scholarly journals The Effectiveness of Rehabilitation of Occupational Voice Disorders in a Health Resort Hospital Environment

2021 ◽  
Vol 10 (12) ◽  
pp. 2581
Author(s):  
Anna Sinkiewicz ◽  
Agnieszka Garstecka ◽  
Hanna Mackiewicz-Nartowicz ◽  
Lidia Nawrocka ◽  
Wioletta Wojciechowska ◽  
...  
Keyword(s):  
Voice Disorders ◽  
Rehabilitation Program ◽  
Self Report ◽  
Hospital Environment ◽  
Health Resort ◽  
Self Assessment ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Before And After ◽  
Time Assessment

Background: The aim of this study was to present a rehabilitation program of occupational voice disorders for teachers, conducted in the form of health resort stays, and evaluate its effectiveness depending on job seniority. Methods: The study included 420 teachers who participated in a complex vocal prophylactic and rehabilitation program carried out during a 24-day stay at a health resort hospital. Employment time varied from 4 to 45 years (mean 28.3 years). The participants were divided into three groups: employment time < 21 years (57 teachers), 21–30 years (182 teachers) and > 30 years (181 teachers). All of the subjects underwent maximum phonation time assessment as well as jitter, shimmer and NHR (noise to harmonic ratio) parameters assessment before and after the program; they also underwent perceptual evaluation using the GRBAS scale and voice self-assessment using the VHI-30 scale. Results: The perceptual evaluation using the GRBAS scale and self-report measures of voice function assessed using the VHI scale revealed improvement (p < 0.001). The parameters of jitter, shimmer and NHR improved significantly: jitter p < 0.001, shimmer p < 0.001 and NHR p < 0.003. Maximum phonation time increased slightly but significantly (p < 0.001). For all of the studied groups regardless of their employment time, maximum phonation time increased (p < 0.001). Initially, the lowest values of maximum phonation time were observed in teachers with longer job seniority, which improved after the rehabilitation but remained <15 s. Conclusions: Voice care for teachers is crucial regardless of their job seniority. Early prophylaxis for voice disorders is effective, as the results of rehabilitation are better in teachers with a shorter employment time.

scholarly journals Cognitive Vocal Program applied to individuals with signals presbylarynx: preliminary results

CoDAS ◽  
2014 ◽  
Vol 26 (6) ◽  
pp. 503-508 ◽  
Author(s):  
Katia Nemr ◽  
Glaucia Verena Sampaio de Souza ◽  
Marcia Simões-Zenari ◽  
Domingos Hiroshi Tsuji ◽  
Adriana Hachiya ◽  
...  
Keyword(s):  
High Speed ◽  
Vocal Production ◽  
Maximum Phonation Time ◽  
Preliminary Results ◽  
Perceptual Evaluation ◽  
Articulatory Movements ◽  
Before And After ◽  
Screening Protocol ◽  
Program Intervention ◽  
Vocal Quality

PURPOSE: To propose and verify the feasibility of a vocal program intervention in patients with presbylarynx signs with or without vocal complaints. METHOD: Among 20 elder participants of the current research, 3 female patients with median age of 67 years were chosen for the pilot study. Laryngological examination, vocal recording with CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice) protocol, and Screening Protocol of Risk of Dysphonia (SPRD) were conducted before and after the program intervention. They joined the Cognitive Vocal Program for presbyphonia based on the genetic epistemology by Jean Piaget associated with vocal techniques based on scientific literature. This program is structured with six sessions and each one of them is focused in different aspects of vocal production. RESULTS: After the program intervention, some aspects such as loudness, coordination between breathing and speaking, accuracy in articulatory movements, jitter, and harmonics-to-noise ratio improved with parameters within the expected range for the age group. Three female participants were observed for better vocal quality, higher fundamental frequency, and better maximum phonation time. In two cases, tension related to loudness elevation and better scores on SPRD was observed. Using by high-speed laryngeal image, we also observed reduction of presbylarynx signs, and remarkable improvement in glottis closure competence and mucosal wave movement of the patients with and without vocal complaints. CONCLUSION: The preliminary results suggest encouraging prospects for the proposal with improvement in the aspects analyzed. This program was well designed and did not require any further adjustments.

