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Colla CN, Andriollo DB, Cielo CA. Self-assessment of teachers with normal larynges and vocal and osteomuscular complaints. J Voice 2024; 38:1253.e1-1253.e10. [PMID: 35570174 DOI: 10.1016/j.jvoice.2022.04.001] [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: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Teachers face vocal problems related to long periods of speech and increased sound pressure, as well as environmental noise, inadequate posture and tension of the cervical muscles. OBJECTIVE To verify the results of self-assessment of teachers with normal larynges and vocal and musculoskeletal complaints, and compare them with the reference values. METHODS Fifty-seven teachers, aged between 21 and 60 years (average 40.14 years) participated in the study. Anamnesis, otorhinolaryngological examination, hearing screening and self-assessment protocols were performed. RESULTS In the Nordic musculoskeletal questionnaire, the majority of teachers had discomfort in most parts of the body and in the situations evaluated; on the voice-related quality of life, the total and physical subscores were lower than the normative values while the emotional subscore was higher; regarding voice symptoms scale and vocal tract discomfort scale, the scores were higher than the normative values; in the hospital anxiety and depression scale, there was alteration in the total score; in the Vocal Activity and Participation Profile, the effects on work and emotion were above the normative values; on the University of Rhode Island change assessment-voice and on the voice handicap index there were no significant differences. CONCLUSION Most of the teachers presented vocal, musculoskeletal, and emotional complaints on the self-assessment results, what suggests excessive voice use as well as overload on the body muscles, including the larynx and vocal tract, and that they presented emotional changes. These aspects had an impact on their quality of life, but they showed no action in coping with the condition.
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Affiliation(s)
- Carla Nolasco Colla
- Speech Therapy Department, Voice Laboratory, Federal University of Santa Maria, Building 26E, Av. Roraima, 1000, Camobi, Santa Maria, Rio Grande do Sul 97105-900, Brazil.
| | | | - Carla Aparecida Cielo
- Department of Speech Therapy and at the Postgraduate Program in Human Communication Disorders, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Slavych BK, Zraick RI, Ruleman A. A Systematic Review of Voice-Related Patient-Reported Outcome Measures for Use with Adults. J Voice 2024; 38:544.e1-544.e14. [PMID: 34782227 DOI: 10.1016/j.jvoice.2021.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This paper's purpose is to provide a resource for clinicians and researchers of select voice-related patient-reported outcome measures (PROMs) available in the English language. METHOD A systematic search for voice-related PROMs was conducted between September 2020 and July 17, 2021. Databases included APA PsychInfo, Nursing and Allied Health Source, MEDLINE via the EBSCO interface, and Science Direct. Reference lists for PROMs-related articles were mined for reference to PROMs protocols. RESULTS Thirty voice-related PROMs were identified and categorized as either developed primarily for use in the clinic (n = 12), developed primarily for use in a specific research study (n = 6), or translated into English for publication (n = 12). Twelve PROMs were summarized: Aging Voice Index, Disease Specific Self-Efficacy in Spasmodic Dysphonia, Evaluation of the Ability to Sing Easily, Evaluating Voice Disability - Quality of Life Questionnaire, Glottal Function Index, Linear Analog Scale of Assessment of Voice Quality, Quality of Life in Recurrent Respiratory Papillomatosis, Speech Disability Questionnaire, Trans Woman Voice Questionnaire, Vocal Cord Dysfunction Questionnaire, Vocal Fatigue Index, and the Vocal Tract Discomfort Scale. CONCLUSION The PROMs can be categorized into English-language voice-related PROMs developed primarily for clinical use, English-language PROMs developed primarily for research use, and English-language PROMs translated into English. The extent of reliability and validity testing completed varies in the PROMs developed primarily for clinical use. A PROM's psychometric properties as well as the language in which the PROM was tested, should guide clinicians and researchers as they consider which instrument(s) to use.
