-perception with vocal use characteristics during this period.

METHODOLOGY

Participants were 121 singers divided into professional singers group (PSG) (12 men and 20 women) comprising singers who depended exclusively on singing as a profession and an amateur singers group (ASG) (37 men and 52 women) of singers who did not depend exclusively on singing for their livelihood. All answered online questionnaires through Google Forms ®. Sociodemographic and vocal characteristics were investigated before and during the pandemic; symptoms of vocal fatigue were assessed through the vocal fatigue index (VFI); and self-perception of use of singing voice through the evaluation of the ability to sing easily protocol for Brazil (EASE-Br).

RESULTS

In the comparison between groups, the PSG presented higher scores of vocal fatigue in fatigue and vocal limitation (P = 0.045), vocal restriction (P = 0.002), and recovery with vocal rest (P = 0.008) domains than did the ASG. There was no difference between the groups regarding the use of singing voice. Based on the relationship between self-perception and vocal use characteristics during the pandemic, it was observed that the presence of vocal complaint was the only factor associated with self-perception of fatigue symptomatology in both groups. Regarding the self-perception of the current status of the singing voice, singing time, the presence of vocal complaints, the need to increase visual concentration, and the perception of vocal worsening during the pandemic were considered predictive for amateur singers. For professional singers, vocal complaints and vocal training were predictors for self-perception of the current status of the singing voice.

CONCLUSION

Professional singers presented with higher scores of vocal fatigue than did amateur singers. The symptomatology of vocal fatigue was associated with the presence of vocal complaints in both groups. However, self-perception of the current status of the singing voice was different between the groups and was associated with vocal training for professional singers and characteristics of vocal demand of singing voice during the pandemic period for amateur singers.

Complexity of Vocal Vibrato in Opera and Jazz Recordings: Insights From Entropy and Recurrence Analyses

INTRODUCTION

Vibrato is an oscillation in frequency, intensity, and timbre of the singing voice. Previous studies have found a relationship between its periodicity and perceived quality. The diversity of vibrato enriches the music and singer's performances but create challenges for quantifying and capturing the characteristics that contribute to achieving these expressive goals. Vibrato tones have been addressed using rate, extent, jitter, and shimmer; however, these do not necessarily capture relevant complex time-varying features. This paper applies techniques from disciplines that specialize in periodicity and complexity to provide insight into vibrato characteristics not yet understood.

OBJECTIVES

This study aimed to assess whether nonlinear metrics are relevant features in characterizing and illustrating differences in vibrato behavior in opera and jazz singing, as well as considering the relationship of nonlinear metrics to other vibrato parameters.

METHODS

Vibrato tones from published music material of world-class singers from opera and jazz were analyzed with entropy, recurrence, and the established parameters of rate, extent, jitter, and shimmer. Dimensionality reduction was employed to consider the relationship and significance of each of the metrics in collectively characterizing vibrato.

RESULTS

The principal component, explaining 40% of variability, had positive weights of determinism and line length derived from recurrence while having negative weights of rate, shimmer, and sample entropy. Using these components, the vibrato tones from opera compared to jazz singing were found to be more regular and had lower rate and extent, and it was possible to spotlight singers and notes with high periodicity.

CONCLUSION

Our study shows that nonlinear metrics applied to vibrato tones provide a valuable tool for observing and quantifying regularity in vibrato tones. The results of this study highlight the potential for more detailed descriptions of vibrato characteristics that may support categorization of individuals, genres, or musical expression in the future and could be applicable to pedagogical techniques.

Dysphonia in Pediatric Professional Voice Users: Is It Just Nodules?

OBJECTIVES/HYPOTHESIS

Professional voice users of any age are often concerned about nodules, particularly in pediatric singers. However, an accurate diagnosis allows formulation of an optimal management plan and a successful continuation of these young patients' careers. There is very little literature regarding pediatric professional singers; we aimed to share our experience of over a decade of referrals to our tertiary pediatric voice clinic.

STUDY DESIGN

This was a retrospective review.

METHODS

A retrospective review was undertaken of all consecutive patients aged 0-18 years who self-identified as professional voice users and attended our tertiary pediatric voice clinic between December 2010 and December 2021. We analyzed demographics, professional singing status, diagnosis, management, and clinical voice scores. The patients were subdivided into those aged 0-9, 10-16, and 17-18 years.

