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Nanjundaswamy RKB, Jayakumar T. Comparison of Two Multiparameter Acoustic Voice Outcome Indices in the Treatment of Hyperfunctional Voice Disorders: Dysphonia Severity Index and Acoustic Voice Quality Index. J Voice 2024:S0892-1997(24)00174-7. [PMID: 38906742 DOI: 10.1016/j.jvoice.2024.06.002] [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: 04/29/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The Dysphonia Severity Index (DSI) and Acoustic Voice Quality Index (AVQI) are the two widely used multiparameter acoustic instrumented indices that estimate dysphonia severity and track treatment outcomes. This study compared the performance of these two indices in identifying voice quality changes with eclectic voice therapy in individuals with hyperfunctional voice disorders (HFVD). METHOD Twenty individuals with HFVD including eight males and 13 females in the age range of 20-55 years received an eclectic voice therapy program named the Comprehensive Voice Habilitation Program. All the participants attended 15 sessions of voice therapy. DSI and AVQI measures were obtained at the baseline, immediate post therapy, 15 days post therapy (follow-up 1), and 60 days post therapy (follow-up 2). Repeated measures analysis of variance was performed to verify whether there were any differences between the time points for dependent variables DSI and AVQI. The effect sizes obtained for the DSI and AVQI measures were also noted. RESULTS A significant difference was obtained between the baseline and post therapy, follow-up 1 and follow-up 2 for AVQI measure with a very large effect size, ηp2 = 0.451. In contrast, DSI showed a significant difference only between the baseline and follow-up 1 with effect size, ηp2 = 0.187. CONCLUSIONS The results of this study confirmed that both DSI and AVQI were effective in tracking the changes in the severity of dysphonia. However, when compared, AVQI appeared to be more sensitive than DSI in potentially reflecting the effect of eclectic voice therapy in HFVD.
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Affiliation(s)
| | - Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
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Jamshidpour P, Moradi N, Raiesian S, Masoudrad M, Seyedtabib M, Soltani M, Shaterzadeh Yazdi MJ. Voice quality in patients with temporomandibular disorders. Cranio 2024:1-7. [PMID: 38738830 DOI: 10.1080/08869634.2024.2350922] [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: 05/14/2024]
Abstract
OBJECTIVES This study assessed the voice quality in TMD patients compared to healthy individuals using the Dysphonia Severity Index (DSI) and evaluated the correlation between the DSI and TMD severity. METHODS Patients who had TMD with Fonseca's anamnestic index were subjected to an examination based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). A sample of 35 patients with TMD and 36 healthy subjects were included in the study. RESULTS There were significant differences in the DSI score and its components between healthy subjects and TMD patients (p < .001). A significant correlation was found between the DSI scores and TMD severity (Spearman's rho: -0.90, p < .001). CONCLUSION Patients with TMD demonstrated lower DSI scores and lower voice quality compared to healthy subjects.
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Affiliation(s)
- Parizad Jamshidpour
- Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Negin Moradi
- Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, River Falls, WI, USA
| | - Shahrokh Raiesian
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdis Masoudrad
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Soltani
- Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Nemr K, Simões-Zenari M, Cologis VCDA, Martins GA, Saito IT, Gonçalves RDS. COVID-19 and Remote Learning: Predictive Factors of Perceived Improvement or Worsening of the Voice in Brazilian Teachers. J Voice 2024; 38:246.e27-246.e38. [PMID: 34610882 PMCID: PMC8421100 DOI: 10.1016/j.jvoice.2021.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Given the transformations in teaching modalities as a result of the COVID-19 pandemic, this study aimed to evaluate the factors associated with vocal self-perception during the pandemic and to investigate the ability of selected variables to predict changes in vocal self-perception in teachers with professional vocal demands during the investigated period. STUDY DESIGN Cross-sectional survey. METHOD A total of 1,126 teachers of both genders (ages 19-78 years, average 43.23 years) who were participating in remote teaching activities using their voice answered the online questionnaire. To characterize vocal changes (improvement, worsening or no change), the teachers' self-assessment of their voice quality was considered; the association between the variables reported in the questionnaire and vocal changes was analyzed, as was the capacity of these variables for predicting voice changes. RESULTS Most of the teachers worked at a public school, reported having no previous voice changes or difficulties with their voice during online classes and indicated that they began to use their voice less often and with reduced intensity during the pandemic. Vocal demands were divided between teaching synchronous online classes, recording video lessons and participating in online meetings. Several variables were associated with voice improvement and worsening, and some had the capacity to predict voice changes: improvement in voice quality was associated with working in a public school or as an autonomous teacher, reduced voice use and, to a lesser extent, participating in online meetings, certain vocal habits and a reduction in vocal symptoms; worsening voice quality was associated with working in a private school, increased voice use, using the voice at a higher intensity, difficulty with the voice in online classes, vocal habits and vocal symptoms. CONCLUSION The context of remote education has changed the way teachers communicate during classes, and monitoring is necessary to ensure that necessary adaptations are made to preserve the voice and ensure effective communication.