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Affiliation(s)
- Bonnie K Slavych
- Communication Disorders program, University of Central Missouri, Warrensburg, Missouri, USA.
| | - Richard I Zraick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, Florida, USA
| | - Alice Ruleman
- Communication Disorders program, University of Central Missouri, Warrensburg, Missouri, USA
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Aguiar ACD, Almeida LNA, Pernambuco L, Ramos N, Andrade JMD, Behlau M, Almeida AA. Urica-VV Scale: A New Research Perspective of The Stage of Readiness for Treatment in Patients with Dysphonia. J Voice 2023; 37:807-821. [PMID: 34272143 DOI: 10.1016/j.jvoice.2021.06.004] [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: 03/06/2021] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To obtain evidence of validity for the URICA-V scale and estimate the psychometric properties of its items based on item response theory (IRT). METHOD A total of 658 individuals of both sexes over 18 years of age were allocated into two groups: with dysphonia group (WDG) and vocally healthy group (VHG). A digital database was constructed with personal and professional data and item-by-item responses on the URICA-V scale. Subsequently, Cronbach's alpha, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), application of IRT using Samejima's model and ROC curve analysis were used to obtain the cutoff point for the URICA-V scale. RESULTS A different version of the original URICA-V scale was obtained. Of the 32 items from the original protocol, 25 better explained the instrument and were regrouped into two domains: contemplation and maintenance. It was possible to identify which items generated higher difficulty (b) and discrimination (a) values and which contributed to the presentation of a calculation based on the theta of each participant. The ROC curve was analyzed, and a cutoff point of -0.236 was established; establishing a cutoff point facilitates the decision of which individuals are in a state of readiness for voice treatment. CONCLUSION The present study provided evidence that allows us to propose the URICA-Voice validated (URICA-VV) scale within a more contemporary perspective and with a reduced number of items and domains. In addition, a cutoff point was obtained based on IRT to measure, with greater accuracy, sensitivity and specificity, the stage of readiness and to differentiate individuals who have an indication for speech therapy.
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Affiliation(s)
- Alexandra Christine de Aguiar
- Speech therapist. Master's degree in Speech Therapy and Doctoral Student in Decision and Health Models from Federal University of Paraíba (Universidade Federal da Paraíba - UFPB)
| | - Larissa Nadjara Alves Almeida
- Speech therapist. PhD in Decision and Health Models from Federal University of Paraíba (Federal University of Paraíba - UFPB)
| | - Leandro Pernambuco
- Speech therapist. Professor, Department of Speech Therapy, Federal University of Paraíba
| | - Noemi Ramos
- Speech therapist. Master's degree in Decision and Health Models from Federal University of Paraíba (Federal University of Paraíba - UFPB)
| | - Josemberg Moura de Andrade
- Psychologist. Professor, Department of Social and Work Psychology, University of Brasília (Universidade de Brasília - UnB)
| | - Mara Behlau
- Speech therapist. Professor, Graduate Program in Human Communication Disorders, Federal University of São Paulo - (Universidade Federal de São Paulo - UNIFESP). Centro de Estudos da Voz, São Paulo - SP
| | - Anna Alice Almeida
- Speech therapist. Professor, Department of Speech Therapy, Federal University of Paraíba.
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Chamun WWA, Ribeiro VV, Madazio G, Behlau M. Mapping of the characteristics in the CoDAS journal publications in the voice area: a scoping review. Codas 2023; 35:e20220088. [PMID: 37283366 PMCID: PMC10266801 DOI: 10.1590/2317-1782/20232022088pt] [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: 03/23/2022] [Accepted: 07/28/2022] [Indexed: 06/08/2023] Open
Abstract
PURPOSE To map and describe the characteristics present in the publications of the CoDAS journal in the voice segment. RESEARCH STRATEGIES The research was carried on the Scielo database using the descriptor voice. SELECTION CRITERIA CoDAS publications in the field of voice. DATA ANALYSIS Specific data collected according to delineation, summarized by descriptive analysis and analyzed in narrative format. RESULTS Studies published in 2019 and with cross-sectional delineation were more frequent. The most frequent result in the cross-sectional studies was the vocal self-assessment. Most intervention studies were of immediate single-session-only effect. The most frequent procedures in the validation studies were translation and transcultural adaptation. CONCLUSION There was a gradual increase in the number of publications of voice studies, though these had heterogeneous characteristics.
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Affiliation(s)
| | - Vanessa Veis Ribeiro
- Centro de Estudos da Voz - CEV - São Paulo (SP), Brasil.