RESULTS

A total of 113 pediatric professional voice users attended the tertiary voice clinic in the study period. The commonest self-reported voice use was as a singer. Within the 0-9 years age group, there was a strong male predominance (22 males and three females) and mostly organic (52%) causes. For ages 10-16 years, there was a noted female predominance (15 males and 29 females). In the 17-18 years age group, there was a strong female predominance (10 males and 34 females), with predominantly functional diagnoses (48%). Of significance, only five of the 113 patients had nodules (4.4%).

CONCLUSIONS

We present a large data set of pediatric professional voice users and demonstrate the numerous underlying diagnoses for their dysphonia, particularly functional disorders. Our experience highlights the need for adequate vocal training for pediatric professional voice users and the need for a multidisciplinary diagnostic and management approach.

Vocal Demands of Musical Theatre Rehearsals: A Dosimetry Study

OBJECTIVE

To investigate singers' vocal load by documenting three types of vocal doses (time, cycle, and distance doses) and sound pressure levels during the four phases of rehearsal and how the vocal doses vary between singers across rehearsals in the musical Nine, written by Maury Yeston.

METHODS/DESIGN

Five student-singers participating in the musical Nine gave informed consent to participate in the study. All five participants were assigned female at birth and female-identifying individuals. They attached a KayPENTAX APM 3300 dosimeter sensor to their lower neck and wore the accelerometer during four three-hour rehearsals throughout the rehearsal process (the music learning phase, the choreography learning phase, the blocking learning phase, and the dress rehearsal) of the musical. The dosimeter records neck vibrations at a rate of 20 samples per second. but it does not record linguistic content.

RESULTS

A dosimetric analysis of five student singers identified variability in voice production throughout the rehearsal process. According to the dosimetry findings, singers employed extensive low-frequency voicing below the first passaggio, with belting and mixed vocal strategies as the predominant stylistic choices when performing in Nine. Additionally, the singers used an occasional head voice effect at specific moments. The roles of Carla, Saraghina, La Fleur, and Ensemble One and Two required specific vocal ranges due to the musical score.

CONCLUSIONS

Researchers have yet to establish a safe baseline vocal dose for singers. The vocal dose is affected by many factors, such as duration of phonation, frequency range, SPL, and styles of vocalism required by the score. Louder and heavier vocalization produces larger distance doses, representing the cumulative load placed on vibrating tissue. The cycle dose, distance dose, and SPL reported in this study varied within and between singers. The phonation density graphs show this variability and the low tessitura required by the score. Time doses ranged from 4% to 7% of rehearsal time; this short dose suggests that the rehearsals provided healthy conditions for the successful rehearsal process with efficient attention to the vocalization of a score that requires heavy vocal styles, including belting. While the rehearsal pace was not alarming, the demands of the score alone may prove to be much greater than the vocal dose reported through the rehearsal. Further studies are needed to establish the overall dose of each Broadway role to serve as parameters for vocal pacing and voice care.

Cepstral Measurements: A Comparison of Results Between Singing and Non-Singing Individuals

OBJECTIVE

To analyze and compare cepstral measurements in singing and non-singing men and women to understand if vocal adaptations of singers reflect greater cepstral measurement results.

METHOD

The study included 91 vocally healthy individuals, consisting of 60 erudite or popular singers (30 males, 30 females) and 31 non-singers (16 males, 15 females). The Cepstral Peak Prominence (CPP) and Cepstral Peak Prominence-Smoothed (CPPS) measures were carried out using the sustained /a/ vowel recorded with a unidirectional condenser microphone associated with a sound card on the computer. The Praat software (version 6.1.16) was used to extract the CPP and CPPS measurements. The intra and intergroup values obtained for each sex were compared using the t-test with a 5% significance level.

RESULTS

There was a CPP (P = 0,000) and CPPS (P = 0,000 and P = 0,001) value difference between the sexes in both groups. Cepstral measurements showed no statistically significant difference between singing and non-singing participants (male: P = 0,778 and P = 0,622; female: P = 0,622 and P = 0,460).

CONCLUSION

Men presented higher CPP and CPPS values than women, which may be related to the presence of the physiological posterior glottic cleft in women. The knowledge of the cepstral values of singers shows that singing specificities may not reflect in all vocal evaluations.

"Unplug to recharge": accessing respite through song in a culturally and linguistically diverse perinatal context

BACKGROUND

This original, qualitative study examines the ways in which the concept of respite is expressed and experienced through the activity of singing in refugee mothers, new and expectant, in a perinatal healthcare setting in Logan, Queensland.

