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White A, Carding P, Booth V, McGlashan J, Van Stan J, Logan P, Awad R. Pre- and post-operative voice therapy for benign vocal fold lesions: protocol for a non-randomised, multicentre feasibility trial with embedded process evaluation. Pilot Feasibility Stud 2024; 10:84. [PMID: 38783383 PMCID: PMC11112800 DOI: 10.1186/s40814-024-01508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Management of benign vocal fold lesions (BVFLs) is variable with individuals receiving surgery, voice therapy, or a combination of these approaches. Some evidence suggests that the best outcomes may be achieved when patients are offered pre- and post-operative voice therapy in addition to phonosurgery, but what constitutes pre- and post-operative voice therapy is poorly described. The pre- and post-operative voice therapy (PAPOV) intervention has been developed and described according to the TIDieR checklist and Rehabilitation Treatment Specification System (RTSS) for voice. The PAPOV intervention is delivered by specialist speech and language therapists trained in the intervention and comprises 7 essential and 4 additional components, delivered in voice therapy sessions with patients who are having surgery on their vocal folds for removal of BVFLs. STUDY DESIGN Non-randomised, multicentre feasibility trial with embedded process evaluation. METHOD Forty patients from two sites who are due to undergo phonosurgery will be recruited to receive the PAPOV intervention. Measures of feasibility, including recruitment, retention, and adherence, will be assessed. The feasibility of gathering clinical and cost effectiveness data will be measured pre-treatment, then at 3 and 6 months post-operatively. An embedded process evaluation will be undertaken to explain feasibility findings. DISCUSSION This study will assess the feasibility of delivering a described voice therapy intervention protocol to patients who are undergoing surgery for removal of BVFLs. Findings will be used to inform the development and implementation of a subsequent effectiveness trial, should this be feasible. TRIAL REGISTRATION This trial has been prospectively registered on ISRCTN (date 4th January 2023), registration number 17438192, and can be viewed here: https://www.isrctn.com/ISRCTN17438192 .
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Affiliation(s)
- Anna White
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
- Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Paul Carding
- Oxford Institute of Applied Health Research, Oxford, UK
| | - Vicky Booth
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Pip Logan
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rehab Awad
- University Hospital Lewisham NHS Trust, London, UK
- Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
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Morrison RA, Fetzer DT, Patterson-Lachowicz A, McDowell S, Smeltzer JCC, Mau T, Shembel AC. Optical Flow Analysis of Paralaryngeal Muscle Movement. Laryngoscope 2024; 134:1792-1801. [PMID: 37772838 PMCID: PMC10947946 DOI: 10.1002/lary.31063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/11/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES The paralaryngeal muscles are thought to be hyperfunctional with phonation in patients with primary muscle tension dysphonia (pMTD). However, objective, quantitative tools to assess paralaryngeal movement patterns lack. The objectives of this study were to (1) validate the use of optical flow to characterize paralaryngeal movement patterns with phonation, (2) characterize phonatory optical flow velocities and variability of the paralaryngeal muscles before and after a vocal load challenge, and (3) compare phonatory optical flow measures to standard laryngoscopic, acoustic, and self-perceptual assessments. METHODS Phonatory movement velocities and variability of the paralaryngeal muscles at vocal onsets and offsets were quantified from ultrasound videos and optical flow methods across 42 subjects with and without a diagnosis of pMTD, before and after a vocal load challenge. Severity of laryngoscopic mediolateral supraglottic compression, acoustic perturbation, and ratings of vocal effort and discomfort were also obtained at both time points. RESULTS There were no significant differences in optical flow measures of the paralaryngeal muscles with phonation between patients with pMTD and controls. Patients with pMTD had significantly more supraglottic compression, higher acoustic perturbations, and higher vocal effort and vocal tract discomfort ratings. Vocal load had a significant effect on vocal effort and discomfort but not on supraglottic compression, acoustics, or optical flow measures of the paralaryngeal muscles. CONCLUSION Optical flow methods can be used to study paralaryngeal muscle movement velocity and variability patterns during vocal productions, although the role of the paralaryngeal in pMTD diagnostics (e.g., vocal hyperfunction) remains suspect. LEVEL OF EVIDENCE 2 Laryngoscope, 134:1792-1801, 2024.
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Affiliation(s)
- Robert A. Morrison
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - David T. Fetzer
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Amber Patterson-Lachowicz
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sarah McDowell
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Julianna C. Comstock Smeltzer
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Ted Mau
- Department of Otolaryngology-Head and Neck, Center for Voice Care, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Adrianna C. Shembel
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
- Department of Otolaryngology-Head and Neck, Center for Voice Care, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Tohidast SA, Mansuri B, Memarian M, Ghobakhloo AH, Scherer RC. Voice Quality and Vocal Tract Discomfort Symptoms in Patients With COVID-19. J Voice 2024; 38:542.e29-542.e33. [PMID: 34776316 PMCID: PMC8511652 DOI: 10.1016/j.jvoice.2021.09.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dysphonia and laryngeal problems are some of the manifestations of the COVID-19 pandemic due to respiratory disease as a primary effect of COVID-19. The aim of the present study was to investigate voice quality and vocal tract discomfort symptoms in patients with COVID-19. MATERIALS AND METHODS Forty-four COVID-19 patients with a mean age of 49.61 ± 16.48 years and 44 healthy subjects with a mean age of 48.52 ± 13.8 years participated in the study. The voice quality of the participants was evaluated using auditory-perceptual evaluation with the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale. The vocal tract discomfort symptoms of the participants were assessed using the Persian version of the VTD scale. RESULTS Patients with COVID-19 had higher scores in all items of the GRBAS, including grade, roughness, breathiness, asthenia, and strain, than healthy subjects, and these differences were statistically significant (P < 0.05). Among the GRBAS parameters, grade had the highest effect size and asthenia had the lowest effect size in both speech tasks. The COVID-19 patients had a greater frequency of vocal tract discomfort symptoms than healthy subjects in all items of the VTDp scale and these differences were statistically significant (P < 0.05) in the following items: burning, tight, dry, pain, sore, irritable, and lump in the throat. The most and the least effect size in frequency of the vocal tract discomfort symptoms were related to dry (d = 1.502) and tickling (d = 0.157), respectively. Also, COVID-19 patients had more significant severity in all items of the VTDp scale except tight and tickling. The most and the least effect size in severity of the vocal tract discomfort symptoms was related to dry (d = 1.416) and tickling (d = 0.152), respectively. CONCLUSION The present study suggests that COVID-19 patients have more deviations in voice quality than healthy subjects. Moreover, mild vocal tract discomfort is prevalent in patients with COVID-19, and patients have more frequent and severe physical discomforts of the vocal tract than healthy subjects.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mohammad Memarian
- Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Ronald Callaway Scherer
- Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio
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Hockey K, Kennedy E. Clinical Characteristics of Individuals Presenting to Physiotherapy for Voice and Throat Care: A Retrospective Case Notes Review. J Voice 2024:S0892-1997(24)00009-2. [PMID: 38429117 DOI: 10.1016/j.jvoice.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Currently, little is known about the characteristics of individuals presenting for physiotherapy care with voice and throat problems. PURPOSE The aim of this study is to describe the demographic and clinical characteristics of individuals presenting to physiotherapy for voice and throat-related problems, and to use this information to clarify the role of physiotherapy in the management of people with voice and throat problems. METHODS A retrospective clinical case notes review was conducted of all clients who accessed physiotherapy for voice and throat problems at a private practice based in Christchurch within a 12-month period from 1st October 2020 to 1st October 2021. RESULTS Data were analyzed from 53 patient charts. The typical profile of an individual accessing physiotherapy for voice and throat problems were female (n = 37), NZ European (n = 26), singer (n = 43), with chronic problems (n = 20), of a nontraumatic origin (n = 45). Voice problems were present in 39 cases and muscle-related problems were present in 42 cases. Treatment primarily included manual therapy and various modes of exercise therapy. CONCLUSIONS The clinical characteristics described offer insight into the demographic and clinical characteristics of individuals accessing physiotherapy services for voice and throat problems. A high prevalence of muscle-related problems and wider issues were identified, consistent with the physiotherapy skill set. Physiotherapy appears to complement existing ENT or SLT services by identifying and managing muscle-related voice problems and addressing wider factors contributing to voice and throat problems.