- Departamento de Fonoaudiologia, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.
| | | | - Mara Behlau
- Centro de Estudos da Voz - CEV - São Paulo (SP), Brasil.
- Departamento de Fonoaudiologia, Universidade Federal de São Paulo - Unifesp - São Paulo (SP), Brasil.
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Andriollo DB, Frigo LF, Cielo CA. Effect of Pompage on Teachers Self-Assessment-Clinical Trial. J Voice 2023; 37:293.e25-293.e36. [PMID: 33446440 DOI: 10.1016/j.jvoice.2020.12.023] [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: 07/23/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To verify the results of self-assessments of teachers with vocal and musculoskeletal complaints and with the normal larynx, after myofascial release using pompage. METHODS Double-blind, controlled, and randomized clinical trial including 28 teachers in the study group and 28 teachers in the control group, totaling 56 participants. Anamnesis, video laryngoscopy, hearing screening, clinical and photogrammetric postural assessment, pain threshold in cervical muscles, sound pressure and maximum phonation time measurements, and manovacuometry were performed. Protocols for vocal self-assessment, neck pain, anxiety and depression, and musculoskeletal pain were filled out. Pompage therapy consisted of a total of 24 sessions (8 weeks) of 40 minutes each, three times a week. Afterward, the groups were reassessed. RESULTS In the study group, there was a significant improvement in the results of the following instruments: Hospital Anxiety and Depression Scale, Vocal Tract Discomfort Scale, Voice Symptoms Scale, Vocal Activity and Participation Profile, Vocal Handicap Index, Voice-Related Quality of Life, and Nordic Musculoskeletal Questionnaire. CONCLUSIONS After myofascial release using pompage in teachers, there was an improvement in the self-assessed aspects regarding characteristics and quality of life related to the voice, social participation related to the voice, anxiety and depression, and musculoskeletal symptoms.
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Affiliation(s)
| | | | - Carla Aparecida Cielo
- Department of Speech Therapy and Graduate Program in Human Communication Disorders, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Behlau M, Almeida AA, Amorim G, Balata P, Bastos S, Cassol M, Constantini AC, Eckley C, Englert M, Gama ACC, Gielow I, Guimarães B, Lima LR, Lopes L, Madazio G, Moreti F, Mouffron V, Nemr K, Oliveira P, Padovani M, Ribeiro VV, Silverio K, Vaiano T, Yamasaki R. Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment. Codas 2022; 34:e20210240. [PMID: 35920467 PMCID: PMC9886186 DOI: 10.1590/2317-1782/20212021240pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023] Open
Abstract
During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part "a" of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.
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Affiliation(s)
- Mara Behlau
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Escola Paulista de Medicina – EPM, Universidade Federal de São Paulo – UNIFESP - São Paulo (SP), Brasil.
| | - Anna Alice Almeida
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Universidade Federal da Paraíba – UFPB - João Pessoa (PB), Brasil.
| | - Geová Amorim
- Universidade Federal de Alagoas – UFAL - Maceió, AL, Brasil.
| | - Patrícia Balata
- APTA COMUNICAÇÃO - Recife (PE), Brasil.
- Universidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.
| | - Sávio Bastos
- Centro de Fotobiomodulação e Saúde – CFOTOBIOS - Belém (PA), Brasil.
| | - Mauricéia Cassol
- Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil.
| | | | - Claudia Eckley
- Faculdade de Ciências Médicas da Santa Casa de São Paulo – FCMSCSP - São Paulo (SP), Brasil.
| | - Marina Englert
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
| | | | - Ingrid Gielow
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
| | - Bruno Guimarães
- Clínica Bruno Guimarães Serviços de Fonoaudiologia e Fisioterapia - Fortaleza (CE), Brasil.
| | | | - Leonardo Lopes
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Universidade Federal da Paraíba – UFPB - João Pessoa (PB), Brasil.
| | | | - Felipe Moreti
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Centro Universitário da Faculdade de Medicina do ABC – FMABC - Santo André (SP), Brasil.
