Vocal Parameters in Individuals with Traumatic Spinal Cord Injury: A Systematic Review

Patients' Demographics and Risk Factors in Voice Disorders: An Umbrella Review of Systematic Reviews

OBJECTIVES

This study aimed to provide a comprehensive overview of the systematic reviews that focus on the prevalence of voice disorders (VDs), associated risk factors, and the demographic characteristics of patients with dysphonia. An umbrella review was conducted to identify general research themes in voice literature that might guide future research initiatives and contribute to the classification of VDs as a worldwide health concern.

STUDY DESIGN

Umbrella review of systematic reviews.

METHODS

Pubmed/Medline and Embase were searched for eligible systematic reviews by two authors independently. Extracted data items included the study publication details, study design, characteristics of the target population, sample size, region/country, and incidence and/or prevalence of the VD(s) of interest.

RESULTS

Forty systematic reviews were included. Sixteen reported a meta-analysis. Great heterogeneity in methods was found. A total of 277,035 patients across the included studies were included with a prevalence ranging from 0%-90%. The countries represented best were the United States and Brazil, with 13 studies each. Aging, occupational voice use, lifestyle choices, and specific comorbidities, such as obesity or hormonal disorders, seem to be associated with an increased prevalence of dysphonia.

CONCLUSIONS

This review underscores the influence of VDs on distinct patient groups and the general population. A variety of modifiable or non-modifiable risk factors, having varied degrees of impact on voice qualities, have been identified. The overall effect of VDs is probably underestimated due to factors, such as sample size, patient selection, underreporting of symptoms, and asymptomatic cases. Employing systematic reviews with consistent methodologies and criteria for diagnosing VDs would enhance the ability to determine the prevalence of VDs and their impact.

Effect of Vocal Exercise on Respiratory Function and Voice Quality in Patients with Cervical Spinal Cord Injury: A Mini-review

Objectives

This study reviewed the effect of vocal exercise on patients with cervical spinal cord injury (SCI).

Methods

An electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase databases was conducted for relevant studies published between 1980 and 2022. The review included studies that used randomized controlled trials to examine the effects of vocal exercise on people with cervical SCI.

Results

We screened 1351 articles, of which 4 studies were eligible for inclusion. Vocal exercises were conducted two or three times a week for 12-24 weeks. Random sequences were adequately generated in all studies. All studies used respiratory function as the main outcome, and three studies used vocal quality as an outcome. In all studies, there were no dropouts other than those caused by unexpected illness. Vocal exercises were reported to have a positive effect on respiratory function in all studies and on voice quality in three studies. Meta-analysis was not possible because of the heterogeneity of the studies.

Conclusions

Vocal exercise for SCI is a sustainable method that does not require special equipment or skills. More studies with large sample sizes are needed to confirm the effects of vocal exercises in patients with cervical SCI.

Traumatic Spinal Injury: Preliminary Results of Respiratory Function, Voice and Quality of Life

OBJECTIVES

Assess respiratory muscle strength, voice and the quality of life of patients with traumatic cervical and thoracic spinal cord injury.

METHODS

Preliminary analytical case control study of 28 adult men, aged between 18 and 65 years, divided into two groups: a research group consisting of 14 patients with cervical and thoracic spinal cord injury, and control group (CG) with 14 noninjured individuals. The subjects had their maximum inspiratory and expiratory pressures measured, underwent voice handicap index-10 assessment, had their voices recorded for auditory perception analysis, using the voice deviation and GRBASI scales, and for acoustic analysis, based on extraction of the parameters selected and completed a quality-of-life questionnaire (WHOQOL-bref protocol).

RESULTS

Intergroup comparison indicated that the research group exhibited lower respiratory muscle strength in relation to the CG, MIP and MEP P-values < 0.001 and < 0.001, respectively; and in relation to the device's reference value, MIP and MEP P-values < 0.001 and < 0.001, respectively; the patients reported no voice handicaps according to the voice handicap index; overall vocal deviation severity on the voice deviation was higher in the CG, P = 0.040; there was greater occurrence of roughness and instability on the GRBASI scale, P= 0.040; there was greater difficulty in modulating vocal frequency (P= 0.002) and resonance, with a laryngopharyngeal focus; the acoustic parameters were normal; and lower scores were obtained in the physical domain of quality of life (P< 0.001).

CONCLUSION

The individuals with traumatic spinal cord and thoracic injury exhibited changes in respiratory measures, vocal deviation and dissatisfaction in the physical domain of the WHOQOL-bref protocol.