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Shembel AC, Morrison RA, Fetzer DT, Patterson-Lachowicz A, McDowell S, Comstock Smeltzer JC, Mau T. Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography. Laryngoscope 2023; 133:3482-3491. [PMID: 37334857 PMCID: PMC10728340 DOI: 10.1002/lary.30830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES It has been assumed that patients with primary muscle tension dysphonia (pMTD) have more extrinsic laryngeal muscle (ELM) tension, but tools to study this phenomenon lack. Shear wave elastography (SWE) is a potential method to address these shortcomings. The objectives of this study were to apply SWE to the ELMs, compare SWE measures to standard clinical metrics, and determine group differences in pMTD and typical voice users before and after vocal load. METHODS SWE measurements of the ELMs from ultrasound examinations of the anterior neck, supraglottic compression severities from laryngoscopic images, cepstral peak prominences (CPP) from voice recordings, and self-perceptual ratings of vocal effort and discomfort were obtained in voice users with (N = 30) and without (N = 35) pMTD, before and after a vocal load challenge. RESULTS ELM tension significantly increased from rest-to-voiced conditions in both groups. However, the groups were similar in their ELM stiffness levels at SWE at baseline, during vocalization, and post-vocal load. Levels of vocal effort and discomfort and supraglottic compression were significantly higher and CPP was significantly lower in the pMTD group. Vocal load had a significant effect on vocal effort and discomfort but not on laryngeal or acoustic patterns. CONCLUSION SWE can be used to quantify ELM tension with voicing. Although the pMTD group reported significantly higher levels of vocal effort and vocal tract discomfort and, on average, exhibited significantly more severe supraglottic compression and lower CPP values, there were no group differences in levels of ELM tension using SWE. LEVEL OF EVIDENCE 2 Laryngoscope, 133:3482-3491, 2023.
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Affiliation(s)
- Adrianna C. Shembel
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Robert A. Morrison
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - David T. Fetzer
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Amber Patterson-Lachowicz
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sarah McDowell
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Julianna C. Comstock Smeltzer
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Ted Mau
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Al Awaji NN, Alghamdi KA, Alfaris AM, Alzamil RZ, Alhijji LN, Alyehya GS, Al Harbi SM, Mortada EM. Measuring Perceived Voice Disorders and Quality of Life among Female University Teaching Faculty. J Pers Med 2023; 13:1568. [PMID: 38003883 PMCID: PMC10672704 DOI: 10.3390/jpm13111568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Occupations that require heavy vocal use can place the person at risk of voice disorders (VDs). Heavy demands on the voice, especially for a long time or with loud back-ground noise, can lead to vocal abuse or misuse. The study aimed to measure the prevalence of perceived voice disorders among the teaching faculty at a female university, identify the risk fac-tors that affect their voice, and determine the effect of perceived voice disorders on their quality of life (QoL). METHODS The study sample consisted of female teaching faculty (N = 401). The ques-tionnaire included general sociodemographic data, general voice data, the vocal tract discomfort (VTD) scale, and the World Health Organization Quality of Life assessment (WHOQOL)-BREF. RESULTS The results demonstrated that 44.1% of the participants had perceived voice disorders, and stress, reflux, and asthma had a significant relationship with self-perceived voice disorders. Furthermore, the data showed that self-perceived voice disorders negatively impacted the overall QoL of teaching faculty. CONCLUSIONS Perceived voice disorders are affected by various factors, including health conditions, medications, and lifestyle choices. Although teaching characteristics and demo-graphic factors are believed to be the cause, in this study they did not significantly contribute to perceived voice disorders. Faculty members with perceived voice disorders have a poorer quality of life, highlighting the need for education on preventative vocal measures and awareness of voice care.
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Affiliation(s)
- Nisreen Naser Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (N.N.A.A.); (R.Z.A.); (L.N.A.); (G.S.A.); (S.M.A.H.)
| | - Khaled Abdulraheem Alghamdi
- Rehabilitation Department, King Abdullah Bin Abdulaziz University Hospital, P.O. Box 47330, Riyadh 11552, Saudi Arabia; (K.A.A.); (A.M.A.)
| | - Abdullah Mohammed Alfaris
- Rehabilitation Department, King Abdullah Bin Abdulaziz University Hospital, P.O. Box 47330, Riyadh 11552, Saudi Arabia; (K.A.A.); (A.M.A.)
| | - Rahaf Zamil Alzamil
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (N.N.A.A.); (R.Z.A.); (L.N.A.); (G.S.A.); (S.M.A.H.)
| | - Lojain Naser Alhijji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (N.N.A.A.); (R.Z.A.); (L.N.A.); (G.S.A.); (S.M.A.H.)
| | - Ghaida Saad Alyehya
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (N.N.A.A.); (R.Z.A.); (L.N.A.); (G.S.A.); (S.M.A.H.)
| | - Shadan Mohammed Al Harbi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (N.N.A.A.); (R.Z.A.); (L.N.A.); (G.S.A.); (S.M.A.H.)
| | - Eman M. Mortada
- Health Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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Tohidast SA, Fazeli F, Golmohammadi G, Scherer RC, Mansuri B. Vocal Tract Discomforts among Smokers. J Voice 2023:S0892-1997(23)00289-8. [PMID: 37914658 DOI: 10.1016/j.jvoice.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Smoking is a dangerous behavior for the human body and the vocal tract. Smoking can cause several laryngeal and vocal tract symptoms in smokers. One of these symptoms can be physical discomfort experienced by this population. Therefore, the aim of the present study was to investigate vocal tract discomfort (VTD) in smokers compared to healthy non-smoker participants. MATERIALS AND METHODS The smokers group was forty-eight men with a mean age of 47.54 ± 9.21 years, and the matched non-smokers group was 48 men with a mean age of 44.88 ± 10.81 years. The participants underwent vocal tract discomfort assessment using the Persian version of the VTD scale. Statistical Package for the Social Science (SPSS) was used for statistical analysis and the Mann-Whitney U test was used to compare variables between groups. RESULTS The smokers more frequently had VTD symptoms (P < 0.05) than non-smokers for all items of the VTD scale with the exception of aches. Also, smokers had more significant VTD severity in all items than non-smokers (P < 0.05). Moreover, there were significant statistical differences between the total score of both frequency and severity of VTD between smokers and non-smokers. The most to the least VTD symptoms in smokers were irritation, sore, tickling, burning, tightness, lump in the throat, dry, and aching symptoms, respectively. CONCLUSION The present study suggests that smoking can cause more physical vocal tract discomfort in smokers compared to non-smokers. These results can inform future research and interventions in the smoker population.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Faezeh Fazeli
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Golnoosh Golmohammadi
- Department of Speech Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Ronald C Scherer
- Distinguish Research Professor, Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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Fuentes C, Castañón S, Roldán L. Differences between the Perilaryngeal Pressure Pain Thresholds in Asymptomatic Women, Women With Bruxism, and Women With Odynophonia. J Voice 2023:S0892-1997(23)00219-9. [PMID: 37661520 DOI: 10.1016/j.jvoice.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE This study was aimed at comparing perilaryngeal pressure pain thresholds (PPT) among asymptomatic women, women with bruxism, and women with odynophonia. DESIGN Observational cross-sectional study. METHODS Eighty-four women whose age mean was 23.75 (SD, 3.02) years were grouped according to inclusion and exclusion criteria into a group of asymptomatic women (G1), another group of women with bruxism (G2), and another of women with odynophonia (G3). Palpation was used to identify regions of interest for this study, and an analog algometer was used to evaluate perilaryngeal PPT in the previously localized regions. Each PPT evaluation was done twice. RESULTS G1 PPT mean were between 1.35 (SD, 0.20) and 2.29 (SD, 0.28) kg/cm2, G2 PPT mean were found between 0.85 (SD, 0.12) and 1.78 (SD, 0.23) kg/cm2, and G3 PPT mean were located between 0.71 (SD, 0.11) and 1.45 (SD, 0.19) kg/cm2. Differences were observed between PPT in the three groups evaluated (P < 0.05). The intra-evaluator agreement between the evaluations performed fluctuated between 60.71% (κ = 0.51) and 92.86% (κ = 0.91). CONCLUSIONS There are significant differences between the perilaryngeal PPT of asymptomatic women, women with bruxism, and women with odynophonia. Asymptomatic women had the highest PPT, while odynophonia sufferers had the lowest.
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Affiliation(s)
- Christopher Fuentes
- Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Región Metropolitana, Chile.
| | - Sebastián Castañón
- Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Región Metropolitana, Chile
| | - Lylia Roldán
- Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Región Metropolitana, Chile
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Baker CP, Purdy SC, Rakena TO, Bonnini S. It Sounds like It Feels: Preliminary Exploration of an Aeroacoustic Diagnostic Protocol for Singers. J Clin Med 2023; 12:5130. [PMID: 37568532 PMCID: PMC10420037 DOI: 10.3390/jcm12155130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
To date, no established protocol exists for measuring functional voice changes in singers with subclinical singing-voice complaints. Hence, these may go undiagnosed until they progress into greater severity. This exploratory study sought to (1) determine which scale items in the self-perceptual Evaluation of Ability to Sing Easily (EASE) are associated with instrumental voice measures, and (2) construct as proof-of-concept an instrumental index related to singers' perceptions of their vocal function and health status. Eighteen classical singers were acoustically recorded in a controlled environment singing an /a/ vowel using soft phonation. Aerodynamic data were collected during a softly sung /papapapapapapa/ task with the KayPENTAX Phonatory Aerodynamic System. Using multi and univariate linear regression techniques, CPPS, vibrato jitter, vibrato shimmer, and an efficiency ratio (SPL/PSub) were included in a significant model (p < 0.001) explaining 62.4% of variance in participants' composite scores of three scale items related to vocal fatigue. The instrumental index showed a significant association (p = 0.001) with the EASE vocal fatigue subscale overall. Findings illustrate that an aeroacoustic instrumental index may be useful for monitoring functional changes in the singing voice as part of a multidimensional diagnostic approach to preventative and rehabilitative voice healthcare for professional singing-voice users.