- Complexo Hospitalar Municipal de São Bernardo do Campo – CHMSBC - São Bernardo do Campo (SP), Brasil.
| | - Vanessa Mouffron
- Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Katia Nemr
- Universidade de São Paulo – USP - São Paulo (SP), Brasil.
| | | | - Marina Padovani
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Faculdade de Ciências Médicas da Santa Casa de São Paulo – FCMSCSP - São Paulo (SP), Brasil.
| | - Vanessa Veis Ribeiro
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Universidade Federal da Paraíba – UFPB - João Pessoa (PB), Brasil.
| | - Kelly Silverio
- Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.
| | - Thays Vaiano
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
| | - Rosiane Yamasaki
- Centro de Estudos da Voz – CEV - São Paulo (SP), Brasil.
- Escola Paulista de Medicina – EPM, Universidade Federal de São Paulo – UNIFESP - São Paulo (SP), Brasil.
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Behlau M, Almeida AA, Amorim G, Balata P, Bastos S, Cassol M, Constantini AC, Eckley C, Englert M, Gama ACC, Gielow I, Guimarães B, Lima LR, Lopes L, Madazio G, Moreti F, Mouffron V, Nemr K, Oliveira P, Padovani M, Ribeiro VV, Silverio K, Vaiano T, Yamasaki R. Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment. Codas 2022. [DOI: 10.1590/2317-1782/20212021240en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part “a” of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.
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Affiliation(s)
- Mara Behlau
- Centro de Estudos da Voz, Brasil; Universidade Federal de São Paulo, Brasil
| | - Anna Alice Almeida
- Centro de Estudos da Voz, Brasil; Universidade Federal da Paraíba, Brasil
| | | | - Patrícia Balata
- APTA COMUNICAÇÃO, Brasil; Universidade Federal de Pernambuco, Brasil
| | | | - Mauricéia Cassol
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brasil
| | | | - Claudia Eckley
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Brasil
| | | | | | | | - Bruno Guimarães
- Clínica Bruno Guimarães Serviços de Fonoaudiologia e Fisioterapia, Brasil
| | | | - Leonardo Lopes
- Centro de Estudos da Voz, Brasil; Universidade Federal da Paraíba, Brasil
| | | | - Felipe Moreti
- Centro de Estudos da Voz, Brasil; Centro Universitário da Faculdade de Medicina do ABC, Brasil; Complexo Hospitalar Municipal de São Bernardo do Campo, Brasil
| | | | | | | | - Marina Padovani
- Centro de Estudos da Voz, Brasil; Faculdade de Ciências Médicas da Santa Casa de São Paulo, Brasil
| | | | | | | | - Rosiane Yamasaki
- Centro de Estudos da Voz, Brasil; Universidade Federal de São Paulo, Brasil
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Dornelas R, Silva KD, Pellicani AD. Proposal of the vocal attendance protocol and vocal redesignation program in the services of the transsexualizing process. Codas 2021; 33:e20190188. [PMID: 33886744 DOI: 10.1590/2317-1782/20202019188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 03/08/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To present the Trans Ambulatory Vocal Protocol (AVP-trans) and the Vocal Redesignation Program (VRP-trans). METHODS The protocol consists of the following steps: 1) user routing; 2) speech therapy evaluation, application of self-perception protocols, referral for otorhinolaryngological evaluation and definition of conduct: individualized therapy (sound source) or VRP-trans for vocal filter; 3) VRP-trans, containing 12 vocal parameters to be worked monthly individually and in a group with the users; 4) After the end of the VRP-trans, the user is referred for vocal re-evaluation and otorhinolaryngological re-evaluation, in which it will be observed if the objective of the vocal redesignation was reached. RESULTS VRP-trans is a program that aims at developing a vocal filter work for the transgender population, flexible and that contemplates the complaints of this population, in which it presents difficulties to access the health service. CONCLUSION AVP-trans and VRP-trans are tools that can subsidize the speech therapy for transgender people in Brazil, outlining mechanisms that allow greater confidence for transgenders in search of social passiveness through voice, minimizing transphobia, establishing comfort and social acceptance.
