Correlation Between Subjective and Objective Parameters of Voice in Elderly Male Speakers

Effect of Smoking on Cepstral Parameters

Smoking exerts certain damage to the voice, which affects sound characteristics. This study explored the effects of smoking, smoking time, and smoking amount on cepstral parameters. We collected the acoustic signals of sustained vowels in 301 participants (135 smokers and 166 nonsmokers). The cepstral parameters, including cepstral peak prominence (CPP), CPP standard deviation (CPP SD), low to high-frequency spectral ratio (L/H), low to high-frequency spectral ratio standard deviation (L/H SD), and voice disorder cepstral/spectral index of dysphonia (CSID), of the sustained vowels were investigated through the analysis of dysphonia in speech and voice (ADSV) application. The effects of smoking on these parameters were explored. The influences of smoking time and smoking amount on cepstral parameters were also analyzed by multiple linear regression. The CPP and L/H values in the smoking group were lower than those in the nonsmoking group (CPP: P < 0.001, L/H: P = 0.033) and negatively correlated with smoking time (CPP: R2 = 0.3828, P < 0.0001; L/H: R2 = 0.02996, P = 0.0447) and smoking amount (CPP: R2 < 0.4526, P < 0.0001; L/H: R2 = 0.08823, P = 0.00005). The CPP SD, L/H SD, and CSID values in the smoking group were higher than those in the nonsmoking group (CPP SD: P = 0.006, L/H SD: P = 0.034, CSID: P < 0.001) and positively correlated with smoking time (CPP SD: R2 = 0.03648, P = 0.0265, L/H SD: R2 = 0.09121, P = 0.0004, CSID: R2 = 0.01247, P = 0.1972) and smoking amount (CPP SD: R2 = 0.05495, P = 0.0062, L/H SD: R2 = 0.1316, P < 0.0001, CSID: R2 = 0.03851, P = 0.0225). Compared with other cepstral parameters, smoking time and smoking volume had the greatest impact on CPP (smoking time: R2 = 0.385, smoking amount: R2 = 0.443). This study confirmed that smoking has a significant effect on cepstral parameters. Compared with the cepstral parameters of nonsmokers, an increase in smoking time and smoking volume increases the abnormality of the cepstral parameters of smokers.

Psychometric Properties of the Vocal Fatigue Handicap Questionnaire in Kannada Among Teachers

BACKGROUND

As the literature review suggests, most professional voice users, such as teachers and singers, are prone to vocal abuse or misuse and frequently experience vocal fatigue. Therefore, validating the Vocal Fatigue Handicap Questionnaire among professional voice users with and without the symptoms of vocal fatigue might provide appropriate external validity of the questionnaire.

OBJECTIVE

The objective of the study was to validate the Kannada version of the Vocal Fatigue Handicap Questionnaire (VFHQ-K) among a cohort of Kannada-speaking primary and secondary school teachers with and without self-reported vocal fatigue symptoms.

STUDY DESIGN

This was a validation study.

METHOD

The study consisted of two groups of participants. Group 1 included 40 teachers with self-reported vocal fatigue symptoms, and Group 2 included 57 teachers without self-reported vocal fatigue symptoms. The VFHQ-K was administered to each participant after obtaining informed consent. The questionnaire was again readministered between 1 and 2 weeks to assess the test-retest reliability. All the responses that were obtained were tabulated for analysis.

RESULTS

The VFHQ-K demonstrated good test-retest reliability, internal consistency, and acceptable discriminant validity. The cutoff value of VFHQ-K obtained in the present study between the teachers with and without self-reported symptoms of vocal fatigue was much less than the cutoff values reported by the earlier version of VFHQ-K.

CONCLUSION

The VFHQ-K can be a helpful tool in the early identification of teachers with vocal fatigue and in improving the vocal health of professional voice users.

Acoustic measurements of CPPS and AVQI pre and post speech therapy

PURPOSE

To compare the acoustic measurements of Cepstral Peak Prominence-Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) at pre- and post-voice therapy times.