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Affiliation(s)
- Calvin Peter Baker
- Speech Science, School of Psychology, University of Auckland, Auckland 1023, New Zealand;
- School of Music, University of Auckland, Auckland 1010, New Zealand;
| | - Suzanne C. Purdy
- Speech Science, School of Psychology, University of Auckland, Auckland 1023, New Zealand;
| | - Te Oti Rakena
- School of Music, University of Auckland, Auckland 1010, New Zealand;
| | - Stefano Bonnini
- Department of Economics & Management, University of Ferrara, 44121 Ferrara, Italy;
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Saeedi S, Aghajanzadeh M, Khoddami SM, Dabirmoghaddam P, Jalaie S. Relationship of cepstral analysis with voice self-assessments in dysphonic and normal speakers. Eur Arch Otorhinolaryngol 2023; 280:1803-1813. [PMID: 36229669 DOI: 10.1007/s00405-022-07690-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/04/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aimed to investigate the relationship of cepstral analysis (Cepstral Peak Prominence [CPP] and Cepstral Peak Prominence-Smoothed [CPPS]) with voice self-assessments (The Persian version of vocal tract discomfort [VTDp] scale and non-standard hoarseness self-assessment [NHS] questionnaire). METHODS 223 participants (159 with and 64 without dysphonia) were asked to utter the vocal tasks namely vowels /a/ and /e/, six standard sentences, and a non-standard connected speech sample. CPP and CPPS were calculated in these three vocal tasks using the "Praat" software. The participants also asked to complete the VTDp scale and the NHS questionnaire. RESULTS The means of frequency and severity the VTDp and the means of NHS were statistically different between the dysphonic and normal voice groups (P < 0.05), except for tickling (P > 0.05). There was a very low significant correlation between cepstral analysis with aching and in the dysphonic group (P < 0.05). However, a very low to low significant correlation between cepstral analysis with burning, tight, aching, tickling, sore, and both frequency and severity subscales scores of the VTDp in the normal voice group (P < 0.05). Moreover, the means of the cepstral analysis did not differ significantly between all scores of the NHS in the dysphonic the normal voice groups (P > 0.05), except for 1 with 3, 4, and 5 in the dysphonic group (P < 0.05). CONCLUSION The cepstral analysis can provide some information about the status of vocal tract and person's perception of his/her own voice quality.
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Affiliation(s)
- Saeed Saeedi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Aghajanzadeh
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyyedeh Maryam Khoddami
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Dabirmoghaddam
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Jalaie
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Silva CRDL, Nunes ADDS, de Souza LBR, Barbosa IR. Wind instrumentalists' work-related vocal tract discomfort. Work 2023; 74:89-95. [PMID: 36214007 DOI: 10.3233/wor-205244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Wind instrumentalist use the vocal tract intensively in their professional activities, which can lead to the development work-related voice disorders. OBJECTIVE To analyze the perception of vocal tract discomfort (VTD) by wind instrumentalists from Natal, Brazil. METHOD Cross-sectional study with 117 professional musicians and music students from six official bands/orchestras in the city of Natal. Both the Vocal Tract Discomfort Scale and a sample characterization questionnaire were applied. The Chi-square test, Fisher's exact test, and Mann-Whitney U test were applied in the statistical analysis of the variables. RESULTS The most frequent and intense symptoms of VTD were sensitive throat and sore throat. There was a significant difference between the values of frequency and intensity of all symptoms both before and after playing the instrument. Dryness was the most intense symptom felt after playing the instrument. Musicians who report muscle pain and gastroesophageal reflux showed more VTD symptoms. CONCLUSION Symptoms of VTD are experienced by wind instrumentalists and can be work-related since there was a difference in their perception after playing their instruments. There was also a relationship with gastroesophageal reflux and muscle pain, indicating that, in addition to collective issues, the individual musicians' health should be taken into account.
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Affiliation(s)
| | | | | | - Isabelle Ribeiro Barbosa
- Health Sciences College of Trairi (FACISA), Federal University of Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil
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12
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Tahamtan M, Kakavandi A, Scherer RC, Vahedi M. Vocal Tract Discomfort Symptoms in Elementary and High School Teachers. J Voice 2023; 37:68-78. [PMID: 33455854 DOI: 10.1016/j.jvoice.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The vocal tract discomfort scale is a self-rating seven-point Likert scale that quantifies frequency and severity of eight qualitative descriptors including burning, tight, dry, aching, tickling, sore, irritable, and lump in the throat, and ranges from 0 (never/none) to 6 (always/extreme; Mathieson et al. 2009). The objectives of the current study were to compare the vocal tract discomfort scale results between elementary school teachers and high school teachers and between male and female teachers using the Persian vocal tract discomfort scale. Also, teachers in different age ranges and with different experiences were compared regarding vocal tract discomfort symptoms. METHODS The researchers chose 20 elementary and high schools by simple random sampling in Khorramabad, Iran. The survey was given to available teachers of the selected schools. Considering the inclusion criteria, required sample size, and after excluding questionnaires that were not correctly answered, 120 were selected such that 30 were chosen for each subgroup. Subjects consisted of 60 elementary school teachers (30 females and 30 males) with the mean age of 40.92 years (standard deviation = 6.07) and 60 high school teachers (30 females and 30 males) with the mean age of 40.67 years (standard deviation = 6.00). SPSS 25 was used for analyzing the data. RESULTS Results indicated that the frequency and severity of the vocal tract discomfort in elementary school teachers were significantly higher than for the high school teachers with a medium to large effect size. Although the frequency and severity of the symptoms were higher in female compared with male teachers, those differences were not significantly different. Younger teachers had lower frequency and severity ratings of vocal tract discomfort symptoms than older teachers. Teaching experience was not an important factor in predicting vocal tract discomfort symptoms in teachers. CONCLUSIONS The results of this study suggest that there is higher frequency, greater severity, and higher percentages of vocal tract discomfort symptoms in elementary compared with high school teachers. In addition, although the mean frequency and severity of vocal tract discomfort symptoms were not significantly different between females and males, females reported higher percentages of the symptoms. Because each of the eight vocal tract symptoms was experienced at the time of testing by between 42% (tightness) and 68% (dryness) of the participants, it is suggested that an educational program regarding vocal tract discomfort may be helpful for this profession.
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Affiliation(s)
- Mahdi Tahamtan
- Department of Communication Sciences and Disorders, College of Health and Human Services, Bowling Green State University, Bowling Green, Ohio
| | - Ali Kakavandi
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Ronald C Scherer
- Department of Communication Sciences and Disorders, College of Health and Human Services, Bowling Green State University, Bowling Green, Ohio
| | - Mohsen Vahedi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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13
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Guzman M, Calvache C, Pacheco F, Ugalde N, Ortiz V, Lago JD, Bobadilla M. A Voice Rehabilitation Protocol With the Semioccluded Ventilation Mask in Subjects With Symptoms of Vocal Fatigue and Phonatory Effort. J Voice 2023; 37:60-67. [PMID: 33097365 DOI: 10.1016/j.jvoice.2020.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE The present study was designed to assess the efficacy of a six-session physiologic voice therapy program with the semioccluded ventilation mask (SOVM) in a group of subjects with voice complaints (vocal effort and fatigue). METHODS Thirty-four participants with functional dysphonia were randomly assigned to one of two treatment groups: (1) voice treatment with physiologic voice therapy plus vocal hygiene program (n = 17), and (2) vocal hygiene program only (n = 17). Laryngoscopic assessment was performed in all subjects to confirm laryngeal diagnosis. Before and after voice therapy, participants underwent aerodynamic assessment. The Voice Handicap Index (VHI), Vocal Tract Discomfort Scale (VTDS), and self-assessment of resonant voice were also performed. The treatment included six voice therapy sessions. For the experimental group, the exercises consisted of a sequence of seven phonatory tasks performed with the SOVM. Comparison for all variables was performed between experimental group and control group. RESULTS Statistical analysis showed significant improvements for experimental group for VHI (decrease), VTDS (decrease), and self-perception of resonant voice quality (increase). Significant decrease for experimental group was observed in subglottic pressure and phonation threshold pressure. CONCLUSION Physiologic voice therapy based on the SOVM with connected speech exercises seems to be an effective tool to improve voice in subjects diagnosed with voice complaints. Apparently, improvements are reflected in both subjective and objective outcomes. A reduction in phonatory effort and perceptual aspects of vocal fatigue are the main subjective improvements. A decrease in air pressure-related variables seems to be the most important objective change after voice therapy.