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Affiliation(s)
- Rodrigo Dornelas
- Faculdade de Medicina, Universidade Federal de Rio de Janeiro - UFRJ - Rio de Janeiro (RJ), Brasil
| | - Kelly da Silva
- Departamento de Fonoaudiologia, Universidade Federal de Sergipe - UFS - Lagarto (SE), Brasil
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Adherence of Patients With Dysphonia to Voice Therapy: Systematic Review. J Voice 2020; 34:808.e15-808.e23. [DOI: 10.1016/j.jvoice.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/20/2022]
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10
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Stages of Readiness in Patients With Dysphonia: A Proposal Based on Factor Analysis Using the URICA-V Scale. J Voice 2020; 34:547-558. [DOI: 10.1016/j.jvoice.2018.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 11/20/2022]
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Behlau M. The 2016 G. Paul Moore Lecture: Lessons in Voice Rehabilitation: Journal of Voice and Clinical Practice. J Voice 2019; 33:669-681. [PMID: 29567050 DOI: 10.1016/j.jvoice.2018.02.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/22/2018] [Indexed: 12/19/2022]
Abstract
This Paul Moore Lecture honors the contributions made by authors to the Journal of Voice during a period of 30 years, from 1987. Fifty articles were selected and included under the following five topics: (1) normalcy of the larynx and voice; (2) the clinical speech-language pathologist's evaluation; (3) the patient's perspective; (4) the core of vocal rehabilitation; and (5) behavioral versus organic dysphonias. The analysis reflects a vivid landscape of the specific area and significant advances in knowledge. It also shows the valuable interdependence between science and clinical practice. The topics highlight the following information: (1) The physical appearance of a healthy larynx varies across individuals with normal voices. (2) The voice is not a binary descriptor (normal versus abnormal) but a variable measure, with many cultural influences on the perceptual auditory analysis of a voice. (3) The clinical speech-language pathologist assessment is multidimensional and multiparametric, with both subjective and objective analyses. The patients' opinion about the impact of a voice problem on his or her quality of life is significant when proposing a treatment. Therefore, it is also included in the initial assessment. (4) Vocal rehabilitation is a nonlinear process that combines direct and indirect approaches. Evidence of the positive effect of voice therapy is now well established. (5) Behavioral dysphonias may be linked to self-regulation of the use of voice and this needs to be taken into consideration. Although organic dysphonias are not necessarily the result of harmful vocal behaviors, they too can benefit from vocal rehabilitation.
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Affiliation(s)
- Mara Behlau
- "Centro de Estudos da Voz" - CEV, São Paulo, Brazil; "Universidade Federal de São Paulo-UNIFESP", São Paulo, Brazil.
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12
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Zencke da Silva K, Bello JZ, Cassol M. Motivational Stage Analysis of Patients with Behavioral Dysphonia. Folia Phoniatr Logop 2019; 72:267-272. [PMID: 31189167 DOI: 10.1159/000500403] [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: 08/14/2018] [Accepted: 04/12/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the applicability of the University of Rhode Island Change Assessment (URICA)-VOICE scale before and after a therapeutic program for functional balance in voice production. PATIENTS AND METHODS The sample comprised 26 adult participants (18 female) from the -Brazilian Public Healthcare System. The URICA-VOICE scale was applied prior to the intervention and after 10 sessions of a therapeutic program. RESULTS The motivational stage values were significantly increased after the intervention compared with the first application of the scale. Precontemplation and action were the stages most commonly reported by the participants. Significant differences were found in 6 statements of the URICA-VOICE scale after voice therapy. CONCLUSIONS The motivational stage of the participants improved after voice therapy. Being motivated is important for adherence to behavioral changes regarding the voice, and this study shows that using the URICA-VOICE scale in clinical practice is essential to measure patient performance in the voice therapy process, as well as to determine the ideal moment of discharge.
