Music for Wellness in rehabilitation patients: programme description and evaluation results

OBJECTIVE

The evaluation of real-world, hospital-based, arts programmes is important for quality assurance, to increase knowledge of successful practice and awareness of effective arts-health collaborations. The objective of this study was to describe the Music for Wellness programme and evaluation at St John of God Frankston Rehabilitation Hospital, Australia.

STUDY DESIGN

An impact evaluation and quasi-experimental pre-post study was conducted.

METHODS

The Music for Wellness programme for rehabilitation patients ran on a weekly basis for 18 weeks (i.e., 18 stand-alone workshops). Evaluation feedback was collected from patients and hospital staff/visitors. The primary outcome measures were pre-post workshop changes in patients' mood, measured via a 'faces' visual analogue scale; and pain, measured via a numerical rating scale. Linear mixed models and growth curve analyses were performed. Evaluation questions about mental well-being, pain reduction, musical skill attainment and the hospital environment were also asked and, a descriptive analysis was conducted.

RESULTS

Between the baseline, preworkshop and postworkshop time points, a significant increase in rehabilitation patients' mood and decrease in self-reported pain were found. Changes were consistent over time. The patients and hospital staff/visitors agreed the programme enhanced the hospital environment and music skills, resulted in positive benefits (e.g., relaxation, opportunity to socialise) and should be continued.

CONCLUSION

This study provides valuable information about a low-cost, non-pharmacological programme that successfully enhanced the hospital environment and supported patients' well-being in a rehabilitation setting.

Comorbidity and cognitive overlap between developmental dyslexia and congenital amusia in children

Developmental dyslexia and congenital amusia are two specific neurodevelopmental disorders that affect reading and music perception, respectively. Similarities at perceptual, cognitive, and anatomical levels raise the possibility that a common factor is at play in their emergence, albeit in different domains. However, little consideration has been given to what extent they can co-occur. A first adult study suggested a 30% amusia rate in dyslexia and a 25% dyslexia rate in amusia (Couvignou et al., Cognitive Neuropsychology 2019). We present newly acquired data from 38 dyslexic and 38 typically developing children. These were assessed with literacy and phonological tests, as well as with three musical tests: the Montreal Battery of Evaluation of Musical Abilities, a pitch and time change detection task, and a singing task. Overall, about 34% of the dyslexic children were musically impaired, a proportion that is significantly higher than both the estimated 1.5-4% prevalence of congenital amusia in the general population and the rate of 5% observed within the control group. They were mostly affected in the pitch dimension, both in terms of perception and production. Correlations and prediction links were found between pitch processing skills and language measures after partialing out confounding factors. These findings are discussed with regard to cognitive and neural explanatory hypotheses of a comorbidity between dyslexia and amusia.

Vocalizing and singing reveal complex patterns of corollary discharge function in schizophrenia

INTRODUCTION

As we vocalize, our brains generate predictions of the sounds we produce to enable suppression of neural responses when intentions match vocalizations and to make adjustments when they do not. This may be instantiated by efference copy and corollary discharge mechanisms, which are impaired in people with schizophrenia (SZ). Although innate, these mechanisms can be affected by intentions. We asked if attending to pitch during vocalizations would take these mechanisms "off-line" and reduce suppression.

METHODS

Event-related potentials (ERP) were recorded from 96 SZ and 92 healthy controls (HC) as they vocalized triplets in monotone (Phrase) or sang triplets in ascending thirds (Pitch). Pre-vocalization activity (Bereitschaftspotential, BP), N1, and P2 ERP components to sounds were compared during vocalization and playback.

RESULTS

N1 was not as suppressed during Pitch as during Phrase. N1 suppression was not affected by SZ in either task when all data were collapsed across pitches (Pitch) and positions (Phrase). However, when binned according to vocalization performance, SZ showed less N1 suppression than HC at longer (>2 s) inter-stimulus intervals (Phrase) and inconsistent suppression across pitches (Pitch). Unlike N1, P2 was more suppressed during Pitch than Phrase and not affected by SZ. BP was greater during vocalization than playback but did not contribute to N1 or P2 effects. Pitch variability was inversely related to negative symptoms.