METHODS

Data were collected using a multi-method approach using field notes, yarning circles, and semi-structured interviews. Reflexive Thematic Analysis (TA) yielded themes influenced also by literature on singing, wellbeing, health inequities, and the conceptual lens of respite.

RESULTS

The research found that singing afforded respite for mothers across four dimensions, allowing for safe spaces, me time, new direction, and immersion. Respite and singing are identified here as strength-based and cultural solutions to wellbeing. No negative effects were reported.

CONCLUSIONS

The article discusses implications for socially-mediated healthcare in culturally diverse contexts. The idea of "song" enables access to a space of sanctuary wherein health inequities can be tackled in meaningful and decolonising ways.

Early social communication through music: State of the art and future perspectives

A growing body of research shows that the universal capacity for music perception and production emerges early in development. Possibly building on this predisposition, caregivers around the world often communicate with infants using songs or speech entailing song-like characteristics. This suggests that music might be one of the earliest developing and most accessible forms of interpersonal communication, providing a platform for studying early communicative behavior. However, little research has examined music in truly communicative contexts. The current work aims to facilitate the development of experimental approaches that rely on dynamic and naturalistic social interactions. We first review two longstanding lines of research that examine musical interactions by focusing either on the caregiver or the infant. These include defining the acoustic and non-acoustic features that characterize infant-directed (ID) music, as well as behavioral and neurophysiological research examining infants' processing of musical timing and pitch. Next, we review recent studies looking at early musical interactions holistically. This research focuses on how caregivers and infants interact using music to achieve co-regulation, mutual engagement, and increase affiliation and prosocial behavior. We conclude by discussing methodological, technological, and analytical advances that might empower a comprehensive study of musical communication in early childhood.

Help is on its Way: Exploring the Mental Health and Wellbeing Outcomes of a Massed Community Choir Program

BACKGROUND

This paper explores the mental health and wellbeing outcomes of a massed community choir program in Australia.

METHODS

This study employed a mixed methods approach. Data were collected via a survey of choir participants (N = 305), four qualitative interviews and focus groups with facilitators and participants (N = 22), and two workshops with organising staff (N = 5). Questions were derived from a co-designed program logic, and data were triangulated and analysed thematically.

RESULTS

Participants reported feeling a sense of connectedness (psychological), but also experiencing connection (social) with their fellow singers. Psychological outcomes included the sensations of affect, arousal, and affirmation. Social outcomes included experiencing belonging, inclusion, and sharing. These positive psycho-social experiences promoted positive mental health and wellbeing outcomes in the large group of participating singers.

CONCLUSIONS

This paper addresses gaps in our understanding about the mental health and wellbeing outcomes fostered by community choirs at scale.

Development of a person-centered caregiver singing model for formal caregivers of people living with dementia in South Africa

This action research study explored the co-design of a person-centered caregiver singing (PCCS) protocol and caregivers' experiences of applying the PCCS intervention with people living with dementia. Eight caregivers across two care homes participated in four iterative cycles aimed at refining the training. Qualitative data collected from semi-structed group interviews, individual interactions and researcher reflections were analysed via thematic analysis which informed the refinements to the training protocol. A Person-Centered Caregiver Singing Model was developed from the thematic findings relating to caregivers' experiences of applying the PCCS intervention: enhanced caregiver capabilities, resident's wellbeing, improved relationship, the positive ecological shift, and ease of caregiving. PCCS fostered caregivers' empathy and self-efficacy, helping them better attune to and meet the needs of people with dementia. Findings suggest music therapists could share music therapy-informed skills with caregivers for use in daily care. Further research would be beneficial to understand the relationship between live music interventions and caregivers' self-efficacy and empathy, and to explore the training barriers in South Africa.

Task-Dependent Velopharyngeal Timing in Singers with Classical Training

OBJECTIVE

This study examined velopharyngeal (VP) timing characteristics during singing and speaking tasks among singers with varying degrees of classical training.

METHODS

Pressure-flow data were collected when eight soprano singers sang and spoke the phrase, "I will say hamper," at different pitch (C4 and C5) and loudness levels (soft, medium, and loud). VP aerodynamic variables (VP gap, peak nasal airflow [NF], and peak intraoral pressure [OP]) and timing variables (NF pulse duration, OP pulse duration, and total duration of the /mp/ sequence) were of particular interest.