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Affiliation(s)
- Marco Guzman
- Department of Communication Sciences and Disorders, Universidad de los Andes, Chile.
| | - Carlos Calvache
- Department of Communication Sciences and Disorders, Corporacion Universitaria Iberoamericana, Vocology Center, Bogota, Colombia
| | | | | | - Vasti Ortiz
- Department of Communication Sciences and Disorders, Universidad de Chile, Santiago, Chile
| | - Juan Del Lago
- Department of Otolaryngology, Clínica Universidad de los Andes, Santiago, Chile
| | - Marcelo Bobadilla
- Department of Communication Sciences and Disorders, Universidad de los Andes, Santiago, Chile
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14
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McDowell S, Morrison R, Mau T, Shembel AC. Clinical Characteristics and Effects of Vocal Demands in Occupational Voice Users With and Without Primary Muscle Tension Dysphonia. J Voice 2022:S0892-1997(22)00311-3. [PMID: 36334967 PMCID: PMC10151438 DOI: 10.1016/j.jvoice.2022.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objectives of this study were to (1) compare laryngeal configuration patterns in occupational voice users with and without primary muscle tension dysphonia (pMTD), (2) characterize laryngeal configurations in relation to other clinical metrics (acoustic, perceptual), and (3) determine the effects of vocal demands (load) on these clinical parameters. METHODS Thirty subjects (15 pMTD, 15 control) were recruited for the study. Laryngoscopic examinations and voice samples for sustained /i/ were obtained before and after a half hour vocal load task. Subjects rated their vocal effort and discomfort before and after the vocal load. Laryngeal configurations were analyzed subjectively with dichotomous and categorical rating scales and hyper function severity quantified (endolaryngeal area outlets). Overall dysphonia severity and vocal instability of each voice sample was rated on 100mm visual analog scales and cepstral peak prominence (CPP) extracted from each voice sample. RESULTS Laryngeal configurations between groups or vocal load condition were not distinguishable with any of the dichotomous, categorical, or quantitative laryngeal metrics. Vocal effort and discomfort ratings were significantly higher in the pMTD group compared to the control group. Vocal load also had significant effects across groups on vocal effort and vocal tract discomfort ratings. Although CPP values fell within the normal range in both groups, CPP was significantly lower in the pMTD group at both pre-load and post-load time points. Auditory-perceptual ratings were also significantly worse in the pMTD group. Vocal load did not have a significant effect on acoustic or auditory-perceptual measures. CONCLUSION Similar laryngeal configurations between groups at both pre- and post-vocal load suggests classic patterns of laryngeal "hyperadduction" may occur variably in occupational voice users and may not be indicative of pMTD pathophysiology. Greater vocal effort, discomfort, instability, and perturbation within the vocal system may better define pMTD than laryngeal configuration in occupational voice users with pMTD.
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Affiliation(s)
- Sarah McDowell
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas
| | - Robert Morrison
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas
| | - Ted Mau
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Adrianna C Shembel
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas; Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, Texas.
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15
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Kasbi F, Tohidast SA, Mokhlesin M, Mansuri B, Jazem F, Ghorbani R, Kaviani S, Scherer RC. Voice Problems and Related Risk Factors Among Hairdressers. J Voice 2022:S0892-1997(22)00233-8. [PMID: 36163069 DOI: 10.1016/j.jvoice.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Hairdressers are more prone to respiratory diseases, bronchitis, asthma, shortness of breath, and cough due to the nature of their occupation and the constant use of cosmetics. Therefore, they may be prone to voice disorders or laryngeal problems. Voice problems may affect not only their social and emotional relationships but also their jobs. The current study was conducted to investigate voice problems and related risk factors in hairdressers. DESIGN Cross-sectional, descriptive-analytical. PATIENTS AND METHODS A total number of 293 women participated in the study. The study group consisted of 147 hairdressers and the control group consisted of 146 women with other jobs. All study participants were requested to complete a self-reported questionnaire. This questionnaire investigated demographic characteristics, voice problems and symptoms, laryngeal discomfort, working features, and workplace conditions. Chi-square, independent t-test, Fisher's exact test, and logistic regression were used to analyze the data. RESULTS The prevalence of voice problems in hairdressers and the control group was 33.33% and 15.75%, respectively, and this difference was statistically significant (P < 0.001). Results of the Chi-Square test showed that prevalence of hoarseness, vocal fatigue, dryness, and cough were higher in hairdressers than the control group (P < 0.05). According to regression logistic results, work time (hours per week) (P = 0.014; OR = 2.35; CI = 1.18-4.66) and presence of phonotraumatic behaviors (P = 0.012; OR = 2.73; CI = 1.24-5.96) increased the possibility of increasing the presence of voice symptoms among hairdressers. CONCLUSION The findings revealed that self-reported voice problems were more prevalent in the hairdressers group than in the control group and therefore the hairdressers were more prone to an increased risk of developing voice problems. The most common symptoms in the hairdressers group were cough, hoarseness, and dryness in the vocal tract. Based on these results, in addition to paying attention to recommendations related to environmental issues and exposure to chemical hazards, hairdressers may benefit from receiving appropriate training in voice production, voice disorders, and the prevention of voice disorders.
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Affiliation(s)
- Fatemeh Kasbi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyed Abolfazl Tohidast
- Department of Speech Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran.
| | - Maryam Mokhlesin
- Department of Speech Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Jazem
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Raheb Ghorbani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Epidemiology and Biostatistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Shohre Kaviani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ronald Callaway Scherer
- Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio
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16
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Addona S, Evitts PM. Effects of Virtual Instruction on Educators' Voices During the COVID-19 Pandemic. J Voice 2022:S0892-1997(22)00244-2. [PMID: 36243555 PMCID: PMC9376341 DOI: 10.1016/j.jvoice.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Resulting from the COVID-19 pandemic, professionals in the United States were mandated to work virtually from home to protect the health needs of the population. The shift in setting and ergonomic factors posed a threat to the vocal health of workers, and more specifically, to those whose professions inflict significant vocal load, such as educators. This study compared the symptoms of vocal tract discomfort and self-perceived voice handicap in full-time educators between face-to-face and virtual settings. Additionally, this study sought to identify relationships between specific environmental factors and levels of discomfort. METHODS A cross-sectional research study was conducted by distributing an online survey to 223 individuals who identified as full-time educators. This survey collected data on vocal tract symptoms during both face-to-face and virtual instruction, environmental factors of virtual work setting, personal vocal health habits, and self-perceived voice handicap in each setting. RESULTS In this sample population, the shift to a virtual work setting did not result in a significant increase in the number of vocal discomfort symptoms or an increase in vocal handicap. However, environmental factors such as air quality and water intake had the strongest correlation with levels of vocal tract discomfort. CONCLUSION It is beneficial to provide resources to full-time educators regarding the risk of voice disorders and the impact of environmental factors on vocal health.
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Affiliation(s)
- Serina Addona
- Department of Speech-Language Pathology & Audiology, Baltimore, MD 21201.
| | - Paul M Evitts
- Department of Communication Sciences and Disorders, Pennsylvania State University Harrisburg, Middletown, PA 17057
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17
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Nudelman CJ, Ortiz AJ, Fox AB, Mehta DD, Hillman RE, Van Stan JH. Daily Phonotrauma Index: An Objective Indicator of Large Differences in Self-Reported Vocal Status in the Daily Life of Females With Phonotraumatic Vocal Hyperfunction. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1412-1423. [PMID: 35394805 PMCID: PMC9567307 DOI: 10.1044/2022_ajslp-21-00285] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/08/2021] [Accepted: 02/03/2022] [Indexed: 06/03/2023]
Abstract
PURPOSE The purpose of this study is to evaluate if the Daily Phonotrauma Index (DPI) can quantitatively discriminate large differences in overall vocal status in the daily life of patients with phonotraumatic vocal hyperfunction (PVH). METHOD For 1-4 weeks, 23 females with PVH wore an ambulatory voice monitor and answered three vocal status questions (i.e., difficulty producing soft, high-pitched phonation; discomfort; and fatigue) at the beginning, at 5-hr intervals, and the end of each day. DPI values were obtained for each patient's time periods of worst and best self-rated vocal status, and data for the group were analyzed for significant changes using a linear mixed-effects regression model. RESULTS The DPI was significantly lower during periods self-rated as "best vocal status" compared to during periods self-rated as "worst vocal status" (mean difference in DPI = 0.53) with a medium-to-large effect size (Cohen's d = -0.68). CONCLUSIONS In a group of patients with phonotraumatic lesions, the DPI indicated lower potential for phonotrauma during time periods of better vocal status compared to time periods of worse vocal status. Assuming that a large portion of variance in vocal status for patients with PVH is associated with the extent to which voicing is phonotraumatic, these results support the validity of obtaining estimates of DPI for much shorter time periods (i.e., an estimate every 2 min of voicing) than previous studies (i.e., a single estimate for the entire day or week). Future work can investigate the DPI's use for in-clinic assessment/treatment and ambulatory biofeedback and can gain further insights into phonatory mechanisms that underlie DPI via comparisons with other physiologically relevant measures and computational vocal fold modeling.