CONCLUSIONS

Neural processing is not suppressed when patients and controls sing, and corollary discharge abnormalities in schizophrenia are only seen at long vocalization intervals.

Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel-group randomised controlled feasibility study with waiting-list control

Background

As the number of people living with dementia grows, so does the need to provide them with adequate psychosocial support. Many people with dementia live at home with family carers, who also require social and emotional support to cope with their role. Community group singing has received attention for its potential to support people with dementia and their carers. It is postulated that singing can improve cognitive function, strengthen the bonds between care partners and help to establish social support networks. However, there is a lack of rigorous evidence of singing’s benefits for this population. This study aims to test the feasibility of a randomised controlled trial of community singing in dementia, to pave the way for a larger, conclusive study.

Methods

The PRESIDE study is designed as a two-arm, parallel-group randomised trial with a waiting list control. Dyads consisting of a person with dementia (n = 80) and their carer (n = 80) will be recruited. Each dyad will be randomised either to attend 10 weeks of community group singing sessions straight away or to wait for 3 months before attending the sessions. The singing sessions will be led by experienced professional musicians and will last about 90 min, including time for socialising. The primary outcome of this study is the attainment of feasibility criteria around recruitment, retention and the acceptability of the waiting list control. Secondary outcomes include the quality of life, mood, cognition, and musical engagement of the person with dementia, and quality of life, mood, and experiences/challenges of the carer. These data will be collected during home visits at baseline, and 3 and 6 months post-baseline.

Discussion

Despite growing public interest in the positive effects of singing, and encouraging findings from qualitative and non-randomised quantitative studies, there is a lack of rigorous evidence. This is the first randomised controlled trial of community group singing for people with dementia in Europe, to our knowledge. If the results favour a full trial, conclusively demonstrating the effectiveness of group singing could positively affect the opportunities available to community-dwelling people with dementia and their carers.

Trial registration

Unique identification number in ISRCTN registry: ISRCTN10201482. Date registered: 12 May 2020

How music may support perinatal mental health: an overview

There is strong evidence that engaging with music can improve our health and well-being. Music-based interventions, approaches and practices, such as group music-making (singing or playing musical instruments), listening to music and music therapy, have all been shown to reduce symptoms of depression and anxiety. Although the existing literature needs expanding, mounting evidence suggests that music-based interventions, approaches and practices may help support maternal mental health prenatally and postnatally. The purpose of this descriptive overview is to provide a broad view of this area by bringing together examples of research across different practices and research disciplines. Selected evidence is examined, showing how music-based interventions, approaches and practices can reduce labour anxiety and pain, anxiety symptoms in pregnancy, postnatal depression symptoms and support maternal-infant bonding. The examined research includes single studies and reviews that use both qualitative and quantitative methods. Drawing on animal and human models, the effect of music on foetal behaviour and various possible biological, psychological and social mechanisms are discussed. The potential preventive effect of music-based interventions, approaches and practices and their possible use across different cultures are also considered. Overall, we highlight how music, employed in a variety of ways, may support perinatal mental health with the aim of stimulating more interest and research in this area.

The singing voice is special: Persistence of superior memory for vocal melodies despite vocal-motor distractions

Vocal melodies sung without lyrics (la la) are remembered better than instrumental melodies. What causes the advantage? One possibility is that vocal music elicits subvocal imitation, which could promote enhanced motor representations of a melody. If this motor interpretation is correct, distracting the motor system during encoding should reduce the memory advantage for vocal over piano melodies. In Experiment 1, participants carried out movements of the mouth (i.e., chew gum) or hand (i.e., squeeze a beanbag) while listening to 24 unfamiliar folk melodies (half vocal, half piano). In a subsequent memory test, they rated the same melodies and 24 timbre-matched foils from '1-Definitely New' to '7-Definitely Old'. There was a memory advantage for vocal over piano melodies with no effect of group and no interaction. In Experiment 2, participants carried out motor activities during encoding more closely related to singing, either silently articulating (la la) or vocalizing without articulating (humming continuously). Once again, there was a significant advantage for vocal melodies with no effect or interaction of group. In Experiment 3, participants audibly whispered (la la) repeatedly during encoding. Again, the voice advantage was present and did not differ appreciably from prior research with no motor task during encoding. However, we observed that the spontaneous phase-locking of whisper rate and musical beat tended to predict enhanced memory for vocal melodies. Altogether the results challenge the notion that subvocal rehearsal of the melody drives enhanced memory for vocal melodies. Instead, the voice may enhance engagement.