RESULTS

Results of linear mixed-effects models showed no significant main effect of task type (speaking vs. singing) on VP aerodynamic variables. Task type was found to have a statistically significant main effect on OP pulse duration (F_{(1, 77)} = 27.590, P < 0.05) and total duration of the /mp/ sequence (F_{(1, 75.034)} = 17.895, P < 0.05), with both durational measures significantly shorter for singing (OP pulse duration: 200 ms, total duration of the /mp/ sequence: 212 ms) than for speaking (OP pulse duration: 228 ms, total duration of the /mp/ sequence: 238 ms). The pitch had a significant main effect on OP pulse duration, with C5 (207 ms) significantly shorter than C4 (221 ms). Loudness was found to have no significant main effects on any of the VP timing variables.

CONCLUSIONS

VP timing patterns significantly differed between the singing and the speaking task. Specifically, the singers employed a quick OP pulse rise time, which shortened OP pulse duration as well as the total duration of the /mp/ sequence during the singing task in comparison to the speaking task. Robust VP timing patterns observed during singing may reflect the singers' skilled control of the VP mechanism to achieve functional and esthetic goals.

Patient Profiling: Determining the Effects of Patient Factors on Vocal Fatigue

OBJECTIVES

The phenomenon of vocal fatigue and the types of patients that are at greatest risk for vocal fatigue are not fully understood. The goal was to investigate patient profiles such as voice disorder type, demographics (age and gender), singing identity, interoceptive awareness, and psychosocial impacts on the severity of vocal fatigue.

STUDY DESIGN

Prospective cohort study.

METHODS

Ninety-five subjects with voice disorders were asked to complete Part 1 of the Vocal Fatigue Index (VFI-Part1), the Voice Handicap Index-10 (VHI-10), and the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2). The effects of voice disorder type (structural, neurological, functional), psychosocial impact, age, gender, self-reported singing identity, and interoceptive awareness on self-perceived vocal fatigue (VFI-Part1) were determined using multivariate linear regression.

RESULTS

Vocal fatigue had a significant psychosocial impact on patients with voice disorders, as measured by the VHI-10 (P < 0.001). However, there were no significant effects of vocal fatigue across any of the three voice disorder types (P's >0.05). Age (P = 0.220), gender (P = 0.430), and self-identified singing experience (P = 0.360) also did not have significant effects on vocal fatigue. Additionally, there were no significant relationships between interoceptive awareness MAIA-2 sum scores (P = 0.056) or any of the MAIA-2 sub-scores (P's > 0.05) and vocal fatigue severity (VFI-Part1).

CONCLUSION

Vocal fatigue has a significant psychosocial impact on patients with voice disorders. However, patient profiles, including voice disorder type, patient age, gender, singing identity, and level of interoceptive awareness do not appear to play a major role in vocal fatigue symptom reporting. These findings suggest caution should be exercised when attributing patient profiles to vocal fatigue presentation and severity. Studying pathophysiological mechanisms underlying vocal fatigue may help better distinguish unconscious bias in patient profiling from the etiology and severity of vocal fatigue.

The Relationship Between the Stomatognathic System and Voice in Classical Singers

PURPOSE

To evaluate stomatognathic system's structures and functions in classical singers, relating them to the auditory-perceptual judgment of voice quality and voice self-perception.

METHODS

A cross-sectional pilot study was conducted to evaluate the Stomatognathic System (SS) using orofacial myofunctional evaluation (MBGR Protocol). Voice handicap self-perception was assessed by the Classical Singing Handicap Index (CSHI) and the Voice Handicap Index (VHI-10). Voice samples, recorded according to the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol, underwent auditory-perceptual judgment by two voice experts. All statistical analyses adopted a 5% significance level.

RESULTS

The study included 15 classical singers (nine women and six men). Adequate assessments of lip and tongue functionality and mobility, upper and lower lip, mentum, and tongue tone were higher compared with altered assessments (P < 0.001). Nasal and oronasal breathing showed similar proportions among singers (P = 0.273). Participants reported greater pain in the masseter muscle (P ≤ 0.001), temporomandibular joint (TMJ) (P ≤ 0.001), and sternocleidomastoid muscle (SCM), especially on the left side (P ≤ 0.001). MBGR score showed no association with singers' voice handicap and voice quality self-perception.