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Affiliation(s)
- Katia Nemr
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Marcia Simões-Zenari
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, SP, Brazil.
| | | | - Glauciene Amaral Martins
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Isabele Tiemi Saito
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Renata da Silva Gonçalves
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, SP, Brazil
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Uloza V, Pribuišis K, Ulozaite-Staniene N, Petrauskas T, Damaševičius R, Maskeliūnas R. Accuracy Analysis of the Multiparametric Acoustic Voice Indices, the VWI, AVQI, ABI, and DSI Measures, in Differentiating between Normal and Dysphonic Voices. J Clin Med 2023; 13:99. [PMID: 38202106 PMCID: PMC10779457 DOI: 10.3390/jcm13010099] [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: 11/16/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
The study aimed to investigate and compare the accuracy and robustness of the multiparametric acoustic voice indices (MAVIs), namely the Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Acoustic Breathiness Index (ABI), and Voice Wellness Index (VWI) measures in differentiating normal and dysphonic voices. The study group consisted of 129 adult individuals including 49 with normal voices and 80 patients with pathological voices. The diagnostic accuracy of the investigated MAVI in differentiating between normal and pathological voices was assessed using receiver operating characteristics (ROC). Moderate to strong positive linear correlations were observed between different MAVIs. The ROC statistical analysis revealed that all used measurements manifested in a high level of accuracy (area under the curve (AUC) of 0.80 and greater) and an acceptable level of sensitivity and specificity in discriminating between normal and pathological voices. However, with AUC 0.99, the VWI demonstrated the highest diagnostic accuracy. The highest Youden index equaled 0.93, revealing that a VWI cut-off of 4.45 corresponds with highly acceptable sensitivity (97.50%) and specificity (95.92%). In conclusion, the VWI was found to be beneficial in describing differences in voice quality status and discriminating between normal and dysphonic voices based on clinical diagnosis, i.e., dysphonia type, implying the VWI's reliable voice screening potential.
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Affiliation(s)
- Virgilijus Uloza
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Kipras Pribuišis
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Nora Ulozaite-Staniene
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Tadas Petrauskas
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | | | - Rytis Maskeliūnas
- Faculty of Informatics, Kaunas University of Technology, 51368 Kaunas, Lithuania
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Fujiki RB, Thibeault SL. Examining Therapy Duration in Adults With Voice Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1665-1678. [PMID: 37348484 PMCID: PMC10473393 DOI: 10.1044/2023_ajslp-22-00390] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/10/2023] [Accepted: 04/10/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE This study examined the number of voice therapy sessions and the number of weeks in treatment to achieve desired voice outcomes in adults with voice disorders. Factors that may predict therapy duration were examined, as was the percentage of patients returning to the clinic for additional voice therapy after initial discharge. METHOD An observational cohort design was utilized. Data from 558 patients were extracted from the University of Wisconsin-Madison Voice and Swallow Outcomes Database. Patients diagnosed with muscle tension dysphonia, vocal fold paralysis, benign vocal fold lesions, laryngospasm/irritable larynx, and presbyphonia were examined. Patient demographics, auditory-perceptual assessments, acoustics, aerodynamics, videostroboscopy ratings, self-reported scales, and medical comorbidities were collected. RESULTS Patients required an average of 5.32 (SD = 3.43) sessions of voice therapy before voice outcomes were sufficiently improved for discharge. Average number of sessions ranged from 4.3 for presbyphonia to 6.7 for benign vocal fold lesions. Baseline overall Grade Roughness Breathiness Asthenia and Strain rating (p < .001), Dysphonia Severity Index (p < .001), Voice Handicap Index score (p < .01), age (p = .006), and occupational voice user status (p < .001) significantly predicted the number of therapy sessions required. Overall, 14.5% of patients returned for additional voice therapy following an initial discharge from treatment. CONCLUSIONS Findings inform our understanding of how many sessions patients with voice disorders require to achieve desired voice outcomes. Additional research is needed to optimize the efficacy of voice treatment and determine how recurrence of dysphonia might best be prevented.