A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease

BACKGROUND

Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status.

METHODS

Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists.

RESULTS

Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains.

CONCLUSIONS

This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.

Vocal-motor interference eliminates the memory advantage for vocal melodies

Spontaneous motor cortical activity during passive perception of action has been interpreted as a sensorimotor simulation of the observed action. There is currently interest in how sensorimotor simulation can support higher-up cognitive functions, such as memory, but this is relatively unexplored in the auditory domain. In the present study, we examined whether the established memory advantage for vocal melodies over non-vocal melodies is attributable to stronger sensorimotor simulation during perception of vocal relative to non-vocal action. Participants listened to 24 unfamiliar folk melodies presented in vocal or piano timbres. These were encoded during three interference conditions: whispering (vocal-motor interference), tapping (non-vocal motor interference), and no-interference. Afterwards, participants heard the original 24 melodies presented among 24 foils and judged whether melodies were old or new. A vocal-memory advantage was found in the no-interference and tapping conditions; however, the advantage was eliminated in the whispering condition. This suggests that sensorimotor simulationduring the perception of vocal melodies is responsible for the observed vocal-memory advantage.

Quantifying Subjective and Objective Measures of Singing After Different Warm-Up Durations

BACKGROUND

Performing vocal warm-ups prior to singing repertoire has been shown to change the perceived quality and acoustic parameters of the voice. To date, there are no studies that specifically compare singers' and listeners' perceptions of vocal quality after various warm-up durations.

OBJECTIVE

To determine if specific warm-up durations (0, 5, 10, or 15 minutes) change subjective and objective measures of voice.

STUDY DESIGN

Prospective cohort study.

METHODS

Information related to demographics, singing practice, medical history, and vocal hygiene were collected. First- and second-year collegiate classical voice majors completed a series of four warm-up times, 1 week apart, prior to singing Caro mio ben in a standard key for their voice type. A modified Voice Range Profile (mVRP), and the Evaluation of the Ability to Sing Easily (EASE) scale were completed. Participants blindly rated 30-second recorded audio clips using the Auditory-Perceptual Rating Instrument for Operatic Singing. Four independent expert blinded listeners rated all audio clips for each participant in random order.

RESULTS

Six first-year and three second-year classical vocal performance majors completed all measures. Results of the EASE scale showed decreased scores with 5- and 10-minute warm-up duration, compared to 0 and 15 minutes of warm-up (P = 0.029 for the total EASE score and P = 0.044 for Rasch score). Delayed perceptual analysis of voice yielded nearly equal medians between warm-up durations for both self and expert-listener ratings. The mVRP showed that both 5 and 10 minutes of warm-up duration led to increased highest fundamental frequency for females (P = 0.017).

CONCLUSION

This pilot study demonstrates the immediate self-perceived benefit for all participants and increased frequency range for females after performing 5 and 10 minutes of vocal warm-up. No significant differences were found in delayed perceptual analyses completed by the participants or the expert raters after the different warm-up durations. Future investigations should include a larger population and different levels of education and genres of singing.

The effects of a music and singing intervention during pregnancy on maternal well-being and mother-infant bonding: a randomised, controlled study

Purpose

Stress and impaired mother–infant bonding during pregnancy can lead to adverse effects for the expectant mother and the unborn child. The present study investigates whether a prenatal music and singing intervention can improve maternal well-being as well as mother–infant bonding.

Methods

A total of 172 pregnant women took part in this prospective, randomised, three-armed (music, singing or control group) study. Depressive symptoms, self-efficacy, maternal well-being and mother–infant bonding were assessed with visual analogue scales and questionnaires before the intervention phase (30th week of gestation) and afterwards (36th week of gestation). Additionally, immediate changes regarding experienced stress and mood from before until after the music and singing interventions were explored with questionnaires as well as saliva samples (for cortisol, alpha-amylase and oxytocin determination).