Simulation of childbirth improves clinical management capacity and self-confidence in medical students

2018 ◽  
Vol 4 (4) ◽  
pp. 184-189 ◽  
Author(s):  
Paolo Mannella ◽  
Rachele Antonelli ◽  
María Magdalena Montt-Guevara ◽  
Marta Caretto ◽  
Giulia Palla ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Session ◽  
Hospital Environment ◽  
Control Group ◽  
High Fidelity ◽  
Self Assessment ◽  
Normal Cycle ◽  
Self Confidence ◽  
Before And After ◽  
Physiological Childbirth

Background The learning process of physiological mechanisms of childbirth and its management are important elements in the education of medical students. In this study, we verify how the use of a high-fidelity simulator of childbirth improves competence of students in this regard.Methods A total of 132 medical students were recruited for the study in order to attend a physiological childbirth in a no-hospital environment after being assigned to two groups. The control group received only a normal cycle of lectures, while the simulation (SIM) group followed a specific training session on the simulator. Subsequently, both groups were assessed for their technical and non-technical skills in a simulated childbirth. Also, a self-assessment test regarding their self-confidence was administrated before and after simulation, and repeated after 8 weeks.Results The SIM group showed better performance in all the domains with a better comprehension of the mechanisms of childbirth, managing and assistance of labour and delivery. In addition, compared to the control group, they presented a better self-related awareness and self-assurance regarding the possibility of facing a birth by themselves.Conclusion The present study demonstrated that the use of a high-fidelity simulator for medical students allows a significant improvement in the acquisition of theoretical and technical expertise to assist a physiological birth.

scholarly journals VOCAL COMPLAINT, AUDITORY-PERCEPTUAL ASSESSMENT OF VOICE AND VOCAL SELF-ASSESSMENT IN WOMEN WITH MORBID OBESITY

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 23-25 ◽  
Author(s):  
Lourdes Bernadete Rocha de SOUZA ◽  
Leandro de Araujo PERNAMBUCO ◽  
Marquiony Marques dos SANTOS ◽  
Joana Cristina Vasconcelos da SILVA
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Morbidly Obese ◽  
Self Assessment ◽  
Obese People ◽  
Voice Production ◽  
Perceptual Evaluation ◽  
Before And After ◽  
Perceptual Assessment ◽  
The Voice

Background : Obese people often have altered breathing patterns and therefore may experience difficulties in voice production. Aim : To verify the presence of vocal complaints and the correlation between the auditory-perceptual analysis of voice and vocal self-assessment of a group of women with morbid obesity before and after bariatric surgery. Methods : A longitudinal, exploratory, descriptive study of 21 morbidly obese women aged between 28 and 68 years, assessed before and after bariatric surgery, was performed. The women filled out a form containing identification data and type of vocal complaint. Perceptual evaluation of voice and vocal self-assessment were performed using a visual analog scale. For perceptual assessment of voice the women were asked to say three sentences from the Consensus Auditory-Perceptual Evaluation of Voice. Results : Of the 21 patients, 14 (66.6%) reported vocal complaints, of which 10 (71%) vocal fatigue, eight (57.14%) voice failures and seven (50%) vocal effort. All participants reported improvements in the voice after surgery, irrespective of having reported vocal complaints before surgery. There was no correlation between vocal self-assessment and auditory-perceptual assessment of the voice before or after the procedure. There was no correlation between vocal self-assessment and perceptual evaluation of the voice before surgery. Conclusion : Obesity interfered with voice production and influenced negative perception and therefore vocal complaints. Complaints about vocal production cannot be perceived by a speech therapist with the same impact as by patients, as both employ different criteria for vocal evaluation. Vocal self-assessment is an important tool in voice evaluation.