CONCLUSION

MBGR-evaluated SS items were not related to auditory-perceptual judgment of voice quality and voice self-perception. Singers reported more pain with palpation in the SCM, masseter muscle, and TMJ. Preference for a chewing side was higher than bilateral chewing. Assessing SS is paramount for the multidimensional evaluation of classical singers' voice.

Dysphonia and Throat Clearing in Singers During the COVID-19 Pandemic in Brazil

OBJECTIVE

The COVID-19 pandemic in Brazil affected the lives of singers, with negative impacts of the disease on the voice, such as dysphonia and throat clearing. This study aims to evaluate the presence of dysphonia and throat clearing in singers during the COVID-19 pandemic in Brazil.

MATERIAL AND METHODS

This is a cross-sectional analytical study with a sample of 154 singers from all over Brazil. Data collection was carried out online, by completing the questionnaire created by the researcher using Google Forms. The following were considered the outcome variables: voice impairment and throat clearing. The bivariate analysis was performed to test the relationship between COVID-19 infection and voice impairment, COVID-19 infection and throat clearing, COVID-19 infection and laryngeal complaints (voice impairment and throat clearing).

RESULTS

In this study, the mean age of the singers was 35.8 (Standard deviation = ±10.2 years) and 59.2% were female. Most of them worked as professional singers (81.1%) and had more than 10 years of professional experience (57.4%), mainly singing pop music (85.4%). A total of 62% reported vocal alterations during the COVID-19 infection and 53% had vocal alterations after the infection, with 44.0% reporting the onset of throat clearing after the infection. There was a significant association between COVID-19 infection and having voice impairment (P = 0.03; prevalence ratio - PR: 2.33; CI: 1.04-5.46). An association was observed between the onset of throat clearing and the occurrence of COVID-19 infection (P = 0.001; PR: 9.13; CI: 2.47-64.42).

CONCLUSIONS

The results indicated that there is an association between COVID-19 infection and complaints of dysphonia and throat clearing in Brazilian singers. This study demonstrates the importance of guidance to singers infected with COVID-19 by health voice processionals.

Vocal Vibrato Characteristics in Historical and Contemporary Opera, Operetta, and Schlager

OBJECTIVES/HYPOTHESIS

Vibrato is a core aesthetic element in singing. It varies considerably by both genre and era. Though studied extensively in Western classical singing over the years, there is a dearth of studies on vibrato in contemporary commercial music. In addressing this research gap, the objective of this study was to find and investigate common crossover song material from the opera, operetta, and Schlager singing styles from the historical early 20th to the contemporary 21st century epochs.

STUDY DESIGN/METHODS

A total of 51 commercial recordings of two songs, "Es muss was Wunderbares sein" by Ralph Benatzky, and "Die ganze Welt ist himmelblau" by Robert Stolz, from "The White Horse Inn" ("Im weißen Rößl") were collected from opera, operetta, and Schlager singers. Each sample was annotated using Praat and analyzed in a custom Matlab- and Python-based algorithmic approach of singing voice separation and sine wave fitting novel to vibrato research.

RESULTS

With respect to vibrato rate and extent, the three most notable findings were that (1) f_o and vibrato were inherently connected; (2) Schlager, as a historical aesthetic category, has unique vibrato characteristics, with higher overall rate and lower overall extent; and (3) f_o and vibrato extent varied over time based on the historical or contemporary recording year for each genre.

CONCLUSIONS

Though these results should be interpreted with caution due to the limited sample size, conducting such acoustical analysis is relevant for voice pedagogy. This study sheds light on the complexity of vocal vibrato production physiology and acoustics while providing insight into various aesthetic choices when performing music of different genres and stylistic time periods. In the age of crossover singing training and commercially available recordings, this investigation reveals important distinctions regarding vocal vibrato across genres and eras that bear beneficial implications for singers and teachers of singing.