Results

Regarding immediate effects, both interventions showed positive effects on the emotional state, stress (cortisol) and bonding (oxytocin). Additionally, the singing group showed a larger reduction in cortisol and a larger improvement in valence than the music group. Looking at more prolonged effects, significant effects on general self-efficacy and perceived closeness to the unborn child (measured with a visual analogue scale) were found. No significant effects were revealed for the mother–infant bonding questionnaire and for depressive symptoms.

Conclusion

In the present study, promising effects of music and in particular singing on maternal well-being and perceived closeness during pregnancy appeared. Prenatal music and singing interventions could be an easy to implement and effective addition to improve mood and well-being of the expectant mother and support mother-infant bonding.

Trial registration number

DRKS00012822, date of registration: 17.10.2017

Electronic supplementary material

The online version of this article (10.1007/s00404-020-05727-8) contains supplementary material, which is available to authorized users.

Oropharyngeal Geometry and the Singing Voice: Immediate Effect of Two Semi-Occluded Vocal Tract Exercises

PURPOSE

The aim of this study was to verify the immediate effect of a flexible resonance tube in water and of lip trill on oropharyngeal geometry and vocal acoustic parameters of singers without vocal symptoms.

METHODS

Twenty-two adult singers participated in the study. They had an average age of 27 (±4.8) years. Participants were split into two groups: a group composed of 12 singers who performed the flexible resonance tube (FRT) exercise and a group of 10 singers who performed the Lip Trill technique (LTT). Acoustic pharyngometry and acoustic analysis of the voice were used to assess oropharyngeal geometry before and after the exercises.

RESULTS

After performing the techniques, the vocal tract length was longer in the group that performed the FRT, compared to the one that performed the LTT. In the acoustic evaluation, there was an improvement in the glottal to noise excitation ratio and a decrease in noise in the group of singers who performed the LTT. In the analysis by sex men had a longer oral cavity compared to women and after application of the techniques greater volume of the vocal tract.

CONCLUSION

There was variation in the oropharyngeal geometry with the FRT, while the LTT had a positive effect on the vocal acoustic parameters related to glottal noise.

Amplitude Effects of Vocal Tract Resonance Adjustments When Singing Louder

In the literature on vocal pedagogy we may find suggestions to increase the mouth opening when singing louder. It is known that sopranos tend to sing loud high notes with a wider mouth opening which raises the frequency of the first resonance of the vocal tract (f_R1) to tune it close to the fundamental. Our experiment with classically trained male singers revealed that they also tended to raise the f_R1 with the dynamics at pitches where the formant tuning does not seem relevant. The analysis by synthesis showed that such behaviour may contribute to the strengthening of the singer's formant by several dB-s and to a rise in the centre of spectral gravity. The contribution of the f_R1 raising to the overall sound level was less consistent. Changing the extent of the mouth opening with the dynamics may create several simultaneous semantic cues that signal how prominent the produced sound is and how great the physical effort by the singer is. The diminishing of the mouth opening when singing piano may also have an importance as it helps singers to produce a quieter sound by increasing the distance between the f_R1 and higher resonances, which lowers the transfer function of the vocal tract at the relevant spectral regions.

Reflux Symptom Index (RSI) and Singing Voice Handicap Index (SVHI) in Singing Students: A Pilot Study

OBJECTIVE

To correlate, RSI with SVHI, in a group of singing students, by means of a specific anamnestic questionnaire which analyzes the physical, social, emotional, and economic impacts of voice problems on their lives. This study is a cross-sectional single-center observational study.

METHODS

Forty-two modern singing students (26F/16M; average age: 24.9 ± 5.7; range: 16-46 years old) were recruited. A self-assessment of the singing-voice (SVHI) and of reflux symptom (RSI) was performed.

