ABSTRACT
The objective of the study was to measure the subjective long-term effects of vocal therapy (more than 6 months) in 29 patients suffering from dysfunctional dysphonia. Four subjective measurements were used: one visual analog scale ranging from 0 (not efficient at all) to 100 (very efficient); one question "Is the speech therapy still efficient?," answered by yes or no; the GRB parameters of the GRBAS scale (evaluated by the patient); and the VHI-10. The results show that 76% of the patients consider that the vocal therapy they received is still efficient. On the vocal quality (G), roughness (R), and breathiness (B) parameters, we observe a high degree of satisfaction on the G parameter (median=77). The scores on the R and B parameters are lower (median R=12, S=5). Roughness is significantly correlated to the Grade (Spearman coefficient r=0.516, P=0.004), whereas breathiness is not (P=0.251, NS). The comparison of the results on the VHI-10 pre and post treatment shows a significant decrease in the grade of perceived handicap (medians 15 vs 11, P=0.017). The correlations between the judgment of the treatment's efficacy and the vocal quality is significant (r=0.623, P<0.001) as well as the correlation between the VHI-10 and the length of the treatment (r=0.416, P=0.035). The conclusion can be made that speech therapy plays an important role in long-term treatment of dysfunctional dysphonias.
Subject(s)
Dysphonia/therapy , Patient Satisfaction , Speech Therapy/methods , Adult , Female , Humans , Judgment , Male , Middle Aged , Severity of Illness Index , Surveys and Questionnaires , Time Factors , Treatment Outcome , Voice Quality , Young AdultABSTRACT
OBJECTIVE: The present study is the outcome of 5 former studies aiming at adapting the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singers, dysodic or not. MATERIAL AND METHODS: The reliability, validity and internal coherence were evaluated on a population of 192 classical singers and 27 non singers. RESULTS: The comparison of the mean scores at the test and the retest shows that the results at the retest are significantly inferior in both the functional scale (p= 0.013) and the global score (p= 0.006). The test/re-test stability is good (ICC: Functional scale (F): 0.869, Emotional scale (E): 0.846, Physical scale (P): 0.85, Global score (G): 0.878/ Spearman's rho F: 0.855, E: 0.834, P: 0.858, G: 0.886). The internal coherence of each sub scale is good (Cronbach's alpha: > 0.80). The correlation between the 3 subscales is quite high (FvsE: 0,613 /EvsP: 0,737/ FvsP: 0,693) which means that each scale measures a specific dimension but that they are still homogeneous. The test/re-test difference between the singers and the controls are not significant but the control group has a greater variability in their answers (Levene test: F: p<0.001; P: p= 0.009; G: p= 0.02). Three variables increase the results: being a solist (F: p= 0.046; E: p= 0.002; P: p= 0.056; G: p= 0.006), being an amateur (F: p< 0.001; E: p= 0.019; P: p< 0.001; G: p= 0.001), having a vocal complaint (F, E, P et G: p< 0.001). CONCLUSION: This version of the V.H.I. is reliable, valid and adapted to the population of classical singers.
Subject(s)
Disability Evaluation , Music , Voice Disorders/diagnosis , Voice Quality , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Reproducibility of Results , Severity of Illness Index , Voice Disorders/etiology , Voice TrainingABSTRACT
OBJECTIVES: The voice handicap index by Jacobson et al doesn't render the difficulties experienced by singers. The aim of this study is to adapt the V.H.I. to the singing voice and evaluate it's reliability and coherence. In order to obtain this first scale, we went through three stages. MATERIAL ET METHOD: The first consisted in the modification of the existing items and the creation of new ones. The second was to measure the stability by a test - retest and the coherence of the adapted and the new items. This was done on groups of dysodic singers and professional voice users. The third stage consisted in evaluating the reliability and the coherence of 31 items on a homogeneous population of 132 classical singers with and without vocal impairment. The subjects were divided in three groups. The first group was composed of 95 normophonic singers, the second included 37 dysphonic singers and the third group was the control group, composed of 20 non singers without vocal complaints. RESULTS: The statistical results show a good stability of the test - retest (ICC=0.949; Rho: 0.912; Bland et Altman [-010.19, +13.23]). The internal coherence of each sub scale (Cronbach's alpha) is good (>0.70). The correlations between the three sub scales are moderate between the functional and the emotional sub scale: 0.58; between the emotional and the physical: 0.64; and between the functional and the physical: 0.78). Each sub scale is measuring a specific dimension; still they are homogeneous between one another. Four variables have a significative influence on the results: the pathology (p<0.001), being a professional singer (p<0.001), the repetition (p=0.003), being a chorister (p=0.002). CONCLUSION: The VH.I adapted to the singers, appears to be reliable, valid and adapted to the population of dysodic classical singers.