METHODS

This is a before and after intervention study, with retrospective data collection. Twenty-two subjects with a mean age of 49.9 years participated in the study. The vocal therapy occurred between the years 2016 to 2019 in a teaching clinic, and the subjects had vocal samples collected before and after the therapeutic processes. CPPS and AVQI data extractions were performed during pre- and post-therapy. In order to characterize the sample, auditory-perceptual evaluation (APE) regarding the overall degree of vocal deviation at pre- and post-therapy moments was performed. The data were analyzed statistically.

RESULTS

The APE data indicated a decrease in the median values of overall vocal deviation degree at the post-therapy stage for both the vowel (p=0.00) and number (p=0.00) samples. The average CPPS for the vowel was 14.53 pre-therapy and 16.37 post-therapy (p=0.01); for the number emission, it was 8.22 pre-therapy and 9.06 post-therapy (p=0.02), there was a difference in the CPPS of the vowel and numbers indicating vocal improvement at post-therapy. The average AVQI was 2.27 pre-therapy and 1.54 post-therapy (p=0.05). There was an improvement in the AVQI results, with borderline p-value.

CONCLUSION

Vocal therapy produced changes in the general degree of vocal deviation, as well as in CPPS and AVQI measurements, and the results at the post-therapy moment are similar to those of vocally healthy individuals.

Acoustic measurements of CPPS and AVQI pre and post speech therapy

PURPOSE

To compare the acoustic measurements of Cepstral Peak Prominence-Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) at pre- and post-voice therapy times.

METHODS

This is a before and after intervention study, with retrospective data collection. Twenty-two subjects with a mean age of 49.9 years participated in the study. The vocal therapy occurred between the years 2016 to 2019 in a teaching clinic, and the subjects had vocal samples collected before and after the therapeutic processes. CPPS and AVQI data extractions were performed during pre- and post-therapy. In order to characterize the sample, auditory-perceptual evaluation (APE) regarding the overall degree of vocal deviation at pre- and post-therapy moments was performed. The data were analyzed statistically.

RESULTS

The APE data indicated a decrease in the median values of overall vocal deviation degree at the post-therapy stage for both the vowel (p=0.00) and number (p=0.00) samples. The average CPPS for the vowel was 14.53 pre-therapy and 16.37 post-therapy (p=0.01); for the number emission, it was 8.22 pre-therapy and 9.06 post-therapy (p=0.02), there was a difference in the CPPS of the vowel and numbers indicating vocal improvement at post-therapy. The average AVQI was 2.27 pre-therapy and 1.54 post-therapy (p=0.05). There was an improvement in the AVQI results, with borderline p-value.

CONCLUSION

Vocal therapy produced changes in the general degree of vocal deviation, as well as in CPPS and AVQI measurements, and the results at the post-therapy moment are similar to those of vocally healthy individuals.

Multiparametric Analysis of Dysphonic Voice - An Evidence from the Discriminant Analysis

Even though earlier studies have investigated the relationship between various subjective and instrumental measures of voice, determining a standardized set of voice parameters in evaluating dysphonic voices can help in better diagnostic distinctions and judgment of the treatment outcomes in voice disorders. Thus, the primary objective was to examine the differences in the objective and subjective measures of voice between the participants with dysphonia and participants with a clinically normal voice. The subsequent objective was to identify the group of parameters sensitive to vocal changes in dysphonia using discriminant analysis. Two groups of participants were included in the study. Group 1 comprised of 15 participants with dysphonia. Group 2 included 15 participants with a clinically normal voice. Sustained phonations of vowels were recorded from the participants of both groups and were analyzed perceptually using the GRBAS rating scale. Acoustic, cepstral, spectral, and electroglottographic measures were analyzed from dysphonic voices and normal controls. There were significant differences in both instrumental and perceptual measures between the participants with and without dysphonia. The set of five parameters that were significant predictors that discriminated the dysphonic voice from the clinically normal voice with 100% accuracy was also determined using discriminant analysis. Future investigations on the relation between the specific instrumental and perceptual measures of voice identified in the present study among individuals with various voice disorders can deliver more promising and comprehendible insights into better diagnostic distinctions of voice disorders.