scholarly journals The Effect of Voice Therapy for the Treatment of Functional Aphonia: A Preliminary Study

2021 ◽  
Vol 32 (2) ◽  
pp. 75-80
Author(s):  
No Eul Kim ◽  
Jun Seok Kim ◽  
Jae Hwan Oh ◽  
Dong Young Kim ◽  
Joo Hyun Woo
Keyword(s):  
Behavioral Therapy ◽  
Voice Quality ◽  
Retrospective Chart Review ◽  
Clinical Information ◽  
Voice Therapy ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Before And After ◽  
Cepstral Peak Prominence ◽  
The Voice

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly.Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared.Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved.Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient’s vocalization and improving voice quality, pitch and loudness.

Does validation and alliance during the multimodal investigation affect patients’ acceptance of chronic pain? An experimental single case study

2019 ◽  
Vol 19 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Mikael Svanberg ◽  
Ann-Christin Johansson ◽  
Katja Boersma
Keyword(s):  
Chronic Pain ◽  
Therapeutic Effect ◽  
Pain Catastrophizing ◽  
Single Case ◽  
Rehabilitation Program ◽  
Self Report ◽  
Pain Coping ◽  
Chronic Pain Patients ◽  
Before And After ◽  
Pain Patients

Abstract Background and aims Among chronic pain patients who are referred to participation in a multimodal rehabilitation program (MMRP), pain catastrophizing and dysfunctional pain coping is common. In many cases it may have driven the patient to a range of unsuccessful searches for biomedical explanations and pain relief. Often these efforts have left patients feeling disappointed, hopeless and misunderstood. The MMRP process can be preceded by a multimodal investigation (MMI) where an important effort is to validate the patient to create a good alliance and begin a process of change towards acceptance of the pain. However, whether the MMI has such therapeutic effect is unclear. Using a repeated single case experimental design, the purpose of this study was to investigate the therapeutic effect of MMI by studying changes in patients’ experience of validation, alliance, acceptance of pain, coping, catastrophizing, and depression before and during the MMI process. Methods Participants were six chronic pain patients with high levels of pain catastrophizing (>25 on the Pain Catastrophizing Scale) and risk for long term disability (>105 on the Örebro Musculoskeletal Pain Screening Questionnaire) who were subjected to MMI before planned MMRP. For each patient, weekly self-report measures of validation, alliance and acceptance of pain were obtained during a 5–10-weeks baseline, before the MMI started. Subsequently, these measures were also obtained during a 6–8 weeks MMI process in order to enable comparative analyses. Additionally, pain coping, depression and pain catastrophizing were measured using standardized questionnaires before and after the MMI. Results Irrespective of experiences of validation and alliance before MMI, all six patients felt validated and experienced a good alliance during MMI. Acceptance of pain improved only in one patient during MMI. None of the patients showed clinically relevant improvement in pain coping, depression or catastrophizing after the MMI. Conclusions The patients did not change their acceptance and pain coping strategies despite of good alliance and experience of validation during the MMI process. Even if the design of this study precludes generalization to chronic pain patients in general, the results suggest that MMI may not have a therapeutic effect.

The Relationship Between Auditory-Perceptual Rating Scales and Objective Voice Measures in Children With Voice Disorders

2021 ◽  
Vol 30 (1) ◽  
pp. 228-238
Author(s):  
Robert Brinton Fujiki ◽  
Susan L. Thibeault
Keyword(s):  
Concurrent Validity ◽  
Rating Scales ◽  
Voice Disorders ◽  
Information Criterion ◽  
Strongly Correlated ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
University Of Wisconsin ◽  
The University ◽  
The Relationship

