Vocal Fatigue Experiences and Mitigation Strategies in the Sacred Harp Singing Community.

OBJECTIVES: Sacred Harp singers sing at a high volume for sustained periods of time without collective warm-up or cool-down exercises, ostensibly putting them at elevated risk for vocal fatigue (VF) and associated vocal pathologies. Participants are also likely to lack formal vocal training. The purpose of this study was to (1) assess singers' experiences with VF, (2) document singers' strategies for mitigating VF, and (3) determine whether vocal training was associated with decreased vocal difficulties. STUDY DESIGN: Self-reporting via online questionnaire containing quantitative and qualitative items. METHODS: This study employed an online questionnaire that combined demographic items, open-ended questions, and the Evaluation of the Ability to Sing Easily (EASE). Participants were recruited at one in-person event and via social media and a mailing list. RESULTS: This study returned 134 valid responses. Singers with formal choral experience scored lower on the EASE and two subscales, but length of experience had no impact. There were no correlations between vocal training and EASE scores. Women scored higher on the EASE than men and nonbinary individuals, while age, length of experience with Sacred Harp singing, and frequency of attendance at annual singing events were all negatively correlated with EASE score. Singers reported a wide range of mitigation strategies, most of which are unique to the Sacred Harp context. CONCLUSIONS: Sacred Harp singers do not appear to struggle more with VF than other populations of singers. However, a few characteristics of their practice put them at risk, and many singers would benefit from professional guidance concerning vocal health.

Effectiveness of Vocal Training Techniques in School-Aged Drama Students.

OBJECTIVES: The purpose of this study was to determine whether vocal hygiene education and direct vocal training would impact student self-reported preparedness for using voice for performance. STUDY DESIGN: A single-group, pretest-posttest research design was used. METHODS: Twenty-three drama students in middle and high school participated in a 1-hour vocal training workshop, which included vocal hygiene education and vocal training for performance. Changes in student self-reported preparedness for using voice for performance were examined following participation in the workshop. Data analysis involved comparison of pretest and posttest responses to a novel questionnaire. RESULTS: Participants demonstrated a statistically significant increase in self-reported preparedness for using voice for performance following participation (P < .001, d = 2.40), as measured by mean increase in survey scores. Additionally, significant group differences were found by grade level and report of prior vocal training. CONCLUSIONS: School-aged drama students appear receptive to direct vocal training and vocal hygiene education, with significant gains in self-reported preparedness for using voice for performance observed following intervention.

Long-term musical training induces white matter plasticity in emotion and language networks.

Numerous studies have reported that long-term musical training can affect brain functionality and induce structural alterations in the brain. Singing is a form of vocal musical expression with an unparalleled capacity for communicating emotion; however, there has been relatively little research on neuroplasticity at the network level in vocalists (i.e., noninstrumental musicians). Our objective in this study was to elucidate changes in the neural network architecture following long-term training in the musical arts. We employed a framework based on graph theory to depict the connectivity and efficiency of structural networks in the brain, based on diffusion-weighted images obtained from 35 vocalists, 27 pianists, and 33 nonmusicians. Our results revealed that musical training (both voice and piano) could enhance connectivity among emotion-related regions of the brain, such as the amygdala. We also discovered that voice training reshaped the architecture of experience-dependent networks, such as those involved in vocal motor control, sensory feedback, and language processing. It appears that vocal-related changes in areas such as the insula, paracentral lobule, supramarginal gyrus, and putamen are associated with functional segregation, multisensory integration, and enhanced network interconnectivity. These results suggest that long-term musical training can strengthen or prune white matter connectivity networks in an experience-dependent manner.

Using mobile applications in the study of vocal skills.

This article reflects the results of a study involving second- and fourth-year students from Harbin University (Harbin, China), the Chinese Academy of Arts (Hangzhou, China), and the Central Academy of Drama (Beijing, China). The work analyzed the impact of specialized mobile applications Vox Tools: Learn to Sing and Swiftscales Vocal Trainer on the vocal learning process, depending on the age and gender of students. The study, which ran from February to June during the academic year 2020-2021, involved 180 students. The study confirms the effectiveness of multimedia, demonstrating the higher scores of the experimental groups on the five assessment criteria, compared with the control groups, which did not use mobile applications. It was also found that age in two groups of students (second and fourth year) had no effect on performance, regardless of whether the mobile app was used for vocal training. A correlation was found between age and overall student performance, with second-year students showing lower grades in all groups compared to their fourth-year counterparts. Research on current mobile vocal training apps can help improve vocal learning.

