The Effects of Mask Usage on Reported Vocal Health of Educators.

OBJECTIVE: To investigate the self-reported effects of mask usage on vocal fatigue and number of vocal complaints of high school and college educators. METHOD: Forty teachers at high schools and universities who reported using masks to teach in person during the Spring 2020 to Fall 2020 semesters completed an anonymous survey regarding self-report of teaching history, vocal use, vocal complaints, and vocal health. Responses were analyzed using descriptive statistics and t tests. RESULTS: Survey participants reported an increase in all forms of vocal complaints investigated despite an increase in amplification use. Participants also reported a decrease in daily water consumption between eight and 16 ounces of water when wearing a mask in the classroom compared to teaching prior to coronavirus disease 2019. Participants also reported a significant increase in vocal effort while teaching in a mask (P < 0.001). CONCLUSION: Educators reported a significant effect of increased vocal complaints and decreased water intake while wearing masks. The decrease in water consumption and increase in vocal effort may lead to more frequent vocal complaints in teachers at the high school and college level.

Effects of singing on voice, respiratory control and quality of life in persons with Parkinson's disease.

Purpose Interventions focused on singing may provide additional benefits to established voice and respiratory therapies, due to their greater emphasis on the respiratory muscle control system in those with Parkinson's disease (PD) progresses. The purpose of this study was to examine if singing can improve voice, respiratory pressure and quality of life (QOL) in persons with PD. Methods This pilot study measured the effects of a singing intervention in 27 participants with PD. Participants were assigned to a high (met twice weekly) or low (met once weekly) dosage group. Voice, respiratory and QOL measures were recorded before and after an 8-week singing intervention. Sessions were led by board-certified music therapists and included a series of vocal and articulation exercises and group singing. Results Both groups demonstrated significant improvements in maximum inspiratory and expiratory pressure, as well as phonation time. While other voice measures improved, they did not reach statistical significance. Voice QOL and whole health QOL also significantly improved. Conclusion These results suggest singing may be a beneficial and engaging treatment choice for improving and maintaining vocal function and respiratory pressure in persons with PD. Implications for Rehabilitation In a small sample, group singing proved beneficial for improving voice and respiratory impairment in persons with Parkinson's disease. Completing group singing one time per week for 8 weeks was as effective as completing group singing two times per week for 8 weeks in persons with Parkinson's disease. Group singing is an effective means of improving overall quality of life in persons with Parkinson's disease.

Acoustic parameters critical for an appropriate vibrato.

BACKGROUND: A plethora of investigations have studied the acoustic characteristics of vibrato such as the rate, extent, onset (time from initiation of phonation until the first peak of vibrato), and periodicity. Despite extensive research, the degree to which various parameters of vibrato contribute to its acceptability remain unclear. PURPOSE: The present study sought to determine the psychoacoustical relationship of mean fundamental frequency (f(0)), modulation frequency (f(f0m)), modulation depth (d(f0m)), and intensity to the appropriateness or inappropriateness of vibrato. METHOD: Phonation samples of eight voice majors singing at low, middle, and high pitches were obtained. A high fidelity vocoder (STRAIGHT; Kawahara, 1997) was used to resynthesize these vowels with systematic manipulations of f(f0m) and d(f0m) of the f(0) contours resulting in a total of 600 stimuli (8 singers×3 pitches×5 f(f0m) levels×5 d(f0m) levels). Nine listeners (four experts and five students) evaluated these stimuli for appropriateness of vibrato at two different presentation levels (70 and 90 dB sound pressure level). RESULTS: Statistical analyses of the perceptual data suggest that appropriateness of vibrato tends to increase with mean f(0) and decrease with d(f0m.) Appropriateness of vibrato is greatest for f(f0m) value of 6 Hz, but decreases both above and below this frequency. CONCLUSION: perceived appropriateness of vibrato results from an interaction of mean f(0), f(f0m), and d(f0m) of the vowel waveform.

An acoustic-perceptual study of vocal tremor.

BACKGROUND: Essential tremor of the voice (ETV) is an involuntary intention tremor of the vocal folds that causes fluctuations in fundamental frequency (f(0)) and/or intensity leading to an unsteady voice. There is limited data on how different acoustic variables affect perception of severity of tremor. AIM: The purpose of the study was to determine if systematic changes in f(0), rate or modulation frequency (f(f0m)), extent or depth of modulation (d(f0m)), and signal-to-noise ratio (SNR) affect perception of severity of tremor. METHOD: Vowel phonations of four speakers (two male and two female) with a clinical diagnosis of ETV were selected from the Kay Elemetrics Disordered Voice Database (Lincoln Park, NJ). A high fidelity speech vocoder (STRAIGHT; Kawahara, 1997) was used to synthesize the f(0) contour for each of these voices, which were varied in mean f(0), f(f0m), and d(f0m). The f(0) contour was modified 30 Hz above and below the mean f(0) for each speaker. f(f0m) ranged from 3 to 12 Hz in steps of 3 Hz. d(f0m) ranged from 2 to 32 Hz in steps of 6 Hz. Six (three experts and three naïve) listeners rated the "severity" of tremor on a seven-point rating scale. RESULTS: Significant main effects and interactions were found between the study variables. Perceived severity of tremor increased with f(f0m) and d(f0m). There was no systematic effect of SNR on perceived tremor severity. CONCLUSION: The perception of severity for steady-state tremor results from a complex interaction of multiple acoustic cues with d(f0m) acting as the primary acoustic cue.