Purpose The purpose of this study was to determine concurrent validity of the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) auditory-perceptual scales in children with voice disorders. A secondary purpose was to determine correlation between the GRBAS, CAPE-V, and objective voice measures. Method GRBAS and CAPE-V ratings and acoustic and aerodynamic measures were collected from the University of Wisconsin–Madison Voice and Swallow Outcomes Database. Correlations between CAPE-V and GRBAS ratings were calculated for overall severity of dysphonia, roughness, breathiness, and strain. Correlations between auditory-perceptual voice ratings and objective voice measures were also examined. Results One hundred thirty GRBAS and CAPE-V auditory-perceptual ratings were significantly correlated for overall severity, roughness, breathiness, and strain. r 2 values were highest for overall severity of dysphonia ( r 2 = .75) and lowest for strain ( r 2 = .54). CAPE-V and GRBAS ratings were largely associated with similar acoustic and aerodynamic measures. The highest correlations were observed for auditory-perceptual ratings of breathiness and jitter% (CAPE-V r 2 = .44, GRBAS r 2 = .44), shimmer% (CAPE-V r 2 = .45, GRBAS r 2 = .45), noise-to-harmonic ratio (CAPE-V r 2 = .42, GRBAS r 2 = .40), fundamental frequency (CAPE-V r 2 = .47, GRBAS r 2 = .44), and maximum phonation time (CAPE-V r 2 = .56, GRBAS r 2 = .51). Akaike information criterion values indicated that CAPE-V ratings were more strongly correlated with objective voice measures than GRBAS ratings. Conclusions CAPE-V and GRBAS scales have concurrent validity in children with voice disorders. CAPE-V ratings are more strongly correlated with acoustic and aerodynamic voice measures.

The recommended presbyphonia recognition model in elderly men

2019 ◽  
Vol 73 (4) ◽  
pp. 1-5
Author(s):  
Bożena Kosztyła-Hojna ◽  
Maciej Zdrojkowski ◽  
Emilia Duchnowska
Keyword(s):  
High Speed ◽  
Voice Disorders ◽  
Vocal Folds ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Elderly Men ◽  
Voice Analysis ◽  
Self Assessment ◽  
Acoustic Voice Analysis ◽  
Maximum Phonation Time

Introduction. The process of aging begins after 60 years of age and is referred to as presbyphonia (Vox senium). The causes include functional or organic voice disorders, often coexisting with dry upper respiratory tract infection. Materials and methods. The aim of the study is the use of High-Speed camera and acoustic voice analysis in diagnostics of the clinical form of presbyphonia. The study included group of 50 men, non-smokers, age from 51 to 72, who do not use voice professionally. High-Speed Digital Imaging and HS camera have been used, allowing evaluation of real vibrations of vocal folds, along with acoustic voice analysis using software by DiagNova Technologies. Results. VHI questionnaire has been used for self-assessment of voice disability. Visualization of the larynx enabled recognition of hypofunctional dysphonia or atrophy of vocal folds that cause voice disorders. This was confirmed by parameters of voice acoustic evaluation: F0, NHR, narrowband spectrography. Pathological value of NHR and the presence of nonharmonic components in the range of high frequency levels indicated glottal insufficiency, recorded with the visualization technique of the larynx by HS camera. A significant shortening of maximum phonation time in relation to the control group has also been recorded. Discussion. The objective examination of voice pathology is crucial in the diagnosis and rehabilitation, however, the subjective assessment of patient is important in the scope of the procedure used. Subjective self-assessment of patients voice (VHI) confirmed the sense of voice disorders in elderly men, indicating the need for rapid and accurate clinical diagnosis.