Acoustical Theory of Vowel Modification Strategies in Belting

Various authors have argued that belting is to be produced by "speech-like" sounds, with the first and second supraglottic vocal tract resonances (f_R1 and f_R2) at frequencies of the vowels determined by the lyrics to be sung. Acoustically, the hallmark of belting has been identified as a dominant second harmonic, possibly enhanced by first resonance tuning (f_R1≈2f_o). It is not clear how both these concepts - (a) phonating with "speech-like," unmodified vowels; and (b) producing a belting sound with a dominant second harmonic, typically enhanced by f_R1 - can be upheld when singing across a singer's entire musical pitch range. For instance, anecdotal reports from pedagogues suggest that vowels with a low f_R1, such as [i] or [u], might have to be modified considerably (by raising f_R1) in order to phonate at higher pitches. These issues were systematically addressed in silico with respect to treble singing, using a linear source-filter voice production model. The dominant harmonic of the radiated spectrum was assessed in 12987 simulations, covering a parameter space of 37 fundamental frequencies (f_o) across the musical pitch range from C3 to C6; 27 voice source spectral slope settings from -4 to -30 dB/octave; computed for 13 different IPA vowels. The results suggest that, for most unmodified vowels, the stereotypical belting sound characteristics with a dominant second harmonic can only be produced over a pitch range of about a musical fifth, centered at f_o≈0.5f_R1. In the [ɔ] and [ɑ] vowels, that range is extended to an octave, supported by a low second resonance. Data aggregation - considering the relative prevalence of vowels in American English - suggests that, historically, belting with f_R1≈2f_o was derived from speech, and that songs with an extended musical pitch range likely demand considerable vowel modification. We thus argue that - on acoustical grounds - the pedagogical commandment for belting with unmodified, "speech-like" vowels can not always be fulfilled.

Prospective Determination of Normative Value of the Singing Voice Handicap Index-10 (SVHI-10)

OBJECTIVES/HYPOTHESIS

To prospectively establish a normative value for the validated Singing Voice Handicap Index-10 (SVHI-10) patient reported outcome measure (PROM).

STUDY DESIGN

Prospective cross-sectional study.

METHODS

Adult singers without voice complaints were prospectively invited to complete a demographics questionnaire followed by the SVHI-10. Participants were excluded if they had sought medical care for voice changes within the last year or currently had throat problems. Statistical analysis was completed to establish a normative value and the distribution of demographics by singing experience, primary genre, and gender.

RESULTS

One hundred forty-nine healthy participants from diverse backgrounds (including singing, financial, educational, and geographic location) successfully completed the SVHI-10. The mean (SD) score of this cohort was 9.13 (5.15). We defined a normative value as two standard deviations above the mean: 19.43 There was no difference in SVHI-10 score in different age groups.

CONCLUSIONS

A normative value for the SVHI-10 questionnaire has been missing from the current literature and will be of great utility both in clinical practice and research. In previous research, singers have been shown to be more perceptive to quality change in their singing voices, which may be why the normative score is higher than one may expect. A SVHI-10 score ≥20 should be considered abnormal.

Independence of Vocal Load From Vocal Pathology Across Singing Genres

OBJECTIVE

To investigate the extent to which vocal load is associated with previous diagnosis of a vocal pathology among four major genres of singers (primarily classical, primarily musical theatre (MT), classical and MT combined, and contemporary commercial music only).

STUDY DESIGN

Cross sectional survey.

METHODS/DESIGN

An anonymous online survey was sent out to about 1000 professional singers through convenience sampling to touring companies, opera companies, MT companies, agents, directors and musical directors. Social media and email were used to solicit participation in the study. We utilized means and standard deviations for continuous characteristics and frequencies and percentages for categorical characteristics and calculated P values to assess whether differences were statistically significant.

RESULTS

A total of 396 professional singers completed the survey, yielding a 40% response rate. Nonprofessional singers, incomplete surveys, and respondents <18 years old were excluded, resulting in a total of 238 responses. Among the 238 participants, 32% were performing in the classical style primarily, 33% in the MTstyle primarily, 15% in both classical and MT, and 20% in other contemporary styles only. Mean age was highest among CV + MT and lowest among primarily MT. Combined classical/MT singers were most likely to have a career outside of vocal performance and continue to work in that career followed by other contemporary styles, classical and MT (P = 0.02). Participants in the combined classical/MT group were most likely to have a reported history of vocal pathology followed by classical, other contemporary styles and MT (not statistically significant). However, participants in the contemporary styles were most likely to have a history of more than one type of vocal pathology. Mean vocal load was highest for the MT group. Other nonsinging factors proved significant such as allergy, hydration and acid reflux. Symptoms of allergies were found to be significant across singing genres. A possible reverse causality association was identified in regards to water intake. Participants with acid reflux were three times more likely to have ever reported vocal pathology.

CONCLUSION

Vocal load was not significantly associated with vocal pathology across singing genres; however other nonsinging factors such as allergy, reflux and water intake were significantly associated with vocal pathology.