Recognition of the Effect of Vocal Exercises by Fuzzy Triangular Naive Bayes, a Machine Learning Classifier: A Preliminary Analysis.

OBJECTIVES: Machine learning (ML) methods allow the development of expert systems for pattern recognition and predictive analysis of intervention outcomes. It has been used in Voice Sciences, mainly to discriminate between healthy and dysphonic voices. Parameter patterns of vocal acoustic analysis and vocal perceptual assessment can be evaluated by ML classifiers, such as the Fuzzy Triangular Naive Bayes (FTriangNB), after using techniques that improve the vocal quality of individuals with healthy or dysphonic voices. Thus, the goal of this study was to analyze the performance of the FTriangNB to detect patterns in the acoustic parameters and the auditory-perceptual assessment of 12 women with dysphonia and 12 vocally healthy women, after performing three vocal exercises (tongue trills, semi-occluded vocal tract exercise with a high-resistance straw - SOVTE, and over-articulation). METHODS: The FTriangNB classifier contained in the Fuzzy Class package was implemented in the data analysis software R Studio version 1.4.1106 for Macintosh. The confusion matrix was extracted, as well as the accuracy, the Kappa coefficient, and the class statistics. The final result was compared with those generated by FTriangNB with the same variables from the preapplication database of the exercises. RESULTS: The FTriangNB presented good accuracy (87.5%) and Kappa coefficient (81.3%), and showed almost perfect agreement after application of the exercises, while the results before the application of the exercises demonstrated accuracy without acceptable discrimination capacity (33.3%) and Kappa coefficient with a poor agreement (-6.67%). The Semioccluded Vocal Tract Exercises (SOVTE) with high strength straw presented with a sensitivity and Negative Predictive Value (NPV) of value 1 (one), and the over-articulation's specificity and Positive Predictive Value (PPV) also showed a value of 1 (one). CONCLUSIONS: The FTriangNB showed great accuracy in recognizing the effect of vocal exercises. Exploratory studies with larger samples using FTriangNB, as well as other Machine Learning classifiers should be further carried out for this purpose in the Voice Science to enable inferences.

The Effect of Vocal Training on Vocal Quality in Chinese Singing Students.

OBJECTIVE: The purpose of this study was to investigate the effect of vocal training on singing voice in Chinese folk song major students. A longitudinal study over a two years' period (four consecutive semesters) was conducted to observe the effects. METHOD: Ten college students majoring in Chinese folk music (seven females and three males; age range: 19-21 years) were recorded three times while singing, at the beginning of the first, third, and fifth semesters. Acoustical parameters including maximum phonational frequency range (MPFR), sound pressure level (SPL), intonation accuracy and long-term average spectrum (LTAS) were measured to evaluate the effects. RESULTS & CONCLUSIONS: Results indicated that vocal training had a significant effect on MPFR, and SPL increased as vocal training progressed. A slight improvement in intonation accuracy was observed during training period, and LTAS changes as a function of training were detected in some subjects. This longitudinal study indicates that the effect of vocal training on vocal quality improvement can be observed in Chinese singing students and evaluated by measuring certain acoustic parameters.

Can Vocal Therapy With Transcutaneous Electrical Nerve Stimulation (TENS) Followed by Vocal Exercises Reduce Benign Laryngeal Lesions in Dysphonic Women?: Randomized, Blind Clinical Trial.