RESULTS

Using the validated RSI threshold, 31% of participants were classified as RSI greater than 13 as an indication of suspected LPR. Classifying the SVHI score as proposed in the recent literature (cutoff of 20.35) our sample was a voice disorders prevalence of 71.4%. There was no significant positive or negative relationship between RSI and SVHI total score (rho = 0.238, P = 0.13). Instead, by considering the relationship between the individual items of the two questionnaires, it is highlighted that the item 1 of SVHI was significantly correlated with most of the RSI items (P = 0.0001-0.006). In the same vein, the item 5 of SVHI was correlated to hoarseness and coughing (P = 0.005-0.006). The item 20 of SVHI was significantly correlated with hoarseness, excess mucus in the throat or postnasal drip and with the pharyngeal Globus sensation (P = 0.001-0.005). By aggregating the SVHI item response as a positive response (2-4) versus a negative response (0 or 1) between "RSI pathology classification," a significant association was observed for SVHI item 1 (P < 0.021), item 5 (P < 0.006), item 20 (P < 0.042), item 24 (P < 0.044) item 25 (P < 0.047). These associations were confirmed by univariate binary logistic. Multivariate binary logistic regression confirms that SVHI Item 1, Item 5 were more associated with RSI positive. Based on results, we propose a questionnaire that combines the most relevant SVHI items correlated to LPRD (SVHI-10-LPRD questionnaire). Cronbach's alpha coefficient for the 10 items selected was 0.87; item-total correlation coefficients for each item were in the range of 0.461 to 0.670.

CONCLUSIONS

This pilot study shows that, in case of significant RSI for LPR, it is possible to observe a significant association with some symptoms described in SVHI. These results underline that the association of the RSI and SVHI questionnaires administered to singers and singing students, can represent a simple screening to reveal possible alterations of the singing voice correlate to LPR. Moreover, we propose a Singing Voice Handicap Index correlated to LPR (SVHI-10-LPRD). It will be necessary to increase the sample of subjects in the study to confirm these preliminary data.

Amateur Music Theatre Singers' Perceptions of their Current Singing Voice Function

PURPOSE

The primary aim of this study was to investigate amateur music theatre singers (MTS)' perceptions of their current singing voice function according to evaluation of ability to sing easily (EASE) scores while involved in a musical theatre production, to determine if scores were influenced by demographic or voice-related factors and to compare EASE scores of amateur MTS and previously published professional MTS.

METHOD

Amateur singers were recruited through the Townsville Choral Society during the preproduction of Les Misérables. A total of 51 amateur MTS completed an online questionnaire including the EASE scale and a supplementary demographic questionnaire. Nonparametric statistical analyses were conducted.

RESULTS

Three singers reported they had a voice problem at the time they completed the questionnaire. The EASE did not detect significant differences in perceived vocal function among the singers according to demographic (age and gender) and voice-related characteristics. The amateur cohort reported lower current voice-use demands, such as current vocal load and number of shows over past week, than the previously described professional MTS and no significant differences were found between the two cohorts in the median EASE scores.

CONCLUSIONS

The results of this study supported both the overall validity of the EASE scale and its use with amateur MTS. In addition, the findings suggest the value of future research investigating the potential use of the EASE for broader clinical application with other population groups.

Voice After Rhinoplasty. An Important Question for the Opera Singers

OBJECTIVE

The primary goal of the study was to evaluate the influence of cosmetic and functional rhinoplasty on quality of life and voice performance preservation in opera singers.

MATERIALS AND METHODS

This study was conducted in the ENT Department of Clarós Clinic and included 18 opera singers: 16 women (8 sopranos, 5 mezzos, 2 contralto, and 1 unclassified) and 2 men (1 tenor and 1 baritone). Patients underwent either cosmetic or functional rhinoplasty. We excluded patients with previous nasal surgery, allergic or vasomotor rhinitis, laryngeal pathology, nasal pathology except septal deviation, hormonal or psychiatric disorders, psychic lability, or younger than 18 years of age. We evaluated the fundamental frequency, jitter, shimmer, maximal phonation time, Voice Handicap Index-10, and subjective perception of the patient before and 6 months after surgery.

RESULTS

Rhinoplasty was indicated for aesthetic reasons in 12 cases. Six patients also associated nasal obstruction due to septal deviation. The fundamental frequency presented no variation and jitter, shimmer and the maximal time phonation improved slightly. Voice Handicap Index-10 scores decreased after the intervention (5.3 vs 5) and the overall perception of the surgical intervention was considered positive both aesthetically and vocally.