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Affiliation(s)
| | | | - Mauriceia Cassol
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Measurement properties of self-report questionnaires on health-related quality of life and functional health status in dysphonia: a systematic review using the COSMIN taxonomy. Qual Life Res 2018; 28:283-296. [DOI: 10.1007/s11136-018-2001-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/14/2022]
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14
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Costa BOID, Silva POC, Pinheiro RSDA, Silva HFD, Almeida AAFD. Estágio de prontidão de pacientes com disfonia comportamental pré e pós-terapia de voz de grupo. Codas 2017; 29:e20160198. [DOI: 10.1590/2317-1782/20172016198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/02/2017] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Verificar a efetividade da terapia de grupo no estágio de prontidão de pacientes com disfonia comportamental, bem como identificar que itens da Escala URICA-Voz são mais sensíveis a mudanças pós-terapia de grupo em pacientes com disfonia comportamental. Método Trata-se de um estudo de intervenção realizado com 49 pacientes com disfonia comportamental. A terapia de grupo ocorreu em oito sessões, sendo a primeira e a última de avaliação e as outras seis terapêuticas, com abordagem eclética. A escala URICA-Voz foi utilizada para avaliar o estágio de prontidão em que o paciente se encontra nos momentos pré e pós-terapia de grupo para voz. Foi realizada uma análise estatística descritiva e inferencial para a análise dos resultados. Resultados A maioria dos pacientes que participaram deste estudo era do gênero feminino, não faziam uso profissional da voz e tinham lesão membranosa da prega vocal. A maior parte estava no estágio de Contemplação tanto no momento pré quanto pós-terapia. Houve mudança significativa na comparação do pré e pós-terapia, a maioria dos pacientes apresentou redução no estágio de prontidão e poucos avançaram para um estágio maior. Na comparação dos itens da Escala URICA-V, sete questões apresentaram respostas iguais ou inferiores no momento pós-terapia. Conclusão Não houve diferença estatística ao se comparar as médias do escore total URICA-V no pré e pós-terapia de grupo. Houve mudanças significativas dos estágios de prontidão dos pacientes nos momentos pré e pós-terapia fonoaudiológica de grupo. Sete itens da URICA-V tiveram número igual ou menor no momento pós-intervenção entre os pacientes avaliados.
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Francis DO, Daniero JJ, Hovis KL, Sathe N, Jacobson B, Penson DF, Feurer ID, McPheeters ML. Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:62-88. [PMID: 28030869 PMCID: PMC5533561 DOI: 10.1044/2016_jslhr-s-16-0022] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/28/2016] [Accepted: 07/20/2016] [Indexed: 05/24/2023]
Abstract
PURPOSE The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties. METHOD MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument databases were searched using relevant vocabulary terms and key terms related to PRO measures and voice. Inclusion and exclusion criteria were developed in consultation with an expert panel. Three independent investigators assessed study methodology using criteria developed a priori. Measurement properties were examined and entered into evidence tables. RESULTS A total of 3,744 studies assessing voice-related constructs were identified. This list was narrowed to 32 PRO measures on the basis of predetermined inclusion and exclusion criteria. Questionnaire measurement properties varied widely. Important thematic deficiencies were apparent: (a) lack of patient involvement in the item development process, (b) lack of robust construct validity, and (c) lack of clear interpretability and scaling. CONCLUSIONS PRO measures are a principal means of evaluating treatment effectiveness in voice-related conditions. Despite their prominence, available PRO measures have disparate methodological rigor. Care must be taken to understand the psychometric and measurement properties and the applicability of PRO measures before advocating for their use in clinical or research applications.
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Affiliation(s)
- David O. Francis
- Vanderbilt Voice Center, Department of Otolaryngology, Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN
- Center for Surgical Quality and Outcomes Research, Nashville, TN
- Vanderbilt Evidence-Based Practice Center, Nashville, TN
| | - James J. Daniero
- Center for Voice and Swallowing, University of Virginia, Charlottesville
| | | | - Nila Sathe
- Vanderbilt Evidence-Based Practice Center, Nashville, TN
- Vanderbilt University Medical Center, Nashville, TN
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Barbara Jacobson
- Department of Hearing and Speech Sciences, Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN
| | - David F. Penson
- Center for Surgical Quality and Outcomes Research, Nashville, TN
- Vanderbilt Evidence-Based Practice Center, Nashville, TN
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
- Departments of Urology and Medicine, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research and Education Coordination Center, Veteran's Administration Tennessee Valley Health System, Geriatric Research and Education Coordination Center, Nashville, TN
| | - Irene D. Feurer
- Center for Surgical Quality and Outcomes Research, Nashville, TN
- Departments of Surgery and Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa L. McPheeters