PURPOSE: To investigate the effectiveness of vocal therapy with the use of low-frequency transcutaneous electrical nerve stimulation (TENS) followed by voice exercises on vocal fold lesion size, vocal quality and quality of life in dysphonic women. METHODS: 27 women with vocal nodules participated, randomized into to: experimental group (EG)-13 women who received vocal therapy with 12 sessions of 20 min of TENS application (pulse:200µs, frequency:10Hz, motor threshold intensity, electrodes positioned in the trapezius muscle [descending fibers and submandibular region, bilaterally]). Each TENS session was followed by 30 min of vocal exercises; and the Control Group (CG)- 14 women who received 12 sessions with 20 min of application of placebo TENS (same conditions EG, but without receiving the stimulus electric), followed by 30 min of vocal exercise. Before, immediately after and one month after vocal therapy, participants underwent vocal recording for acoustic analysis, vocal self-assessment, laryngological examination and answered voice-related quality of life (V-RQOL) protocol. RESULTS: There was reduction in the size of vocal fold lesions only in the EG, immediately after treatment and one month after treatment. Acoustic analysis showed decreases in SPI values immediately after and one month after treatment in both groups. There was improvement in voice self-perception in both groups after treatment and one month after, but no significant difference in V-RQOL values. CONCLUSION: TENS followed by vocal exercises produced results similar to vocal therapy without TENS regarding voice quality, self-perception and quality of life in voice. However, vocal therapy with low-frequency TENS followed by vocal exercise was effective in reducing vocal fold lesion size in dysphonic women.

Feasibility and Preliminary Efficacy of Two Technology-assisted Vocal Interventions for Older Adults Living in a Residential Facility.

OBJECTIVES/HYPOTHESIS: An increasing number of older adults are seeking behavioral voice therapy to manage their voice problems. Poor adherence to voice therapy is a known problem across all treatment-seeking populations. Given age-related physical and cognitive impairments and multiple chronic conditions, older adults are more susceptible to low adherence to behavioral therapies. The purpose of this study was to test the feasibility of an at-home, vocal training intervention for older adults without a known voice disorder living in a senior living community, as well as compare the effects of two modes of mobile health (mHealth) technology-assisted vocal training targeting vocal function and adherence in older adults. STUDY DESIGN: Cohort Study (Prospective Observational Study). METHODS: Twenty-three individuals were recruited from a single residential retirement community and randomly allocated into two experimental groups. Both groups were asked to practice the Vocal Function Exercises with increasing frequency over an 8-week period. Tablets with instructions for performing the exercises were provided to all participants. The feedback group's tablets also contained an application providing real-time feedback on pitch, loudness, and duration. Acoustic and aerodynamic measures of vocal function and cognitive measures were obtained before and after the intervention. Self-reported measures of practice frequency, perceived vocal progress and changes, and motivation were obtained weekly. RESULTS: The feedback control group adhered to the requested practice sessions more in the latter half of the intervention (weeks 5 and 8). Vocal function measures remained stable. Overall, a pattern reflecting self-reported vocal progress and a general improvement in working memory and global cognitive functioning was observed in the feedback group. CONCLUSIONS: This study demonstrated that an 8-week mHealth intervention is viable to facilitate vocal practice in older adults. Although vocal ability did not improve with training, results indicated that vocal performance remained stable and age-related vocal changes did not progress. Future research on implementation of mHealth applications in conjunction with behavioral voice therapy is warranted to assess adherence and improvements in vocal function in individuals with age-related voice problems.

Mapping of the Execution of Resonance Tubes Phonation Immersed in Water Exercise in Adults: A Scoping Review.

OBJECTIVE: To map the execution of resonance tubes phonation immersed in water exercise in adults with healthy or altered voices. METHODS: This study was a scoping review. An electronic search was performed using the following databases: MEDLINE, LILACS, SCOPUS, Web of Science, EMBASE, Cochrane Library, gray literature, and a manual search. A blinded review was performed by two authors to determine the selection and extraction procedures. Studies with adult participants with dysphonic or healthy voices who underwent intervention with phonation in a resonance tube immersed in water in the context of the vocal clinic, with an experimental intervention, quasi-experimental, or before and after the intervention were included. Data from the publication, sample, execution, and results obtained from the exercises were extracted by two blinded reviewers. Disagreements were resolved through consensus. The analysis was performed quantitatively. RESULTS: A total of 44 publications were analyzed. Among these, Brazilian studies were the most frequent, with a publication peak in 2020. The characterization of the sample was variable, with a higher frequency of participants of both sexes who were not voice professionals. The most frequent studies were before and after exercise with a resonance tube immersed in water, in one session, with an exercise execution time of 3 minutes; in cases of more than one series of executions, the 30-sseconds rest time was more frequent. The most used resonance tube was a flexible silicone tube, with a wall thickness of 0.1 mm, immersion container in a 500-, 510-, or 600-mL bottle, 2/3 filled with water, and the resonance tube immersed 2 cm from the water surface. The most used phonatory task was flow phonation with rounded lips similar to the articulation of the vowel /u/. Acoustic analysis and vocal self-assessment are the most commonly used outcome measures. The best results were obtained in the self-assessment. CONCLUSION: There is significant variability in the information on the execution of resonance tubes phonation immersed in water exercise influenced by vocal diagnosis and experience with previous vocal training. Studies on the effects of this exercise have been concentrated over the last decade and are of the vocal training and therapy. Acoustic and self-assessment measures were used to verify the results, with self-assessment being the outcome that most frequently indicated positive results.