CONCLUSIONS

Singers evaluated long-term influence of rhinoplasty as positive. Over 88.8% admitted a beneficial effect on vocal emission and function while 11.1% perceived no change regarding their previous voice.

Effect of the Finnish Tube on the Voice of a Deaf Musician: A Case Report

PURPOSE

To verify the auditory-perceptual and acoustic effects of the semioccluded vocal tract exercise with Finnish tube on the vocal quality of a deaf musician.

METHODS

A seven-day protocol with Finnish tube was performed with guidance for its home replication twice a day. A 46-years-old man with profound bilateral sensorineural hearing loss, musician and composer participated. Before and after the application of the protocol had undergone tonal audiometry, nasofibrolaryngoscopy, acoustic analysis with Praat and auditory-perceptual evaluation of the voice with Voice Profile Analysis Scheme for Brazilian Portuguese.

RESULTS

The postintervention auditory-perceptual analysis identified reduction of the deviation in lip spreading, extensive labial range, raised tongue body, pharyngeal expansion, nasal resonance, larynx height, larynx and vocal tract tension and irregularity, pitch, speech rate, and a better respiratory support. The maximum phonation time reduced, probably because of elimination of the abrupt vocal attack and tension, articulatory deviations, improvement in voicing and the absence of the use of expiratory reserve air. The fundamental frequency became lower, and the first, second, third, and fourth formants became higher. The jitter increased, and the shimmer reduced.

CONCLUSION

The use of the Finnish tube might have facilitated the voicing sensations in the deaf musician, by enhancing the tactile-kinesthetic perception of the vocal tract and brought a greater source-filter interaction.

Singing with Gesture: Acoustic and Perceptual Measures of Solo Singers

The purpose of this investigation was to examine the potential effects of two singer gestures on performances of solo singers (N = 32). Participants sang two songs ("Over the Rainbow" with low, circular arm gesture and "Singin' in the Rain" with pointing gesture) five times: Baseline (without singer gesture), three iterations of each song paired with a singer gesture, and a post-test (without singer gesture). This investigation measured acoustic (F_o and amplitude) and perceptual (participant perceptual questionnaire) differences of solo singers. Results indicated significant differences in acoustic measures of intonation between baseline and gestural iterations while employing an upward pointing gesture. However, no significant differences in amplitude were found between iterations of the songs sung with and without gestures. The majority of participant perceptions of singing with gesture related to intonation and timbre when using gestures. Results were discussed in terms of singing pedagogy, limitations of the study, and suggestions for further research.

The Russian Mass Spectrometry Interest Group at ASMS: Over 20 Years of Science and Water Polo

The Russian Mass Spectrometry Interest Group (RMSIG) emerged in 1998 during the annual ASMS meeting in Orlando, FL. The original goal of the group was to help assimilating mass spectrometrists from the former Soviet Union countries into the West. Following the fulfillment of this objective, the RMSIG continues nowadays as a social and scientific club of 200+ members, to the benefit of mass spectrometry at large. Herein, we share with you the tale of the RMSIG: its history, accomplishments, and present days activities-all in a close relation to ASMS.

Upper Airway Thermoregulation During Singing Warm-Up

The primary aim of this research was to quantify the degree to which the upper airway temperature changes with singing warm-up. Based on prior upper airway thermoregulation research it was hypothesized that upper airway temperature would not significantly increase during singing warm up when compared to prewarm up and recovery phases. Ten participants completed a short singing warm-up of their choice until they felt sufficiently warmed up while upper airway temperature was measured at 1 second intervals via a transnasal thermistor placed against the posterior pharyngeal wall, just above the larynx. Descriptive statistics and statistical modeling were used for comparison of pre-warm-up, warm-up, and recovery phases of a short singing warm-up. Results indicated a physiologically-significant increase (≥0.5°C) of upper airway temperature during the singing warm-up when compared to the prewarm up average. Significant differences (P < 0.0001) were identified between all pairwise comparisons analyzed for the three phases of data collected (baseline, warm-up, and recovery). These findings support an upper airway tissue temperature increase in response to the singing warm-up. The extent to which these findings can be generalized to the intrinsic laryngeal muscles is still unknown given the technical difficulty of obtaining intramuscular laryngeal temperature measures.