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Affiliation(s)
| | | | | | - Daryush D. Mehta
- MGH Institute of Health Professions, Boston, MA
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | - Robert E. Hillman
- MGH Institute of Health Professions, Boston, MA
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | - Jarrad H. Van Stan
- MGH Institute of Health Professions, Boston, MA
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
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18
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Schuster M, Deitmerg U, Gantner S. [Vocal tract discomfort and wellbeing of caregivers for the elderly during the pandemic]. Laryngorhinootologie 2022; 101:797-804. [PMID: 35016249 DOI: 10.1055/a-1727-6012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND During the Sars-CoV2-pandemic, people working in healthcare such as caregives for the elderly face additional burden, e.g. by the use of face masks. METHODS In a prospective study, the emotional and physical wellbeing as well as the vocal tract discomfort of caregivers of two municipal homes for the elderly were assessed by questionnaires, the Mini-SCL and the Vocal Tract Discomfort Scale (VTDS), and one on personal data (sex, age, lung disease, previous SARS-CoV2-infection) and on voice symptoms. RESULTS 67% of the questionnaires were answered by 56 women and 11 men aged 45.2 ± 11.5. In the Mini-SCL, increased scores were found in depression in 23.8%, anxiety in 49.3%, somatization in 55.2% and in the global score in 44.7%. 52%. showed increased scores in the VTDS Significant correlations were found in between the subscales of the Mini-SCL and the VTDS as well as to dysphonia symptoms. DISCUSSION Psychological problems, somatization and vocal tract discomfort is more frequently reported by caregivers for the elderly than in the normal population. The VTDS, voice symptoms and the Mini-SCL scales are significantly related. Training on vocal hygiene should be included in workplace health promotion during the pandemic.
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Affiliation(s)
- Maria Schuster
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Chirurgie, Ludwig-Maximiians-Universität München, München, Germany.,Praxis für Hals-Nasen-Ohrenheilkunde, Phoniatrie und Pädaudiologie, Nuremberg, Germany
| | | | - Sophia Gantner
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Chirurgie, Ludwig-Maximiians-Universität München, München, Germany
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19
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Lukaschyk J, Abel J, Brockmann-Bauser M, Keilmann A, Braun A, Rohlfs AK. Cross-Validation and Normative Values for the German Vocal Tract Discomfort Scale. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1855-1868. [PMID: 34038170 DOI: 10.1044/2021_jslhr-20-00462] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The Vocal Tract Discomfort Scale (VTD Scale) is a self-rating questionnaire investigating physical symptoms in the larynx associated with vocal pathology. The aim of this work was to investigate the reliability, validity, sensitivity, and specificity of the first German version and to provide normative data with thresholds for pathology and a scaling scheme. Study Design A retrospective multicenter study was performed. Method A total of 571 participants (409 female and 162 male), with a mean age of 47.2 years, were recruited at three German centers; of these, there were 447 participants with voice disorder and 124 vocally healthy participants. The clinical examination consisted of patient history, visual laryngeal examination, acoustic and aerodynamic assessment, perceptual analysis by the Grading-Roughness-Breathiness-Asthenia-Strain Scale, and subjective evaluation using the VTD Scale and the Voice Handicap Index (VHI). Statistics included group comparisons (t test and analysis of variance), Pearson correlation coefficient (between VTD Scale and VHI), and Cronbach's alpha to assess validity and reliability. Analysis of receiver operating characteristics was performed to examine VTD Scale's discriminatory ability and provide a cutoff score. Additionally, percentiles were applied to provide VTD Scale ranges. Results There were highly significant differences between healthy participants and participants with voice disorder regarding the total score and both subscales of the VTD Scale. Internal consistency was excellent (α = .928). We found moderate, positive correlation between the VTD Scale and VHI (ρ = .596, p < .001). Receiver operating characteristics analysis showed an area under the curve of 0.876 (p < .001, 95% confidence interval [0.846, 0.906]). VTD Scale ranges were no (score: 0-13), mild (score: 14-26), moderate (score: 27-40), and severe (score: 41-96) disorder. Conclusions Results confirm an excellent reliability and validity of the German VTD Scale. It provides additional and independent diagnostic information and is a useful instrument to complement voice assessment. The scaling into four severity subgroups allows the tool to be used for screening patients and considers a transferral to a voice specialist.
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Affiliation(s)
- Julia Lukaschyk
- Department of Otolaryngology, Hannover Medical School, Germany
| | - Jakob Abel
- ENT, Phoniatrics and Pedaudiology-Klosterstern Hamburg, Germany
| | - Meike Brockmann-Bauser
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland
- University of Zurich, Switzerland
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20
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Gantner S, Deitmerg U, Schuster M. Vocal tract discomfort in caregivers for the elderly during an interval of the COVID-19 pandemic. LOGOP PHONIATR VOCO 2021; 47:194-201. [PMID: 33988080 DOI: 10.1080/14015439.2021.1915376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, professional caregivers caring for the elderly may experience more vocal tract problems in addition to regular high vocal demands while wearing face masks/coverings. METHODS AND PARTICIPANTS Vocal tract discomfort (VTD) was assessed in 64 caregivers in one home for the elderly (64% participation rate) in June 2020 using the German version of the VTD scale. RESULTS More than one-half of the participating caregivers experienced VTD, described mostly as dryness, irritability, and tightness. Approximately, 80% reported that sensations were not perceived before enhanced infection prevention standards were implemented. CONCLUSIONS Among caregivers caring for the elderly during the COVID-19 pandemic, special care should be focused on the voice and vocal tract well-being.
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Affiliation(s)
- Sophia Gantner
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University, Munich, Germany
| | | | - Maria Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University, Munich, Germany.,Department of Otorhinolaryngology, Phoniatrics and Pediatric Audiology, Metropol Medical Center, Nuremberg, Germany
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21
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Khoramshahi H, Dehqan A, Scherer RC, Sharifi Z, Ahmadi S. Comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils. Eur Arch Otorhinolaryngol 2021; 278:2429-2436. [PMID: 33978817 DOI: 10.1007/s00405-021-06863-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/30/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to study the comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils. STUDY DESIGN Cross-sectional study METHODS: Participants were 179 teachers (50 male, 129 female) and 30 non-teachers (14 male, 16 female) who participated in the current study. The teachers work in elementary schools. Furthermore, 87 of the teachers work for mentally disabled pupils at special elementary schools. Non-teachers were Ahvaz Jundishapur University of Medical Sciences employees who consider as the control group. They completed the Persian VFI and VTDp questionnaires three times, at the beginning, middle, and end of their office hours for 1 workday. RESULTS The current study's findings indicate that the Persian VFI and VTD scores of non-teachers were significantly lower than teachers' scores. Furthermore, teachers of mentally disabled pupils demonstrated higher values from teachers of normal pupils based on the Persian VFI and VTDp scores CONCLUSION: The study results showed that teachers experienced more vocal fatigue and vocal tract discomfort than non-teachers. Furthermore, teachers of mentally disabled pupils indicated more vocal fatigue, the larynx's physical discomfort, and vocal tract discomfort, but this difference was practically small.
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Affiliation(s)
- Hassan Khoramshahi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Ali Dehqan
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ronald Callaway Scherer
- Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio, USA
| | - Zahra Sharifi
- MSc Student of Speech Therapy, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shayan Ahmadi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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22
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Saeedi M, Yadegari M, Aghadoost S, Naderi M. Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy. LOGOP PHONIATR VOCO 2020; 47:49-55. [PMID: 33371756 DOI: 10.1080/14015439.2020.1864466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aims to investigate the frequency and severity of vocal tract discomfort (VTD) symptoms and to determine the relationship between VTD and type of thyroidectomy, voice problem history, vocal abuse, and misuse behaviors, and the voice handicap index (VHI) in the thyroidectomy patients undergoing thyroidectomy, pre- and post-operatively pre- and post-thyroidectomy. MATERIALS The sample comprised 21 thyroidectomy patients undergoing thyroidectomy, including 10 patients with total thyroidectomy and 11 patients with partial thyroidectomy. The participants underwent videolaryngoscopy examination and completed the voice history questionnaire, the VTD scale, and the VHI, before and after the surgery. RESULTS Dryness was the most frequently occurring symptom, pre- and post-thyroidectomy. Participants with total thyroidectomy reported significantly higher frequency and severity of tickling than those in the preoperative status (p<.05). The frequency and severity of many VTD symptoms in the participants with voice problems and a vocal abuse and misuse history were higher than those without such a history at both assessment times (p<.05). There was significant correlation between the frequency and severity of VTD and VHI scores, pre-thyroidectomy pre-operatively (r = 0.488-0.575, p<.05). CONCLUSIONS An increment in the frequency and severity of tickling was reported by total thyroidectomy patients, post-thyroidectomy post-operatively. The type of thyroidectomy, voice problem history, and vocal abuse and misuse behaviors seem to influence the frequency and severity of VTD. Considering the correlation between VTD and VHI, the VTD scale provides important clinical information and can be used for evaluation and consultation purposes.