- Vanderbilt Evidence-Based Practice Center, Nashville, TN
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
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Góes TRVD, Ferracciu CCS, Silva DROD. Associação entre a adesão da terapia vocal e perfil de atividades vocais em pacientes disfônicos comportamentais. Codas 2016; 28:595-601. [DOI: 10.1590/2317-1782/20162015232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/30/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar a associação entre a adesão da terapia vocal, perfil de atividades vocais em pacientes disfônicos comportamentais e seus possíveis fatores associados. Método Participaram da amostra dezoito indivíduos com disfonia comportamental que estavam em tratamento regular no Serviço de Fonoaudiologia da instituição. Os participantes do estudo responderam ao protocolo Perfil de Participação e Atividades Vocais (PPAV) e à escala URICA-VOZ. As variáveis associadas (número de sessões, faixa etária, tipo de disfonia comportamental, gênero e tratamento fonoaudiológico anterior) foram coletadas por meio de entrevista com o paciente e análise dos seus respectivos prontuários. Os dados foram submetidos à análise estatística inferencial. Resultados A maioria dos pacientes encontrava-se no estágio de ação. Houve associação estatisticamente significante entre o aspecto Efeitos na Emoção do PPAV e os estágios de prontidão para a adesão da terapia vocal, porém os outros aspectos do PPAV não se associaram com a escala URICA-VOZ. Das variáveis associadas, o número de sessões, faixa etária e tipo de disfonia comportamental apresentaram associação com a adesão da terapia de voz. Constatou-se diferença estatisticamente significante entre o tipo de disfonia comportamental e os escores do PPAV. Conclusão O aspecto Efeitos na Emoção do PPAV e as variáveis número de sessões, faixa etária e tipo de disfonia mostraram-se associadas ao estágio de adesão da escala URICA-VOZ. Os indivíduos com disfonia organofuncional apresentaram maior impacto da alteração vocal em suas atividades diárias.
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Lopes LW, Vilela EG. Autoavaliação e prontidão para mudança em pacientes disfônicos. Codas 2016; 0:0. [DOI: 10.1590/2317-1782/20162015111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar se existe associação entre a autoavaliação vocal e a prontidão para mudança em pacientes disfônicos. Método Participaram 151 pacientes com queixa vocal e diagnóstico de disfonia, entre 18 e 65 anos de idade, 47 homens e 104 mulheres, atendidos no ambulatório de voz de uma instituição pública. Foram aplicados quatro instrumentos de autoavaliação, incluindo o Questionário de Qualidade de Vida em Voz (QVV), o Índice de Desvantagem Vocal (IDV) e a Escala de Sintomas Vocais (ESV), além da utilização do instrumento URICA-VOZ, para verificação do estágio de prontidão para mudança dos pacientes. Todos os instrumentos foram aplicados imediatamente antes do início da terapia vocal. As variáveis foram correlacionadas e comparadas por meio de estatística inferencial. Resultados A maioria dos pacientes encontrava-se no estágio de contemplação (76,2%, n = 115), 22 (14,6%), no estágio de pré-contemplação e 14 (9,3%), no estágio de ação. Houve correlação negativa entre o escore no URICA-VOZ e o domínio socioemocional e escore total do QVV. Ocorreu correlação positiva entre o escore do URICA-VOZ e os domínios total, emocional e funcional do IDV, assim como entre o escore do URICA-VOZ e os domínios total, de limitação e emocional da ESV. Apenas os valores do domínio socioemocional do QVV e emocional no ESV apresentaram diferenças estatisticamente significantes entre os estágios motivacionais. Conclusões Existe associação entre a autoavaliação vocal e a prontidão para mudança em pacientes disfônicos. Pacientes com maior impacto na qualidade de vida em voz no QVV e maior frequência de sintomas vocais referida na ESV apresentam maior prontidão para mudança.
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Moore J, Greenberg C, Thibeault SL. Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population. J Voice 2016; 31:41-47. [PMID: 26952321 DOI: 10.1016/j.jvoice.2016.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI). STUDY DESIGN Prospective, survey study. METHODS Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database with voice, concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. The VHI was sent to patients 6 months post clinic visit to determine change in voice handicap from baseline. General health was screened using the 12-item Short Form Health Survey, using physical component summary and mental component summary scores. Predictor variables included treatment (medical and/or behavioral); dysphonia sub-diagnosis; grade, roughness, breathiness, asthenia, and strain rating; age; sex; socioeconomic factors; smoking history; and comorbidity score. RESULTS Two hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned 6-month surveys. The VHI was significantly correlated with mental component summary scores. Patients with a higher grade in baseline grade, roughness, breathiness, asthenia, and strain score were more likely to receive voice intervention (P = 0.04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher educational level in both univariate (P < 0.01, P = 0.04) and multivariate analyses (P < 0.01, P = 0.02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI score. CONCLUSIONS Our results suggest that it is important to consider baseline self-perceived voice impact measures and educational level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted.
