The Effectiveness of the EASE Scale in the Development of a Vocal Warm-up Program for an Amateur Choir

Vocal Fatigue Experiences and Mitigation Strategies in the Sacred Harp Singing Community

OBJECTIVES

Sacred Harp singers sing at a high volume for sustained periods of time without collective warm-up or cool-down exercises, ostensibly putting them at elevated risk for vocal fatigue (VF) and associated vocal pathologies. Participants are also likely to lack formal vocal training. The purpose of this study was to (1) assess singers' experiences with VF, (2) document singers' strategies for mitigating VF, and (3) determine whether vocal training was associated with decreased vocal difficulties.

STUDY DESIGN

Self-reporting via online questionnaire containing quantitative and qualitative items.

METHODS

This study employed an online questionnaire that combined demographic items, open-ended questions, and the Evaluation of the Ability to Sing Easily (EASE). Participants were recruited at one in-person event and via social media and a mailing list.

RESULTS

This study returned 134 valid responses. Singers with formal choral experience scored lower on the EASE and two subscales, but length of experience had no impact. There were no correlations between vocal training and EASE scores. Women scored higher on the EASE than men and nonbinary individuals, while age, length of experience with Sacred Harp singing, and frequency of attendance at annual singing events were all negatively correlated with EASE score. Singers reported a wide range of mitigation strategies, most of which are unique to the Sacred Harp context.

CONCLUSIONS

Sacred Harp singers do not appear to struggle more with VF than other populations of singers. However, a few characteristics of their practice put them at risk, and many singers would benefit from professional guidance concerning vocal health.

EASE-NL: Cross-Cultural Adaptation and Validation of the Dutch Version of the Evaluation of Ability to Sing Easily

OBJECTVES

The Evaluation of the Ability to Sing Easily (EASE) is a self-rating tool that is used to assess the singer's perceptions of the current singing voice status. The purpose of this study was to develop and validate a Dutch translation of the EASE.

METHODS

The original version of the EASE was translated and adapted to Dutch according to the recommendations of the Quality of Life Special Interest Group - Translation and Cultural Adaptation group. Subsequently, the questionnaire was individually completed by 70 singers with a mean age of 35.2 years before and after a singing activity, together with a demographic questionnaire and the Dutch Singing Voice Handicap Index 10 (SVHI-10-NL). Two groups of singers were included between September and June 2020: a group of healthy singers (n = 54) and a group of dysphonic singers (n = 16). Internal and external consistency, construct and criterion validity, test-retest and split-half reliability were calculated using Cronbach's alpha coefficients, Student's t-test, the paired Wilcoxon tests and Pearson correlation coefficients. Furthermore, the impact of sex and age and the diagnostic accuracy of the EASE-NL was measured using the Mann Whitney U-test, the One Way ANOVA and the Brown Forsythe ANOVA-test.

RESULTS

The internal consistency of the EASE was considered good. For the external consistency, the Pearson correlation coefficient showed a positive correlation between the total score of the EASE-NL and the SVHI-10-NL. Dysphonic singers scored significantly higher compared to singers without voice problems and no differences were found between the pre and post singing condition in both groups. Pearson correlations coefficients showed a strong positive correlation between the test and retest condition and between the subscales. A ROC-curve analysis showed a cut-off score of 12.5, with a sensitivity level of 75.0% and a specificity level of 74.1%. No differences for sex and age were found.

CONCLUSIONS

The original English version of the EASE was translated and validated in Dutch. The EASE-NL is found to be a valid and reliable self-reported tool to assess singer's perceptions of the current status of their singing voice.

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

BACKGROUND

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

OBJECTIVE

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

STUDY DESIGN

Prospective cohort study.

METHODS

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

RESULTS

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

CONCLUSION

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

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Equivalencia cultural de la versión Chilena del Evaluation of Ability to Sing Easily: EASE

RESUMEN Objetivo: Adaptar lingüística y culturalmente el protocolo australiano de voz cantada Evaluation of Ability to Sing Easily (EASE) al español chileno. Método: Fue realizada la traducción al español chileno del EASE y posteriormente la retrotraducción; ambas fueron revisadas por un comité compuesto por 4 fonoaudiólogos quienes crearon la primera versión en español chileno (EASE-CL). El EASE-CL está compuesto, al igual que el original, por 22 ítems que se contestan de acuerdo con una escala de Likert de frecuencia, a la que, durante la adaptación, se le sumó la alternativa “no aplicable” para poder identificar las consignas no comprendidas o inapropiadas para el vocabulario de los cantantes chilenos. Esta versión se aplicó a 21 cantantes profesionales de la región de Valparaíso. Durante esta aplicación no existieron sugerencias para el cambio de alguna consigna. Resultado: El EASE-CL refleja la versión original del inglés, tanto en la cantidad de ítems como en dominios. Conclusión: Queda demostrada la equivalencia cultural y lingüística del protocolo EASE al español chileno, originándose la versión EASE-CL.