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Affiliation(s)
- Masoumeh Saeedi
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Meysam Yadegari
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Samira Aghadoost
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Naderi
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Kenny C. Dysphonia and Vocal Tract Discomfort While Working From Home During COVID-19. J Voice 2020; 36:877.e1-877.e8. [PMID: 33223124 PMCID: PMC7566822 DOI: 10.1016/j.jvoice.2020.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 01/22/2023]
Abstract
Objective During COVID-19, government measures to prevent disease spread included advice to work from home. In addition to occupational risk factors, the increased use of telecommunication and changed work environment may contribute to voice and vocal tract discomfort (VTD). This study established the prevalence, incidence, characteristics and impact of self-perceived dysphonia and VTD in those working from home during COVID-19. Methods A cross-sectional, observational study using an online survey recruited 1575 participants. It captured information about dysphonia and VTD presence, onset, and severity. Those with dysphonia completed the voice-related quality of life to measure impact. Regression analyses identified risk factors for voice and vocal tract problems. Results Dysphonia and VTD prevalence rates were 33% and 68%, respectively, incidences were 28% and 50%. Perceived dysphonia severity was mild in 72% of cases. Dry throat was the most common VTD symptom at 66%. Mean voice-related quality of life score was 82.4 (standard deviation ± 13.2). Raising or straining the voice while working predicted new onset dysphonia and VTD. Increasing telecommunication use was associated with worse dysphonia and VTD onset. Conclusion Those working from home have seen a rise in dysphonia and VTD, which were associated with communication modality and change in environment. If home offices become the ‘new normal’ post-COVID, workplaces should consider voice training for employees to limit potential difficulties.
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Affiliation(s)
- Ciarán Kenny
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Ireland.
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Tohidast SA, Mansuri B, Dabirmoghadam P, Choubineh M, Bagheri R, Ebadi A, Azimi H. Development and Preliminary Validation of a Pain Scale Specific to Patients With Voice Disorders: The Voice-Related Pain Scale (VRPS). J Voice 2020; 36:876.e1-876.e7. [PMID: 33060005 DOI: 10.1016/j.jvoice.2020.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/20/2020] [Accepted: 09/23/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Although pain is one of the complaints reported by voice patients, still there is no valid and reliable scale to evaluate pain in Patients with Voice Disorders (PWVDs). Therefore, the aim of the present study was to develop and validate the Voice-Related Pain Scale (VRPS). METHODS The present study was conducted in two stages: (1) development of the VRPS based on semistructured interviews with PWVDs and experts in the field of voice disorders and an in-depth literature review, and (2) Evaluation of the psychometric properties of the VRPS. Determining the validity and reliability of the VRPS was performed using qualitative and quantitative content validity, the qualitative face validity, and the test-retest reliability. Content validity of the VRPS was assessed by Speech and Language Pathologists who are experts in the assessment and treatment of voice patients and laryngologist. The reliability of the scale was determined using test-retest reliability. RESULTS Based on the interviews with PWVDs and experts, and a thorough review of the related literature, a self-reported scale with 11 items and three sections was developed. The three items included ear, temporomandibular joint, and shoulder all of which were divided into right and left pairs based on the experts' suggestion. One item was eliminated because it had a content validity ratio less than 0.62. The content validity index (CVIs) for all the remaining items were higher than 0.79 and the scale content validity index was equal to 0.93. The test-retest reliability was satisfactory with weighted kappa ranging from 0.64 to 1 for VRPS items. The final version of the VRPS comprised of 13 items related to the pain location in the human body. Each of these items has three sections: frequency of pain, severity of pain, and time of pain occurrence. CONCLUSION The present study indicated that VRPS is a valid and reliable tool to evaluate pain in PWVDs. The VRPS is a useful tool for clinical and research purposes. However, more studies are needed in this regard for further evaluation of the VRPS.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Payman Dabirmoghadam
- Otolaryngology Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Mehran Choubineh
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran; Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Abbas Ebadi
- Behavioral sciences Research Center, life style institute, Faculty of Nursing. Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hadi Azimi
- English Language Teaching Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tohidast SA, Mansuri B, Bagheri R, Azimi H. Determining pain in patients with voice disorders: a qualitative study. LOGOP PHONIATR VOCO 2020; 46:155-162. [PMID: 32657233 DOI: 10.1080/14015439.2020.1791249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The present study aimed to determine pain in patients with voice disorders (PWVDs). PATIENTS AND METHODS A total number of 28 patients with a range of voice disorders and without any other diseases participated in the study. To gain maximum variation, purposive sampling method was used. Moreover, semi-structured interviews were employed for data collection. The interviews were then continued until data saturation was reached, and the data were subsequently recorded and transcribed verbatim. Qualitative content analysis was utilized for data analysis. RESULTS Data analysis of the interviews emerged three themes about pain experienced by PWVDs. The emerged themes included location of pain, type of pain, and time of pain occurrence. In this respect, PWVDs reported pain in different locations on their body including head, ears, anterior neck, posterior neck, larynx, temporomandibular joint, submandibular area, shoulders, and upper back. Furthermore, chronic, acute, severe, and mild were the most common types of pain reported by PWVDs. The PWVDs also stated that they had experienced pain at different times, i.e. during speaking, after long-time speaking, after voice use, during swallowing, during palpation, and all the time (even at rest). CONCLUSIONS One of the physical discomforts experienced by PWVDs is pain. According to the results of the present study, pain should properly be considered in the assessment and treatment of PWVDs in clinical practices. Also, our study suggested that a specific scale is needed to measure pain in voice disorders.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Hadi Azimi
- English Language Teaching Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alencar SALD, Santos JPD, Almeida LN, Nascimento JAD, Lopes LW, Almeida AA. Factorial Analysis of the Brazilian Version of the Vocal Tract Discomfort Scale in patients with dysphonia. J Voice 2020; 36:144.e11-144.e20. [PMID: 32600869 DOI: 10.1016/j.jvoice.2020.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/16/2020] [Accepted: 05/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the psychometric properties of the Brazilian version of the Vocal Tract Discomfort Scale, known as Escala de Desconforto do Trato Vocal (EDTV), based on factor analysis, in patients with dysphonia. METHODS This was a retrospective documentary and cross-sectional study. The study database contained sociodemographic variables, laryngeal diagnosis, auditory-perceptual evaluation and EDTV items. All of these variables were extracted from the medical records of 310 patients seen at the Integrated Laboratory of Voice Studies. A descriptive statistical analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were performed. RESULTS The sample consisted of patients of both sexes with a mean age of 39.36 (SD = 15.80) years; the majority were female and were nonvoice professionals. The EFA grouped the EDTV items into four factors according to the interitem correlations. The CFA grouped the EDTV items into three factors because the last two factors found in the EFA were correlated and constituted a single factor. Thus, the CFA revealed that the EDTV was organized as follows: Factor 1, "Hybrid," comprised the items corresponding to the frequency and severity of the symptoms of burning, sore, and irritated throat; Factor 2, "Inflammatory process/tissue lesion," comprised the items related to throat itching and throat sensitivity; and Factor 3, "Muscle discomfort," comprised the items related to symptoms of tightness, dryness, and the sensation of a lump in the throat. Item responses are dichotomous (High/Low), and the result is determined by the sum of the responses, in which high frequency/severity is assigned two points and reduced frequency/severity assigned one point. CONCLUSIONS The CFA allows the proposal of an adjustment to the EDTV and suggests that the described changes be made to the instrument to make it a scale with three factors that behave differently but are related.
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Affiliation(s)
| | - Jozemar Pereira Dos Santos
- Graduate Program in Decision and Health Models, UFPB, João Pessoa, PB, Brazil; Department of Statistic at the UFPB, João Pessoa, PB, Brazil
| | | | - João Agnaldo do Nascimento
- Graduate Program in Decision and Health Models, UFPB, João Pessoa, PB, Brazil; Department of Statistic at the UFPB, João Pessoa, PB, Brazil
| | - Leonardo Wanderley Lopes
- Graduate Program in Decision and Health Models, UFPB, João Pessoa, PB, Brazil; UFPB, João Pessoa, PB, Brazil
| | - Anna Alice Almeida
- Graduate Program in Decision and Health Models, UFPB, João Pessoa, PB, Brazil; UFPB, João Pessoa, PB, Brazil; Department of Speech-Language Pathology at the UFPB, João Pessoa, PB, Brazil.