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Andriollo DB, Frigo LF, Cielo CA. Effect of Pompage on Vocal and Respiratory Measurements from Female Teachers: A Randomized Clinical Trial. Folia Phoniatr Logop 2023; 75:295-305. [PMID: 36812904 DOI: 10.1159/000529832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Teachers stand out among occupational groups due to their contribution to modern societies, and their voice is the main form of interaction. OBJECTIVE The aim of the study was to verify the changes in vocal and respiratory measurements from teachers with vocal and musculoskeletal complaints and with normal larynx after applying a musculoskeletal manipulation protocol of myofascial release using pompage. METHODS Controlled and randomized clinical trial with 56 participants: 28 teachers in the study group and 28 teachers in the control group. Anamnesis, videolaryngoscopy, hearing screening, sound pressure and maximum phonation time measurements, and manovacuometry were performed. The musculoskeletal manipulation protocol of myofascial release using pompage consisted of a total of 24 sessions, 40 min for each session, three times a week, for 8 weeks. RESULTS There was a significant improvement in the maximum respiratory pressure in the study group after the intervention. The sound pressure level and the maximum phonation time did not change significantly. DISCUSSION AND CONCLUSION Musculoskeletal manipulation protocol of myofascial release using pompage had a direct effect on the respiratory measurements from female teachers, significantly increasing the maximum respiratory pressure but without affecting sound pressure level and the /a/ maximum phonation time.
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Affiliation(s)
- Débora Bonesso Andriollo
- Programa de Pós-graduação em Fonoaudiologia, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Universidade Federal de Santa Maria, Santa Maria, Brazil
| | | | - Carla Aparecida Cielo
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Jayakumar T, Yasin HAM, Benoy JJ. Prevalence of Voice Problems and Associated Risk Factors Among Tamil-Speaking Imams. J Voice 2022:S0892-1997(22)00375-7. [PMID: 36517326 DOI: 10.1016/j.jvoice.2022.11.022] [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: 10/28/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Voice of Professional Voice Users (PVUs) are of particular interest to practicing Speech-Language Pathologists. There is a dearth of studies concerning the prevalence of voice disorders and the associated risk factors among Tamil-speaking Imams. We address this research gap using non-experimental survey research. METHODS A questionnaire was framed by reviewing earlier literature. The derived questionnaire was administered to one hundred Tamil-speaking Imams actively involved in religious service in Tamil Nadu. We analyzed the obtained responses quantitatively and qualitatively. We also examined the effect of age on the prevalence of voice disorders and associated risk factors. RESULTS Based on survey responses, the career prevalence of voice problems among Tamil-speaking Imams was as high as 89%, and the point prevalence was 64%. The general health status of the Imams were good. However, vocal health was not satisfactory. This study identified several factors that contribute to voice problems, such as constant use of loud voice, acid reflux, unhealthy vocal habits, and insufficient hydration. A positive aspect observed during this study was the absence of smoking and consumption of alcohol among Imams. Even though the Imams presented good awareness of the voice production mechanism, they reported not seeking medical help when facing a voice problem. Current findings report a minimal impact of age-related differences on associated risk factors for voice disorders among the Imams. CONCLUSIONS Voice disorders are prevalent among Tamil-speaking Imams. Several risk factors leading to voice disorders among these individuals need to be addressed.
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Affiliation(s)
- Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India.
| | - Hasan Ali Mohamed Yasin
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
| | - Jesnu Jose Benoy
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
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Zhao EE, Nguyen SA, Salvador CD, O'Rourke AK. A Meta-Analysis of the Association Between the Voice Handicap Index and Objective Voice Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3461-3471. [PMID: 32955998 DOI: 10.1044/2020_jslhr-20-00209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Dysphonia can be evaluated by both patient-reported quality of life instruments and objective acoustic and aerodynamic analyses. However, less is known about the association between the two metrics. The goal of this study was to perform a meta-analysis of the correlation of the Voice Handicap Index (VHI-30) with the following objective parameters: fundamental frequency, jitter, shimmer, harmonics to noise ratio, noise to harmonic ratio, maximum phonation time, and the Dysphonia Severity Index. Method A literature search was performed in the PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases. Inclusion criteria were subjects age 18 years and older with voice complaints and assessed by both VHI-30 and objective voice analysis. Results A literature search resulted in 1,297 unique articles, of which 310 underwent full-text review and 17 studies were included in quantitative analysis. Significant pooled correlation was observed for VHI-30 total with jitter (.301 [.177; .416]), shimmer (.255 [.162; .344]), noise to harmonic ratio (.200 [.111; .285]), maximum phonation time (-.227 [-.352; -.094]), and Dysphonia Severity Index (-.254[-.455; -.0286]). Significant correlations were observed in 4/7 objective parameters with the Physical subscale, 3/7 with the Functional subscale, and 2/7 with the Emotional subscale. All significant correlations were negligible (0-.3) or low (.3-.5). Conclusions Results from meta-analysis showed that correlations between objective voice parameters and the VHI-30 were negligible or low. Further study is needed to determine if correlations vary by patient demographics or specific pathology.
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Affiliation(s)
- Elise E Zhao
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Craig D Salvador
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Ashli K O'Rourke
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
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