Cognitive and neural mechanisms underlying the mnemonic effect of songs after stroke

Sung melody provides a mnemonic cue that can enhance the acquisition of novel verbal material in healthy subjects. Recent evidence suggests that also stroke patients, especially those with mild aphasia, can learn and recall novel narrative stories better when they are presented in sung than spoken format. Extending this finding, the present study explored the cognitive mechanisms underlying this effect by determining whether learning and recall of novel sung vs. spoken stories show a differential pattern of serial position effects (SPEs) and chunking effects in non-aphasic and aphasic stroke patients (N = 31) studied 6 months post-stroke. The structural neural correlates of these effects were also explored using voxel-based morphometry (VBM) and deterministic tractography (DT) analyses of structural MRI data. Non-aphasic patients showed more stable recall with reduced SPEs in the sung than spoken task, which was coupled with greater volume and integrity (indicated by fractional anisotropy, FA) of the left arcuate fasciculus. In contrast, compared to non-aphasic patients, the aphasic patients showed a larger recency effect (better recall of the last vs. middle part of the story) and enhanced chunking (larger units of correctly recalled consecutive items) in the sung than spoken task. In aphasics, the enhanced chunking and better recall on the middle verse in the sung vs. spoken task correlated also with better ability to perceive emotional prosody in speech. Neurally, the sung > spoken recency effect in aphasic patients was coupled with greater grey matter volume in a bilateral network of temporal, frontal, and parietal regions and also greater volume of the right inferior fronto-occipital fasciculus (IFOF). These results provide novel cognitive and neurobiological insight on how a repetitive sung melody can function as a verbal mnemonic aid after stroke.

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Non-aphasic stroke patients show more stable recall of sung than spoken stories.

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Aphasic patients show larger recency and chunking effects to sung vs. spoken stories.

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The left dorsal pathway mediates better recall of sung stories in non-aphasics.

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The right ventral pathway mediates better recall of sung stories in aphasics.

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Large-scale bilateral cortical networks are linked to musical mnemonics in aphasia.

Difficulty producing high-pitched sounds in singing: correlations with laryngostroboscopy and electromyographic findings

INTRODUCTION

Difficulties or limitations in producing high-pitched sounds while singing may be due to the vocal technique used or organic factor. The observation of such difficulty or limitation by singing teachers is one of the main reasons affected individuals are referred to otolaryngologists.

OBJECTIVE

To evaluate the laryngostroboscopic and electromyographic changes in the cricothyroid muscles of singers with difficulties or limitations producing high-pitched sounds.

METHODS

This is a cross-sectional study. Ten singers with difficulty producing high-pitched sounds underwent voice, laryngostroboscopic, and electromyographic evaluations.

RESULTS

None of the evaluated singers presented signs of impairment of the superior laryngeal nerve on laryngostroboscopy. The electromyographic findings for the cricothyroid muscle were normal for all singers. Six singers presented vocal fold lesions, seven had signs suggestive of laryngopharyngeal reflux, and two presented vascular changes.

CONCLUSION

No signs suggestive of superior laryngeal nerve paresis or paralysis were observed on laryngostroboscopy and electromyography of the cricothyroid muscle in singers with difficulties or limitations producing high-pitched sounds. The presence of vocal fold lesions should be investigated in this population.

Water Resistance Therapy as Vocal Warm-Up Method in Contemporary Commercial Music Singers

BACKGROUND/AIMS

Although water resistance therapy (WRT) has been widely used in voice training, no data are supporting the effectiveness of WRT as vocal warm-up for singers. The present study aimed to determine the effects of WRT as a vocal warm-up method in contemporary commercial music (CCM) singers.

METHODS

Twenty-two CCM singers were randomly assigned to one of two types of 15-min vocal warm-up: open vocal tract (OVT) warm-up and WRT. Self-perceived resonant voice quality and aerodynamic, electroglottographic, and acoustic measures were assessed before, immediately after vocal warm-up, and after 40 min of vocal loading.