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Lee HN, Yoo JY, Han JH, Park YS, Jung DY, Park JH. Transcultural Adaptation and Validation of the Korean Version of the Vocal Tract Discomfort Scale. J Voice 2020; 36:143.e15-143.e23. [PMID: 32576525 DOI: 10.1016/j.jvoice.2020.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The present study translated the Vocal Tract Discomfort Scale (VTDS) into Korean (K-VTDS) and evaluated its reliability and validity. STUDY DESIGN This was a prospective study. METHODS The VTDS was first translated into Korean and validated. One hundred and fifty-nine patients with voice disorders were divided into three different diagnostic groups (functional, structural, and neurologic voice disorder) and 131 vocally healthy adults were also included. All participants completed the K-VTDS and the Korean version of the Voice Handicap Index (K-VHI) and Korean versions of the Voice-Related Quality of Life (K-VRQOL). The internal consistency of the K-VTDS was analyzed through Cronbach's α coefficient. The VTDS score differences related to the diagnostic groups were assessed with t test and analysis of variance. We assessed the correlation between the K-VTDS, the K-VHI, and the K-VRQOL using Pearson's correlation analysis. RESULTS High internal consistency and the test-retest reliability of the K-VTDS were found. The voice disorder group had significantly higher K-VTDS scores for the subscales and total scores than those in the healthy group (P < 0.001). The K-VTDS scores for the subscale of frequency and total scores were highest in the functional voice disorder group. We found a significant difference in frequency and total score of the K-VTDS between the functional voice disorder group and the structural voice disorder group (P < 0.05). We observed a strong positive correlation among the scores for the subscales of frequency and severity, and total scores in the K-VTDS. The K-VTDS showed moderate correlation with the K-VHI and the K-VRQOL. CONCLUSION The K-VTDS is a reliable and valid instrument for voice assessment for voice disorders in Korean-speaking patients.
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Affiliation(s)
- Ha Na Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University Chosun Hospital, Gwangju, South Korea
| | - Jae Yeon Yoo
- Department of Speech Language Pathology, Honam University, Gwangju, South Korea
| | - Ji Hye Han
- Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
| | - Yoon Sik Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
| | - Do Yoon Jung
- Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
| | - Jun Hee Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea.
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Pediatric Vocal Symptoms Questionnaire (PVSQ): Four new versions for parental evaluation and self-evaluation. Int J Pediatr Otorhinolaryngol 2020; 131:109816. [PMID: 31915113 DOI: 10.1016/j.ijporl.2019.109816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To elaborate reduced versions of the Pediatric Vocal Symptoms Questionnaire (PVSQ) protocol for the two forms of application of the instrument: self-evaluation (SE) and parental evaluation (PE). METHODS The Brazilian validation database of the PVSQ was used (Zip code: 758,309). Data were collected from 716 people, comprising 367 children and adolescents and 349 parents/guardians with and without voice complaint and/or vocal alteration. Three major procedures were adopted: 1. Verification of suitability of the database; 2. Determination of the extraction technique and the number of factors to be extracted, and 3. Decision on the type of factor rotation. For factor analysis, the Kaiser rule and Varimax rotation were used; Spearman's correlation analysis was used to verify the degree of relationship between the PVSQ variables, both of the SE and PE. The Mann-Whitney test was used to analyze the ROC curve of the general score of vocal symptoms of each version. A 5% significance statistical level was adopted. RESULTS Factor analysis made it possible to elaborate four new versions of the PVSQ, called: "common core of the PVSQ" (SE and PE), "common core of the PVSQ reduced version" (SE and PE), "PVSQ SE reduced version" and "PVSQ PE reduced version". The most complete version of the PVSQ has 7 domains in the SE and 5 in the PE. The common core of the PVSQ SE reduced version had a better area under the ROC curve (AUC), efficiency and sensitivity, and the PVSQ PE reduced version had better specificity. CONCLUSIONS Four new reduced PVSQ versions are available, containing 10 to 26 items. Aspects of specificity, efficiency and sensitivity, as well as discriminating capacity should be considered in the choice of the version and is a prerogative of the clinician who applies the instrument. As the questionnaire allows the comparison between the parental evaluation and the self-evaluation, it is recommended to apply the same version for parents and children.
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Hong YT, Minh PHN, Hong KH. Which Plosive Consonant Is More Useful for the Aerodynamic Analysis of Pathologic Voice? Clin Exp Otorhinolaryngol 2019; 13:179-185. [PMID: 31739652 PMCID: PMC7248608 DOI: 10.21053/ceo.2019.01039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/19/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives. Both acoustic and aerodynamic analyses are essential to evaluate the phonetic characteristics of voice pathology. The purpose of the study is to determine the magnitude of their correlation with the different types of bilabial plosive consonants. Methods. A controlled prospective study of 35 patients diagnosed with unilateral vocal fold paralysis was performed. The sustained vowel /a/ and bilabial voiceless consonants were used. Three common acoustic parameters were measured from a sustained vowel /a/ and aerodynamic parameters from a set of syllables /pi/, /phi/, and /p’i/. We determined the correlation coefficients between acoustic and aerodynamic measurements for the bilabial plosive consonants /pi/, /phi/, and /p’i/. Results. The mean values of acoustic parameters were higher than the thresholds of pathology. The mean values of aerodynamic parameters varied according to the types of consonants. The correlation between acoustic and aerodynamic parameters was significantly larger with the consonant /phi/ compared with the consonants /p’/ and /p/. The magnitudes of correlation were higher with the consonant /phi/ compared with the consonants /p’/ and /p/. Conclusion. The plosive consonant /phi/ may represent a more valuable investigative consonant than the consonants /p/ or /p’/ for aerodynamic analysis of voice pathology, especially in patients with unilateral vocal fold paralysis.
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Affiliation(s)
- Yong Tae Hong
- Department of Otolaryngology-Head and Neck Surgery, Research Institute for Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Phan Huu Ngoc Minh
- Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Ki Hwan Hong
- Department of Otolaryngology-Head and Neck Surgery, Research Institute for Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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A Comparison of Voice Activity and Participation Profiles Among Etiological Groups. J Voice 2019; 33:804.e5-804.e12. [DOI: 10.1016/j.jvoice.2018.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/26/2018] [Indexed: 11/21/2022]
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Darawsheh WB, Shdaifat A, Natour YS. Validation of the Arabic version of vocal tract discomfort scale. LOGOP PHONIATR VOCO 2019; 45:82-90. [DOI: 10.1080/14015439.2019.1630481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Wesam B. Darawsheh
- Department of Occupational Therapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Abeer Shdaifat
- Huazhong University of Science and Technology, Wuhan, China
| | - Yaser S. Natour
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
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Lopes LW, de Oliveira Florencio V, Silva POC, da Nóbrega e Ugulino AC, Almeida AA. Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Evaluation of Patients With Voice Disorders. J Voice 2019; 33:381.e23-381.e32. [DOI: 10.1016/j.jvoice.2017.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
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de Oliveira Lemos I, da Cunha Pereira G, Druck SantAnna G, Cassol M. Effects of a Voice Therapy Program for Patients with Muscle Tension Dysphonia. Folia Phoniatr Logop 2018; 69:239-245. [DOI: 10.1159/000487942] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/23/2018] [Indexed: 11/19/2022] Open
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Van Stan JH, Maffei M, Masson MLV, Mehta DD, Burns JA, Hillman RE. Self-Ratings of Vocal Status in Daily Life: Reliability and Validity for Patients With Vocal Hyperfunction and a Normative Group. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:1167-1177. [PMID: 29086800 PMCID: PMC5945061 DOI: 10.1044/2017_ajslp-17-0031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/03/2017] [Accepted: 06/12/2017] [Indexed: 05/24/2023]
Abstract
PURPOSE The aim of this study was to establish reliability and validity for self-ratings of vocal status obtained during the daily activities of patients with vocal hyperfunction (VH) and matched controls. METHOD Eight-four patients with VH and 74 participants with normal voices answered 3 vocal status questions-difficulty producing soft, high-pitched phonation (D-SHP); discomfort; and fatigue-on an ambulatory voice monitor at the beginning, 5-hr intervals, and the end of each day (7 total days). Two subsets of the patient group answered the questions during a 2nd week after voice therapy (29 patients) or laryngeal surgery (16 patients). RESULTS High reliability resulted for patients (Cronbach's α = .88) and controls (α = .95). Patients reported higher D-SHP, discomfort, and fatigue (Cohen's d = 1.62-1.92) compared with controls. Patients posttherapy and postsurgery reported significantly improved self-ratings of vocal status relative to their pretreatment ratings (d = 0.70-1.13). Within-subject changes in self-ratings greater than 20 points were considered clinically meaningful. CONCLUSIONS Ratings of D-SHP, discomfort, and fatigue have adequate reliability and validity for tracking vocal status throughout daily life in patients with VH and vocally healthy individuals. These questions could help investigate the relationship between vocal symptom variability and putative contributing factors (e.g., voice use/rest, emotions).