Vocal Tract and Subglottal Impedance in High Performance Singing: A Case Study.

OBJECTIVES/HYPOTHESIS: The respiratory process is important in vocal training and in professional singing, the airflow is highly important. It is hypothesized that subglottal resonances are important to the singing voice in high performance singing. STUDY DESIGN: Single subject, prospective. METHOD: A professional soprano singer shaped her vocal tract to form the vowels [a], [e], [i], [o], and [u] at the pitch d4. We measured phonated vowels and the vocal tract impedance spectra with a deterministic noise supplied by an iPhone buzzer in the range of 200 to 4,000 Hz at closed glottis, during exhalation and during inhalation while maintaining the shape of the vocal tract. RESULTS: Measurements of the phonated vowels before and after the different glottal adjustments were highly reproducible. Vocal tract resonances and the ones resulting during respiration are reported. The impedance spectra show vowel dependent resonances with closed and open glottis. The formants of the vocal spectra are explained by including both, the vocal tract, and the subglottal resonances. CONCLUSION: The findings indicate that subglottal resonances influence the first formant as well as the singers's formant cluster in high-performance singing. The instrumental setup used for the impedance measurement allows a simple and lightweight procedure for a measurement of vocal tract and subglottal resonances.

Presentation and Evaluation of the Teacher's Vocal Health Guide.

OBJECTIVE: in order to contribute of the collective actions of the teacher's vocal health, the specific goal was to build a guide gathering the appliable didactic content in these actions. That being, the stages performed in the instrument elaboration of the denominated Teachers' Vocal Health Guide (TVHG) will be presented. MATERIAL AND METHODS: The elaboration process of the guide is composed of three stages: (1) parameter selection to compose the guide based on a literature review; (2) submission to a specialist examining board, with the calculation of the Content Validity Index (CVI) and the Kappa agreement coefficient; (3) content validation - the instrument was submitted to an analysis of a judges committee, and from the results the Cronbach Alfa coefficient and the CVI were calculated. RESULTS: The elaboration of the TVHG underwent three stages. In the first stage, called parameter selection, 20 didactic contents were found, consisting of 14 theoretical and six practices. In the second stage, an evaluation of the guide was performed by a specialist examining board and two contents were excluded since their CVI was below 8. The result of the Kappa Coefficient Calculation was 0.281. In the third stage, the TVHG underwent evaluation of a new group denominated judges committee, and the items were punctuated as very relevant and completely relevant. The result of the Cronbach Alfa coefficient for the instrument with 18 items was 0.721, and this value categorizes the instrument as valid. It is necessary to continue the process of instrument validation, possibly investigating the applicability of TVHG in the teachers' opinion. CONCLUSION: The current study presents the TVHG from the description of the three stages performed to elaborate a systematized instrument denominated TVHG, which suggests a gathering of didactic content that are appliable in collective actions of vocal health with this professional category.

Voice Performance Chart: A Pedagogical Tool to Enhance Vocal Expressive Ability in Acting Students.