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Affiliation(s)
- Jaime Moore
- Department of Surgery and Communication Sciences and Disorders, 5107 Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave., Madison, Wisconsin 53705-2275
| | - Caprice Greenberg
- Department of Surgery and School of Medicine and Public Health, 7375 Clinical Science Center, K6/148, University of Wisconsin-Madison, 600 Highland Ave., Madison, Wisconsin 53792
| | - Susan L Thibeault
- Department of Surgery, 5107 Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave., Madison, Wisconsin 53705-2275..
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Kopf LM, Graetzer S, Huh J. Videos Influence Behavior Change Measures for Voice and Speech in Individuals with Parkinson's Disease. PROCEEDINGS WIRELESS HEALTH ... [ELECTRONIC RESOURCE]. WIRELESS HEALTH (CONFERENCE) 2015; 2015. [PMID: 26949753 DOI: 10.1145/2811780.2811932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The majority of individuals with Parkinson's disease (PD) experience voice and speech difficulties at some point over the course of the disease. Voice therapy has been found to help improve voice and speech in individuals with PD, but the majority of these individuals do not enroll in voice therapy. The purpose of this study was to determine whether watching short videos about voice symptoms and treatment in Parkinson's disease influences readiness to change, stages of change, and self-efficacy in individuals with PD. Eight individuals with PD participated in the study. Fifteen videos were chosen, three representing each of the five stages of change. We chose videos from YouTube that represented variety in speakers, content, and genre. We found that readiness to change significantly increased after watching videos, suggesting that watching videos helped these individuals move closer to actively improving their voice and speech. In addition, five of the eight participants showed forward movement in stages of change. Finally, self-efficacy demonstrated a positive trend following video watching. Overall, our results demonstrate that watching videos available on the internet can influence individuals with Parkinson's disease in changing vocal behavior. Implications for future wireless health applications are described.
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Affiliation(s)
- Lisa M Kopf
- Michigan State University, Communicative Sciences and Disorders, East Lansing, MI 48824
| | - Simone Graetzer
- Michigan State University, Communicative Sciences and Disorders, East Lansing, MI 48824
| | - Jina Huh
- University of California, San Diego, Biomedical Informatics, San Diego, CA
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Behlau M, Pontes P, Vieira VP, Yamasaki R, Madazio G. Presentation of the Comprehensive Vocal Rehabilitation Program for the treatment of behavioral dysphonia. Codas 2013; 25:492-6. [DOI: 10.1590/s2317-17822013000500015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 09/18/2013] [Indexed: 11/22/2022] Open
Abstract
Voice rehabilitation is the main treatment option in cases of behavioral dysphonia, and it has the purpose of enhancing the quality of vocal production and voice-related life aspects. Several efforts have been made to offer a clinical practice that is based on evidence, including the development of specific therapeutic protocols as an option for clinical and scientific improvement. It is necessary to define the focus/objective of the dysphonia treatment, type of approach, and duration in order to establish the intervention criteria. This paper describes the organization of a program of behavioral dysphonia treatment, based on an approach that has been used for over twenty years, named Comprehensive Vocal Rehabilitation Program, and also to present its concepts, theory, and practical fundamentals. The program has an eclectic approach and associates body work, glottal source, resonance, and breathing coordination in addition to knowledge about vocal hygiene and communicative behavior. The initial proposal suggests a minimum time of intervention of six therapeutic sessions that can be adapted according to the patient' s learning curve and development. The goal is to offer a rational and structured therapeutic approach that can be reproduced in other scenarios.
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Affiliation(s)
- Mara Behlau
- Centro de Estudos da Voz, Brazil; Universidade Federal de Sao Paulo, Brazil
| | - Paulo Pontes
- Universidade Federal de Sao Paulo, Brazil; Instituto da Laringe, Brazil
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