Adaptation and Validation of the Voice-Related Quality of Life Measure into Kannada

BACKGROUND

Earlier researchers have developed various objective tools to document the impact of dysphonia on the patient's daily living and quality of life. Of all these available tools, Voice Related Quality of Life (V-RQOL) is one of the essential self-reported tools to document the quality of life related to voice. Thus, developing the Kannada version of V-RQOL can be a useful tool in the clinical assessment of Kannada-speaking dysphonic patients.

OBJECTIVES

To translate the V-RQOL into Kannada and to evaluate the psychometric properties and the cut off scores for the Kannada version of the V-RQOL.

STUDY DESIGN

This investigation deployed a non-randomized, prospective standard group comparison.

METHODS

V-RQOL was translated to Kannada and was administered to 70 patients with voice disorders (42 males and 28 females) with a mean age of 43.2 ± 15.8 years, and 70 age and gender-matched participants with a clinically normal voice.

RESULTS

Spearman's correlation coefficient was more than 0.94 indicating a good test-retest reliability. Therefore, the Kannada version of VRQOL had a good level of reproducibility. The test also showed a Cronbach alpha coefficient of 0.92, indicating a strong internal consistency of the Kannada version of VRQOL. Receiver Operating Characteristic (ROC) curve analysis revealed that the cut off score for the Kannada version of VRQOL was 93.75 indicating that Kannada version of VRQOL had an excellent construct validity.

CONCLUSION

The present study findings revealed that the Kannada version of VRQOL is a reliable, valid and sensitive self-assessment tool to document the impact of voice problems on the patient's quality of life.

Correlation Between a Self-Voice Assessment and Objective-Voice Evaluation Outcomes in Speech Language Pathology Students

AIM

The aims of this study is to explore the correlation between the Voice Disorder Index (VDI) score and acoustic and phonatory respiratory voice parameters in speech language pathology (SLP) students with and without self-perceived voice disorders.

METHODS

The Voice Disorder Index (VDI) and the Lingwaves 3 "Voice Protocol" were administered to each participant in order to assess his/her self-perceived severity of his/her voice problem, as well as, acoustic and phonatory respiratory measurements. The correlation coefficients were used to evaluate and quantify the degree of a linear relationship between VDI scores and acoustic and phonatory respiratory voice measures in students with and without self-perceived voice disorders.

RESULTS

Relatively strong, strong and strong positive correlations were revealed when comparing the VDI physical subscale with the Dysphonia Severity Index (r(11) = 0.56, P = 0.048), mean loudness when reading in English (r(11) = 0.70, P = 0.008) and mean loudness when reading in Greek (r(11) =0.69, P = 0.009) respectively.

CONCLUSIONS

SLP students may be more aware of the impact of their laryngeal discomfort and voice output characteristics on their daily activities that can predict certain acoustic parameters than the emotional and functional impact on their daily activities.

Multiparametric analysis of voice following prolonged voice use and voice rest in teachers: evidence from discriminant analysis

PURPOSE

Even though recent investigations have used multiparametric protocol, the set of robust parameters in determining the effects of vocal fatigue and voice rest in teachers is not clear. The first objective of the study was to document the impact of prolonged voice use and voice rest on the subjective and objective voice parameters among Indian secondary school teachers. The second objective was to determine the set voice parameters sensitive to vocal changes resulting from continuous voice use and voice rest.

METHOD

The study included 15 male and 15 female secondary school teachers with a clinically normal voice and no history of voice disorders. Phonation samples were recorded in three different conditions, i.e., condition 1 (before voice use), condition 2 (following voice use), and condition 3 (following voice rest). The vocal Fatigue Index (version 2) was administered before the voice recordings in all three conditions. The objective parameters, namely fundamental frequency, range of fundamental frequency, jitter (%), shimmer (%), harmonic to noise ratio, and smoothened cepstral peak prominence, were extracted.

RESULTS

Results revealed that fundamental frequency, jitter, shimmer, Harmonic to noise ratio, and smoothened cepstral peak prominence were significantly different across the three conditions. The discriminant analysis revealed that only three parameters classified 98.3% of samples accurately between the three conditions.

CONCLUSION

Further research on the correlation between the other subjective and the objective parameters of voice after vocal fatigue would provide more penetrating and ample in-depth insights into the assessment and quantification of vocal fatigue.