The purpose of the present study was to explore the effectiveness of the Voice Performance Chart (VPCH) as a pedagogical training tool to enhance vocal expressive ability of 1st year acting students. Forty recorded audio samples were perceptually assessed by six blinded raters, using a five-points Likert scale for each of the dependent variables observed. Results showed that loudness, pitch, and speech rate variations significantly differ when comparing the vocal condition before and after a 11 weeks training period. That suggests that VPCH can be an effective pedagogical tool to develop vocal expressive capabilities of acting students, by enhancing their expressive nuances level, according to the text content. Additionally, it might be argued that VPCH is an effective pedagogical tool not only for acting students, but also for individuals from any discipline requiring the use of the spoken voice in a professional context and/or in an expressive sense.

Exercise Science and the Vocalist.

The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.

Exercise Science and the Vocalist.

The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.

An Acoustic Examination of Pitch Variation in Soprano Singing.

INTRODUCTION: The ability to perform acoustic inspection of data and to correlate the results with perceptual and physiological aspects facilitates vocal behavior analysis. The singing voice has specific characteristics and parameters that are involved during the phonation mechanism, which may be analyzed acoustically. OBJECTIVE: To describe and analyze the fundamental frequency and formants in pitch variation in the /a/ vowel in sopranos. METHODS: The sample consisted of 30 female participants between the ages of 20 to 45 years without vocal complaints. All sustained vowel sounds were recorded with the /a/ vowel sustained for 5 seconds, with three replications at low (C4-261 Hz), medium (Eb4-622 Hz), and high (Bb4-932 Hz) frequencies that were comfortable for the voice classification. In total, 90 samples were analyzed with digital extraction of the fundamental frequency (f0) and the first five formants (F1, F2, F3, F4, and F5) and manual confirmation. The middle segment was considered for analysis, whereas the onset and offset segments were not considered. Subsequently, FFT (fast Fourier transform) plots, LPC (linear predictive coding) graphs, and tube diagrams were created. The Shapiro-Wilks test was applied for adherence and the Friedman test was applied for comparison of paired samples. RESULTS: For vocalizations at low and medium pitches, higher values were observed for the first five formant frequencies than for the f0 value. Overlaying the LPC and FFT graphs revealed a similarity between F1 and F2 at the two pitches, with clustered harmonics in the F3, F4, and F5 region in the low pitch. At the medium pitch, there was similarity between F3 and F4, an F5 peak, and tuned harmonics. However, in the high-pitch vocalizations, there was an increase in the F2, F3, F4, and F5 values in relation to f0, and there was similarity between them along with synchrony between f0 and F1, H2 and F2, H3 and F3, H4 and F4, and H5 and F5. CONCLUSIONS: Pitch changes indicate differences in the behavior of the fundamental frequency and sound formants in sopranos. The comparison of the sustained vowels sounds in f0 at the three pitches revealed specific vocal tract changes on the LPC curve and FFT harmonics, with an extra gain range at 261 Hz, synchrony between peaks of formants and harmonics at 622 Hz, and equivalence of f0 and F1 at 932 Hz.

Adjustment of Vocal Tract Shape via Biofeedback: Influence on Vowels.

The study assessed 30 nonprofessional singers to evaluate the effects of vocal tract shape adjustment via increased resonance toward an externally applied sinusoidal frequency of 900 Hz without phonation. The amplification of the sound wave was used as biofeedback signal and the intensity and the formant position of the basic vowels /a/, /e/, /i/, /o/, and /u/ were compared before and after a vocal tract adjustment period. After the adjustment period, the intensities for all vowels increased and the measured changes correlated with the participants' self-perception.The diferences between the second formant position of the vowels and the applied frequency influences the changes in amplitude and in formant frequencies. The most significant changes in formant frequency occurred with vowels that did not include a formant frequency of 900 Hz, while the increase in amplitude was the strongest for vowels with a formant frequency of about 900 Hz.

Vocal Training for Patients Post Vocal Cord Polyp Surgery Based on ICF and ICHI / 中国康复理论与实践

Objective:To explore the effect of vocal training based on International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHI) on vocal function after vocal cord polyps. Methods:A framework of rehabilitation was developed with joint use of ICF and ICHI. From January, 2017 to December, 2018, 30 patients with vocal cord polyps and vocal dysfunction post operation were sampled. They accepted the therapy for a month, and assessed with Grade, Roughness, Breathiness, Asthenia and Strain scale (GRBAS), and measured acoustic parameters before and after operation, and after training, respectively. Results:The scores of GRBAS decreased after training, compared with those both before and after operation (F > 6.214, P < 0.05), as well as the acoustic parameters of fundamental frequency, fundamental frequency perturbation, normalized noise energy and amplitude perturbation (F > 9.655, P < 0.05). Conclusion:Vocal training based on ICF and ICHI is effective on vocal function after operation for vocal cord polyps.