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Affiliation(s)
- Jarrad H. Van Stan
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| | - Marc Maffei
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
| | - Maria Lúcia Vaz Masson
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- Federal University of Bahia, Brazil
| | - Daryush D. Mehta
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| | - James A. Burns
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | - Robert E. Hillman
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
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Darawsheh WB, Natour YS, Sada EG. Applicability of the Arabic version of Vocal Tract Discomfort Scale (VTDS) with student singers as professional voice users. LOGOP PHONIATR VOCO 2017; 43:80-91. [DOI: 10.1080/14015439.2017.1363282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Wesam B. Darawsheh
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | - Yaser S. Natour
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | - Eve G. Sada
- Music Education, University of Oklahoma, Norman, OK, USA
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Tafiadis D, Kosma EI, Chronopoulos SK, Papadopoulos A, Toki EI, Vassiliki S, Ziavra N. Acoustic and Perceived Measurements Certifying Tango as Voice Treatment Method. J Voice 2017; 32:256.e13-256.e24. [PMID: 28709765 DOI: 10.1016/j.jvoice.2017.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 10/19/2022]
Abstract
Voice disorders are affecting everyday life in many levels, and their prevalence has been studied extensively in certain and general populations. Notably, several factors have a cohesive influence on voice disorders and voice characteristics. Several studies report that health and environmental and psychological etiologies can serve as risk factors for voice disorders. Many diagnostic protocols, in the literature, evaluate voice and its parameters leading to direct or indirect treatment intervention. This study was designed to examine the effect of tango on adult acoustic voice parameters. Fifty-two adults (26 male and 26 female) were recruited and divided into four subgroups (male dancers, female dancers, male nondancers, and female nondancers). The participants were asked to answer two questionnaires (Voice Handicap Index and Voice Evaluation Form), and their voices were recorded before and after the tango dance session. Moreover, water consumption was investigated. The study's results indicated that the voices' acoustic characteristics were different between tango dancers and the control group. The beneficial results are far from prominent as they prove that tango dance can serve stand-alone as voice therapy without the need for hydration. Also, more research is imperative to be conducted on a longitudinal basis to obtain a more accurate result on the required time for the proposed therapy.
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Affiliation(s)
- Dionysios Tafiadis
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
| | - Evangelia I Kosma
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Spyridon K Chronopoulos
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Aggelos Papadopoulos
- Department of Paediatrics, Karamandanio General Children's Hospital NHS, Patra, Greece
| | - Eugenia I Toki
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Siafaka Vassiliki
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Nausica Ziavra
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
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Araújo LFD, Lopes LW, Silva POC, Perrusi VJF, Farias VLDL, Azevedo EHM. Sensory symptoms in patients undergoing thyroidectomy. Codas 2017; 29:e20150294. [PMID: 28538821 DOI: 10.1590/2317-1782/20172016294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/17/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose To verify the occurrence of sensory symptoms in thyroidectomy patients pre- and post-operatively. Methods This is a prospective, quantitative, descriptive study conducted with a sample of twelve patients undergoing thyroidectomy. The participants underwent visual laryngeal examination and responded to the Upper Aerodigestive Symptoms (UADS) and Vocal Tract Discomfort Scale (VTDS) questionnaires before and after the surgery. Results There was higher occurrence of vocal fatigue, hoarseness, pharyngeal bolus, dry throat, and throat clearing preoperatively, whereas higher occurrence of hoarseness, vocal fatigue, cough, and pharyngeal bolus was observed postoperatively for the UADS. Regarding the VTDS sensory symptoms, higher frequency and severity of throat dryness were observed preoperatively, whereas more frequent tickling throat and more severe irritable and sore throat and lump in the throat were observed postoperatively. There was reduction in the choke symptom and in the frequency and severity of the throat dryness symptom pre- and post-operatively. With respect to the frequency and severity of vocal tract discomfort sensory symptoms, reduction in throat dryness was observed at both assessment times. Conclusion The patients presented sensory symptoms of upper aerodigestive tract and vocal tract discomfort pre- and post-operatively characterized by self-reference of hoarseness, vocal fatigue, pharyngeal bolus, and cough, as well as dry, sore, and irritable throat. Reduction in the sensory symptom of choke and in the frequency and severity of throat dryness was self-reported by thyroidectomy patients postoperatively.
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Lukaschyk J, Brockmann-Bauser M, Beushausen U. Transcultural Adaptation and Validation of the German Version of the Vocal Tract Discomfort Scale. J Voice 2017; 31:261.e1-261.e8. [DOI: 10.1016/j.jvoice.2016.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
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Behlau M, Zambon F, Moreti F, Oliveira G, de Barros Couto E. Voice Self-assessment Protocols: Different Trends Among Organic and Behavioral Dysphonias. J Voice 2017; 31:112.e13-112.e27. [DOI: 10.1016/j.jvoice.2016.03.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/24/2016] [Indexed: 12/25/2022]
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Lopes LW, da Silva JD, Simões LB, Evangelista DDS, Silva POC, Almeida AA, de Lima-Silva MFB. Relationship Between Acoustic Measurements and Self-evaluation in Patients With Voice Disorders. J Voice 2017; 31:119.e1-119.e10. [DOI: 10.1016/j.jvoice.2016.02.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
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Amaral ACD, Zambon F, Moreti F, Behlau M. Desconforto do trato vocal em professores após atividade letiva. Codas 2017; 29:e20160045. [DOI: 10.1590/2317-1782/20172016045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 07/13/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Verificar o desconforto de trato vocal autorreferido por professores, comparando com a autoavaliação vocal, nos momentos de pré-jornada, pós-período de quatro horas e pós-período de oito horas de aula. Método Participaram do estudo 50 professores, 42 mulheres e oito homens. O valor de corte da Escala de Sintomas Vocais – ESV dividiu os professores em Grupo Risco Vocal – GRV e Grupo Vocalmente Saudável – GVS e a Lista de Sinais e Sintomas Vocais – LSS foi utilizada para identificação da quantidade de sintomas vocais em cada grupo. Posteriormente, os grupos foram avaliados em três momentos (pré-jornada, pós-quatro horas e pós-oito horas) pela Escala de Desconforto do Trato Vocal – EDTV e autoavaliação vocal. Resultados GRV apresentou mais sinais e sintomas vocais da LSS que o GVS (total: GS=0,56 / GRV=1,60, p<0,001; relacionados ao trabalho GVS=0,79 / GRV=2,49, p<0,001). O GVS não relatou mudança no desconforto, tanto para frequência (p=1,132) quanto para intensidade (p=0,431) e apresentou melhor autoavaliação vocal (pré = 0,67; pós-quatro horas = 0,96; pós-oito horas = 0,96; p=0,007). Já o GRV apresentou mais desconforto no trato vocal após quatro e oito horas, tanto para frequência (pré = 1,60; pós-quatro horas = 2,49; pós-oito horas 2,95; p<0,001) quanto para intensidade (pré = 1,79; pós-quatro horas = 2,52; pós-oito horas = 3,12; p<0,001), com pior autoavaliação vocal (pré = 2,00; pós-quatro horas = 2,42; pós-oito horas = 3,00; p<0,001). Conclusão Professores com risco vocal têm pior autoavaliação de voz e maior desconforto do trato vocal, que aumenta durante o dia de atividade letiva.
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Torabi H, Khoddami SM, Ansari NN, Dabirmoghaddam P. The Vocal Tract Discomfort Scale: Validity and Reliability of the Persian Version in the Assessment of Patients With Muscle Tension Dysphonia. J Voice 2016; 30:711-716. [PMID: 26602253 DOI: 10.1016/j.jvoice.2015.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/04/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To cross-culturally adapt of Persian Vocal Tract Discomfort (VTDp) scale and evaluate its validity and reliability in the assessment of patients with muscle tension dysphonia (MTD). STUDY DESIGN A cross-sectional and prospective cohort design was used to psychometrically test the VTDp. METHODS The VTD scale was cross-culturally adapted into Persian language following standard forward-backward translations. The VTDp scale was administrated to 100 patients with MTD (54 men and 46 women; mean age: 38.05 ± 10.02 years) and 50 healthy volunteers (26 men and 24 women; mean age: 36.50 ± 12.27 years). Forty-five patients with MTD completed the VTDp 7 days later for test-retest reliability. Patients also completed the Persian Voice Handicap Index (VHIp) to assess construct validity. RESULTS The results of discriminative validity demonstrated that the VTDp was able to discriminate between patients with MTD and healthy participants. The internal consistency was confirmed with Cronbach α .77 and 0.73 for VTDp frequency and severity subscales, respectively. The test-retest reliability was excellent with an intraclass correlation coefficient (ICCagreement) of 0.93 for the frequency subscale and 0.91 for the severity subscale. Construct validity of the VTDp was shown with significant correlations between the VTDp frequency and severity subscales and the VHIp total scores (0.36 and 0.37, respectively). The standard error of measurement and smallest detectable change values for VTDp frequency (2.11 and 5.85, respectively) and severity (2.25 and 6.23, respectively) were acceptable. The Bland-Altman analysis for assessing the agreement between test and retest measurements showed no systematic bias. CONCLUSION The VTDp is a valid and reliable self-administered scale to measure patient's vocal tract sensations in Persian-speaking population.
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Affiliation(s)
- Hadi Torabi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyedeh Maryam Khoddami
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Dabirmoghaddam
- Ear, Nose, and Throat Department, Amir-A'lamHospital, Tehran University of Medical Sciences, Tehran, Iran
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Luyten A, Bruneel L, Meerschman I, D'haeseleer E, Behlau M, Coffé C, Van Lierde K. Prevalence of Vocal Tract Discomfort in the Flemish Population Without Self-Perceived Voice Disorders. J Voice 2016; 30:308-14. [DOI: 10.1016/j.jvoice.2015.04.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/29/2015] [Indexed: 12/01/2022]
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