Using Ambulatory Voice Monitoring to Investigate Common Voice Disorders: Research Update

Mehta, Daryush D.; Stan, Jarrad H. Van; Zañartu, Matías; Ghassemi, Marzyeh; Guttag, John V.; Espinoza, Víctor M.; Cortés, Juan Pablo Martínez; Cheyne, Harold A.; Hillman, Robert E.

doi:10.3389/fbioe.2015.00155

Cited by 111 publications

(100 citation statements)

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“…In the literature there is a record of the development of vocal alteration due to occupational use, relating it to the recurrent excessive use of voice 2 . As teachers use it intensely they are predisposed to cause a process of excessive friction by the repetitive movement of the vocal folds, generating a phonotrauma that can lead to lesions in the tissues that make the composition of the anatomical structure [4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Efeitos do exercício do trato vocal semiocluído em canudo comercial na voz do professor

2017

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RESUMO Objetivo: verificar os efeitos do exercício de fonação em canudo comercial na voz de professores. Métodos: estudo de intervenção, com grupo único de professores, cego ao avaliador. Os participantes foram solicitados a executar o exercício de fonação em canudo imerso a uma garrafa com água no início do turno de trabalho, por quatro semanas consecutivas. Utilizou-se o parâmetro “grau global de severidade” do protocolo Consenso da avaliação perceptivoauditiva da voz (CAPE-V) para a avaliação perceptivoauditiva, o protocolo de autoavaliação índice de triagem de distúrbios de voz (ITDV) e os efeitos vocais autorreferidos na comparação entre os momentos pré e pós-intervenção. Resultados: a média de idade dos professores foi de 45,28 (± 8,48) anos, variando entre 30 e 58 anos, sendo composta, na sua maioria, pelo sexo feminino (79,3%). A frequência de alteração vocal autorreferida foi 58,6%. Houve decréscimo na média dos escores do CAPE-V e do ITDV na comparação antes e após a intervenção com significância estatística (p<0,05). Na pós-intervenção os efeitos autorreferidos ocorridos mais frequentes foram “melhora na voz”, “menor cansaço” (ambos com 37,9%). Conclusão: o exercício com canudo comercial promoveu melhora na voz dos professores e efeitos benéficos autorreferidos e pode ser utilizado como medida protetora.

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Section: Introductionmentioning

confidence: 99%

Efeitos do exercício do trato vocal semiocluído em canudo comercial na voz do professor

2017

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“…In a retrospective matched case-control study, 116 adult women aged between 18 and 64 years were drawn from a larger project studying ambulatory voice monitoring 36 Subjects with voice disorders had a mean age of 27.8 years (18-64 years, SD 12.1 years), and the matched-control subjects with normal voices had a mean age of 27.8 years (18-61 years, SD 11.8 years). As determined by a linear mixed model (LMM) analysis, there was no statistical difference in age distribution between the two groups (p>0.05).…”

Section: Subject Sample and Inclusion Criteriamentioning

confidence: 99%

Acoustic Perturbation Measures Improve with Increasing Vocal Intensity in Individuals With and Without Voice Disorders