O impacto da afinação vocal na análise perceptivo-auditiva de vozes normais e alteradas / The impact of vocal tuning in the perceptual auditory judgment of normal and deviated voice qualities

RESUMO Objetivo: Avaliar a habilidade de identificação de vozes normais e alteradas por indivíduos afinados e desafinados, comparando seu desempenho nos testes de processamento auditivo e na avaliação perceptivo-auditiva. Método: Participaram 15 indivíduos afinados e 15 desafinados pareados quanto à idade e sexo, oriundos de um coral amador, com limiares auditivos e qualidade vocal dentro dos padrões de normalidade. Todos foram submetidos à Triagem da Afinação vocal para a alocação nos grupos de afinados e desafinados. Em seguida, realizaram o Teste Padrão de Frequência (TPF), Teste Padrão de Duração (TPD) e análise perceptivo-auditiva de 36 vozes, mais 20% de repetição para teste de confiabilidade. Resultados: Os indivíduos desafinados apresentaram resultados estatisticamente menores que os afinados no TPF e no TPD para ambas as orelhas (p=0,002 OD; p=0,001 OE; p=0,009 TPD). Resultados da análise perceptivo-auditiva e da confiabilidade não apresentaram diferença (p=0,153). Contudo, esses resultados foram melhores quando comparados os participantes com valores normais no TPF e TPD, em relação aos resultados alterados (p=0,033). Assim, participantes com testes temporais de processamento auditivo alterados apresentaram maiores dificuldades na análise perceptivo-auditiva e menor confiabilidade intrassujeito, independentemente de serem ou não afinados. Conclusão: Percebe-se que a afinação vocal não é um pré-requisito para a realização de uma boa avaliação perceptivo-auditiva da voz, mas os padrões temporais e a confiabilidade intrassujeito estão notavelmente associados à análise perceptivo-auditiva de vozes normais e alteradas. Assim, sugere-se que o treinamento auditivo seja contemplado em programas de desenvolvimento da habilidade de realizar avaliação perceptivo-auditiva da voz.

ABSTRACT Purpose: To evaluate the ability that in tune and out of tune individuals have to identify normal and deviated voice qualities and to compare it with their performance in auditory processing tests and perceptual judgment. Method: The study investigated 15 in tune and 15 out of tune individuals. Participants were matched for age and sex, were amateur choir singers, had normal hearing thresholds and normal vocal quality. All individuals underwent Pitch-matching scanning to be classified as in or out of tune. Next, they performed the Pitch Pattern Sequence (PPS) and the Duration Pattern Sequence (DPS) tests and the perceptual judgment of 36 voices plus 20% of repetition for reliability analysis. Results: The out of tune individuals had worse performance in the PPS and DPS for both ears (p=0.002 RE; p=0.001 LE; p=0.009 DPS); no difference was observed in the perceptual judgment and the reliability (p=0.153). However, participants with normal PPS and DPS had better performance in the perceptual judgment and better reliability (p=0.033). Thus, individuals with disorders in temporal auditory processing skills have greater difficulty in the perceptual judgment and have lower intra-rater reliability, despite being in or out of tune. Conclusion: It can be observed that voice tone is not required to guarantee good perceptual judgment. However, temporal patterns and intra-rater reliability are essential to perceptually assess normal and altered voice qualities. Therefore, auditory training should be included in programs that aim to develop voice perceptual judgment abilities.