Fundamental frequency characteristics of Jordanian Arabic speakers.

This study is the first in a series of investigations designed to test the acoustic characteristics of the normal Arabic voice. The subjects were three hundred normal Jordanian Arabic speakers (100 adult males, 100 adult females, and 100 children). The subjects produced a sustained phonation of the vowel /a:/ and stated their complete names (i.e. first, second, third and surname) using a carrier phrase. The samples were analyzed using the Multi Dimensional Voice Program (MDVP). Fundamental frequency (F0) from the /a:/ and speaking fundamental frequency (SF0) from the sentence were analyzed. Results revealed a significant difference of both F0 and SF0 values among adult Jordanian Arabic-speaking males (F0=131.34Hz +/- 18.65, SF0=137.45 +/- 18.93), females (F0=231.13Hz +/- 20.86, SF0=230.84 +/- 16.50) and children (F0=270.93Hz +/- 20.01, SF0=278.04 +/- 32.07). Comparison with other ethnicities indicated that F0 values of adult Jordanian Arabic-speaking males and females are generally consistent with adult Caucasian and African-American values. However, for Jordanian Arabic-speaking children, a higher trend in F0 values was present than their Western counterparts. SF0 values for adult Jordanian Arabic-speaking males are generally consistent with the adult Caucasian male SF0 values. However, SF0 values of adult Jordanian-speaking females and children were relatively higher than the reported Western values. It is recommended that speech-language pathologists in Arabic-speaking countries, Jordan in specific, utilize the new data provided (F0 and SF0) when evaluating and/or treating Arabic-speaking patients. Due to its cross-linguistic variability, SF0 emerged as a preferred measurement when conducting cross-cultural comparisons of voice features.

Treatment outcomes for professional voice users.

Professional voice users comprise 25% to 35% of the U.S. working population. Their voice problems may interfere with job performance and impact costs for both employers and employees. The purpose of this study was to examine treatment outcomes of two specific rehabilitation programs for a group of professional voice users. Eighteen professional voice users participated in this study; half had complaints of throat pain or vocal fatigue (Dysphonia Group), and half were found to have benign vocal fold lesions (Lesion Group). One group received 5 weeks of expiratory muscle strength training followed by six sessions of traditional voice therapy. Treatment order was reversed for the second group. The study was designed as a repeated measures study with independent variables of treatment order, laryngeal diagnosis (lesion vs non-lesion), gender, and time. Dependent variables included maximum expiratory pressure (MEP), Voice Handicap Index (VHI) score, Vocal Rating Scale (VRS) score, Voice Effort Scale score, phonetogram measures, subglottal pressures, and acoustic and perceptual measures. Results showed significant improvements in MEP, VHI scores, and VRS scores, subglottal pressure for loud intensity, phonetogram area, and dynamic range. No significant difference was found between laryngeal diagnosis groups. A significant difference was not observed for treatment order. It was concluded that the combined treatment was responsible for the improvements observed. The results indicate that a combined modality treatment may be successful in the remediation of vocal problems for professional voice users.

Voice handicap index results for older patients with adductor spasmodic dysphonia.

Adductor spasmodic dysphonia (ADSD) adversely affects a speaker's ability to effectively communicate. For many individuals suffering with ADSD, botulinum toxin (Botox) is the chosen treatment to remediate the symptoms. Although Botox's effects on symptom remediation have been examined before, patient perception of improvement post-Botox has been examined less frequently. Further, no studies have addressed the symptomatic changes in older adults that occur after Botox treatment. The Voice Handicap Index (VHI) was used as the instrument to assess older patient's (>65 years) perception of how ADSD impacts certain areas of their life pre- and post-Botox injection. The outcome of the VHI was related to a clinical judgment of voice severity. Participants also completed the Social Readjustment Rating Scale (SRRS) to examine overall stress level, and the outcome of the SRRS was correlated to postinjection VHI scores. Results indicated no significant correlation between VHI scores and voice severity or SRRS ratings. The current study suggests further study of voice outcomes with older adults with ADSD is needed.