2018

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OBJECTIVE: In vocally healthy children and adults, speaking voice loudness differences can significantly confound acoustic perturbation measurements. This study examines the effects of voice sound pressure level (SPL) on jitter, shimmer, and harmonics-to-noise ratio (HNR) in adults with voice disorders and a control group with normal vocal status. STUDY DESIGN: This is a matched case-control study. METHODS: We assessed 58 adult female voice patients matched according to approximate age and occupation with 58 vocally healthy women. Diagnoses included vocal fold nodules (n = 39, 67.2%), polyps (n = 5, 8.6%), and muscle tension dysphonia (n = 14, 24.1%). All participants sustained the vowel /a/ at soft, comfortable, and loud phonation levels. Acoustic voice SPL, jitter, shimmer, and HNR were computed using Praat. The effects of loudness condition, voice SPL, pathology, differential diagnosis, age, and professional voice use level on acoustic perturbation measures were assessed using linear mixed models and Wilcoxon signed rank tests. RESULTS: In both patient and normative control groups, increasing voice SPL correlated significantly (P < 0.001) with decreased jitter and shimmer, and increased HNR. Voice pathology and differential diagnosis were not linked to systematically higher jitter and shimmer. HNR levels, however, were statistically higher in the patient group than in the control group at comfortable phonation levels. Professional voice use level had a significant effect (P < 0.05) on jitter, shimmer, and HNR. CONCLUSIONS: The clinical value of acoustic jitter, shimmer, and HNR may be limited if speaking voice SPL and professional voice use level effects are not controlled for. Future studies are warranted to investigate whether perturbation measures are useful clinical outcome metrics when controlling for these effects. Study Design: Matched case-control study Methods: 58 adult female voice patients, matched according to approximate age and occupation with 58 vocally healthy women, were assessed. Diagnoses included vocal fold nodules (n:39, 67.2%), polyps (n:5, 8.6%), and muscle tension dysphonia (MTD; n:14, 24.1%). All participants sustained the vowel /a/ at soft, comfortable, and loud phonation levels. Acoustic voice SPL, jitter, shimmer, and HNR were computed using Praat. The effects of loudness condition, voice SPL, pathology, differential diagnosis, age, and professional voice use level on acoustic perturbation measures were assessed using linear mixed models and Wilcoxon signed-rank tests.Results: In both patient and normative control groups, increasing voice SPL correlated significantly (p<0.001) with decreased jitter and shimmer, and increased HNR. Voice pathology and differential diagnosis were not linked to systematically higher jitter and shimmer. HNR levels, however, were statistically higher in the patient versus control group at comfortable phonation levels. Professional voice use level had a significant effect (p<0.05) on jitter, shimmer, and HNR.Conclusions: The clinical value of ac...

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“…Careful consideration of all these factors needs to be taken to prevent voice problems in occupational voice users such as teachers. Continuous monitoring of voice during teaching time can be performed using ambulatory phonation monitors (APM) as described by Mehta et al ; the authors conclude that wearable voice monitoring systems have potential to provide more reliable and objective measures of voice that can be used in diagnosis and treatment strategies. APMs, as described by Nacci et al, can be used to assess the phonation time, phonation density, sound pressure level, fundamental frequency and vocal load, making APM a very useful tool in assessment of voice in professional voice users.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Voice burden in teachers and non‐teachers in a UK population: A questionnaire‐based survey

Gadepalli

Fullwood

Ascott

et al. 2019

Clinical Otolaryngology

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Objective To characterise the burden of voice disorders in teachers in a UK population, compare it with non‐teachers and identify groups of teachers who may be particularly at risk of developing a voice problem. Design Questionnaire‐based survey of primary and secondary school teachers and non‐teachers. Questions consisted of general demographics, VHI‐10 and questions relating to voice problems. Methods Distribution of questionnaires to teachers and non‐teachers and statistical analysis of the responses. Setting University teaching hospital. Participants Teachers and non‐teachers in a region of North West England. Main outcome measures Identification of risk factors for voice problems in teachers, compared to non‐teachers. Results A total of 210 primary and 244 secondary school teachers and 304 non‐teachers participated in the questionnaire survey. Response rates were 67.9% from primary schools, 41.2% from secondary schools and 40.0% from the non‐teachers. 30.0% of teachers and 9.0% of non‐teachers had reported problems with their voice. 12.8% of teachers and 2.0% of non‐teachers had missed work due to voice problems. 14.1% of teachers and 5.3% non‐teachers had seen a general practitioner for voice‐related problems, whilst 7.1% of teachers and 6.3% of non‐teachers had been referred to an otolaryngologist or speech therapist for voice problems. Factors related to VHI‐10 (P < .05) were identified. Conclusions Voice disorders are an occupational health problem for teachers, with a significant burden of these disorders in this group of teachers in the UK. We have identified risk factors that could be exploited to identify groups of teachers who would benefit from early intervention.

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Using Ambulatory Voice Monitoring to Investigate Common Voice Disorders: Research Update

Cited by 111 publications

References 46 publications

Efeitos do exercício do trato vocal semiocluído em canudo comercial na voz do professor

Efeitos do exercício do trato vocal semiocluído em canudo comercial na voz do professor

Acoustic Perturbation Measures Improve with Increasing Vocal Intensity in Individuals With and Without Voice Disorders

Voice burden in teachers and non‐teachers in a UK population: A questionnaire‐based survey

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