Efeito imediato do exercício de sucção de ar na qualidade vocal e autoavaliação de professoras com queixas vocais: estudo-piloto / The immediate effect of air suction exercise on vocal quality and vocal self-assessment of teachers with vocal complaints: a pilot study

RESUMO Objetivo analisar o efeito imediato do exercício de sucção de ar na qualidade vocal e na autoavaliação vocal de professoras. Métodos trata-se de um estudo piloto de intervenção. Participaram 13 professoras disfônicas da rede particular do ensino fundamental, com média de idade de 35 anos e 10 meses. O exercício de sucção de ar foi realizado dez vezes, por cada participante. Os desfechos mensurados foram: avaliação perceptivoauditiva da voz, análise acústica da voz e autoavaliação vocal. Os dados foram analisados por estatística descritiva e inferencial. Resultados não houve diferença nos parâmetros acústicos e perceptivoauditivos mensurados antes e após a intervenção. Houve proporção significativamente maior de professoras que autoavaliaram a voz como melhor, após a intervenção. Conclusão o exercício de sucção de ar produz efeitos imediatos positivos na autoavaliação vocal de professores.

ABSTRACT Purpose To analyze the immediate effect of the air suction exercise on vocal quality and vocal self-assessment of teachers. Methods This is an intervention pilot study. Thirteen dysphonic teachers from private elementary schools participated in this study, with an average age of 35 years and ten months. The air suction exercise was performed ten times by each participant. The measured outcomes were: auditory-perceptual evaluation of voice, acoustic analysis, and vocal self-assessment. The data were analyzed using descriptive and inferential statistics. Results there was no difference in the acoustic and auditory-perceptual parameters measured before and after the intervention. There was a significantly higher proportion of teachers who self-evaluated the voice as better after the intervention. Conclusion the air suction exercise produces immediate positive effects on teachers' vocal self-assessment.

Método intensivo de terapia vocal para idosos / Intensive voice therapy for the elderly

RESUMO O objetivo deste relato de caso foi descrever os resultados da terapia fonoaudiológica intensiva, em um caso de presbifonia, e apresentar uma proposta de tratamento vocal para idosos, demonstrando seus resultados na qualidade vocal, qualidade de vida e imagem laríngea de um paciente com presbifonia. O programa Terapia Vocal para Idosos (TVI) é constituído por uma sequência de exercícios, que visam ao aumento da loudness, coordenação pneumofonoarticulatória, melhora na vibração de mucosa e equilíbrio de ressonância, além da variação e controle da frequência. O modelo terapêutico em questão foi aplicado em um indivíduo do gênero feminino, com 87 anos de idade e queixas de voz fraca e dificuldade em ser ouvido. As terapias ocorreram de maneira intensiva em 16 sessões com 30 minutos de duração, quatro vezes por semana e com realização de exercícios em casa. A experiência de aplicação do programa em formato intensivo mostrou efeitos positivos na qualidade vocal, com diminuição do desvio global da voz, soprosidade na emissão sustentada e rugosidade na emissão sustentada e fala. A melhora no desempenho vocal refletiu em aumento nos valores dos domínios físico e global do protocolo de qualidade de vida relacionada à voz. Houve, também, melhora no fechamento glótico. O tratamento vocal com o método TVI intensivo demonstra efeitos positivos no tratamento da presbifonia e tem o potencial de promover benefícios na qualidade vocal, na qualidade de vida relacionada à voz e nos aspectos laríngeos dos idosos.

ABSTRACT The aim of this study is to describe the results of intensive voice therapy in a presbyphonia case and to propose a voice treatment program for the elderly by demonstrating vocal quality, quality of life and laryngeal image results. The Voice Therapy for the Elderly (VTE) program consisted of a sequence of exercises that aimed at increasing intensity, pneumo-articulatory coordination, mucosal vibration and resonance balance, and increasing frequency variation and control. The therapeutic model in question was applied to an 87-year-old female subject with complaints of a weak voice and difficulty to be heard by others. This therapy program was applied with an intensive approach over 16 sessions, 30 minutes each session, four times a week, with assigned homework. The intensive voice therapy format demonstrated positive effects on vocal quality with an overall reduction in voice deviation, breathiness, and roughness on sustained phonation and speech. Vocal performance improvement showed a subsequent increase in the physical and general aspects of voice-related quality of life. There was also improvement in glottic closure. Voice treatment via the VTE method, with an intensive approach revealed to be positive in the treatment of presbyphonia and can potentially promote benefits for the elderly in terms of voice quality, voice-related quality of life, and laryngeal changes.