RESULTS

Significant results were found immediately after vocal warm-up. Subglottic pressure and inspiratory airflow duration decreased in both groups. SPL decreased for the OVT group. No changes in SPL were found for the WRT group. Significant results were observed after vocal loading. Subglottic pressure and inspiratory airflow duration decreased for both groups after vocal loading. Expiratory airflow duration and electroglottographic contact quotient decreased for the OVT group.

CONCLUSION

Some objective data suggest that the WRT method is more effective as vocal warm-up than OVT exercises. Since outcomes in self-perceived resonant voice quality for both methods were similar but physiological effects were different, vocal warm-up strategies might produce a placebo effect.

Principles of Motor Learning in Classical Singing Teaching

INTRODUCTION

Classical singing is a complex and multifaceted skill that requires the amalgamation of multiple cognitive, perceptual and motor functions. The teaching of classical singing is consequently a unique skill that holds further complexity. The singer is required to achieve and maintain consistently high performance development of a specific motor activity, much like the sports athlete. This pilot study examines a method of using the principles of motor learning to more objectively and reliably investigate the teaching behaviors of classical singing teachers. Such a method may establish a nexus between empirical research, teaching quality and learning outcomes in music performance education.

METHOD

A total of 12 participants were recruited from two Australian conservatoria of music. All participants were fluent in English at tertiary level. Participants included four classical singing teachers and eight classical singing students over the age of 18 years. Eight one-to-one singing lessons between the teacher and student were audio-visually recorded. Content analysis was conducted on the observational data. The principles of motor learning were used as a behavioral framework protocol to allow for the systematic identification of teaching behavior.

RESULTS

Results presented various findings regarding teaching behaviors in one-to-one classical singing lessons in higher music education. Key findings included (a) common use of instruction, feedback, modeling, and other behaviors (b) uncommon use of motivation, explanation, and perceptual training behaviors, (c) higher use of knowledge of results than knowledge of performance feedback behaviors, (d) high routine use of instruction, modeling, and feedback behaviors each time a student attempted a task, (e) common use of other suggested teachers use behaviors unidentifiable by the behavioral protocol, and (f) the principles of motor learning appear to be a reliable framework for the identification of teaching behaviors in this field.

CONCLUSION

This study may have implications for how teachers administer and govern their behaviors in one-to-one classical singing lessons. The principles of motor learning may encourage a nexus between empirical research, teaching quality, and learning outcomes. Furthermore, this study provides recommendations for future research on systematically improving teaching and learning in this field.

'Singing with your baby': an evaluation of group singing sessions for women admitted to a specialist mother-baby unit

This paper reports on the acceptability, experience of participation and the immediate impact on maternal mood state of group singing sessions, introduced as a routine component of a mother-baby unit (MBU) treatment programme. Data was collected from 27 women who participated in the pilot programme. Results showed that implementation of a singing intervention in this setting is positively appraised by women and is associated with positive changes in self-reported mood state from pre- to post-session. Key facilitators and barriers to the success of the programme and directions for future research are discussed.

Prevalence, Characterization, and Impact of Voice Disorders in Fado Singers

INTRODUCTION

Fado is a genre of urban folk music from Portugal characterized by some particularities. Some indictions in the study point this population of singers to be at higher risk of developing voice disorders.

AIM

This study aims to provide estimates of the prevalence of voice disorders in Fado singers, and to characterize the professional practice and the impact of voice disorders on their careers.

METHODS

This is a cross sectional study based on a self-administered questionnaire split into six parts and 55 questions.

RESULTS

A gender-balanced sample of 111 singers was achieved. Most of them recorded at least once. Winter and spring were found to be the most difficult seasons in which to sing. The overall prevalence of self-reported voice disorders was 39.6%, significantly higher in females. Almost all sought clinical guidance. Vocal fold nodules, functional dysphonia, and vocal fold polyp were the most common diagnoses. Vocal fatigue and hoarseness were the main symptoms reported. Nearly half of the singers had to cancel shows due to voice disorders.

CONCLUSION

Fado singers reveal both a relative high prevalence of voice disorders and related concerns, even though some discrepancies were found regarding other apparently similar singer populations. These results lead support the need for further investigation regarding the risk or protective factors influencing voice disorders.