Effects of a 6-Week Straw Phonation in Water Exercise Program on the Aging Voice

2020 ◽  
Vol 63 (4) ◽  
pp. 1018-1032
Author(s):  
Chia-Hsin Wu ◽  
Roger W. Chan
Keyword(s):  
Acoustic Analysis ◽  
Vocal Tract ◽  
Exercise Program ◽  
Analysis Of Covariance ◽  
Elderly Subjects ◽  
Control Group ◽  
Perceptual Evaluation ◽  
Positive Effects ◽  
Aging Voice ◽  
Before And After

Purpose Semi-occluded vocal tract (SOVT) exercises with tubes or straws have been widely used for a variety of voice disorders. Yet, the effects of longer periods of SOVT exercises (lasting for weeks) on the aging voice are not well understood. This study investigated the effects of a 6-week straw phonation in water (SPW) exercise program. Method Thirty-seven elderly subjects with self-perceived voice problems were assigned into two groups: (a) SPW exercises with six weekly sessions and home practice (experimental group) and (b) vocal hygiene education (control group). Before and after intervention (2 weeks after the completion of the exercise program), acoustic analysis, auditory–perceptual evaluation, and self-assessment of vocal impairment were conducted. Results Analysis of covariance revealed significant differences between the two groups in smoothed cepstral peak prominence measures, harmonics-to-noise ratio, the auditory–perceptual parameter of breathiness, and Voice Handicap Index-10 scores postintervention. No significant differences between the two groups were found for other measures. Conclusions Our results supported the positive effects of SOVT exercises for the aging voice, with a 6-week SPW exercise program being a clinical option. Future studies should involve long-term follow-up and additional outcome measures to better understand the efficacy of SOVT exercises, particularly SPW exercises, for the aging voice.

Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Middle Age ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Aid Use ◽  
Hearing Handicap ◽  
Before And After ◽  
Hearing Problems

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.

Cirugía de feminización de voz con técnica glotoplastia de Wendler en Barranquilla, Colombia. Voice feminization surgery with Wendler glottoplasty technique in Barranquilla, Colombia.

2018 ◽  
Vol 45 (4) ◽  
pp. 247-253 ◽  
Author(s):  
Antonio J. Ballestas ◽  
Samir A. Ballestas ◽  
Rocio Cuello
Keyword(s):  
Fundamental Frequency ◽  
Speech Therapy ◽  
Vocal Cords ◽  
Maximum Phonation Time ◽  
Study Materials ◽  
Before And After ◽  
Upper Face ◽  
Expert Surgeon ◽  
Frequency Maximum ◽  
Male To Female

Introducción: La glotoplastia de Wendler es la técnica que en la actualidad ofrece mejores resultados entre los diferentes tipos de cirugías para la feminización de la voz. Objetivo: Describir nuestra experiencia con la Glotoplastia de Wendler durante el proceso de feminización de la voz de mujeres transgénero. Diseño: Pseudoexperimental (antes-después) Materiales y Métodos: 36 pacientes transexuales en proceso de transformación de hombre a mujer se sometieron a cirugía y rehabilitación con terapias de voz con el equipo de VOICEFEM - Voice Feminization Colombia. La técnica utilizada consiste en la creación de una sinequia de las cuerdas vocales (CCVV) previa desepitelización de la cara interna del tercio anterior de las mismas, 2 puntos de sutura con Vicryl 4/0 y vaporización con electrocauterio en la región lateral de la cara superior de las CCVV y utilización de goma biológica en la sinequia creada. La medición de la frecuencia fundamental, el tiempo máximo de fonación, y la realización del cuestionario TSEQ, se llevaron a cabo antes y después de la cirugía. Resultados: Se obtuvo un aumento de la Frecuencia fundamental promedio de 112Hz(P<0.05) a los 6 meses posteriores al procedimiento quirúrgico y una disminución de cerca de 30 puntos en los resultados del cuestionario TSEQ. Conclusión: La glotoplastia de Wendler, llevada a cabo por cirujanos con experiencia en este campo, ofrece resultados favorables con aumentos significativos de la frecuencia fundamental a mediano plazo y debe estar necesariamente asociada al manejo postquirúrgico con terapias de voz, para obtener el desenlace óptimo esperado.Introduction: Wendler’s Glottoplasty is the technique that offers the best resultsamong the different types of voice feminization surgeries. Male to Female Transgender patients have in this technique the last step for their successful transformation. Objective: To describe our experience in carrying out Wendler’s glottoplasty during the process of feminization of the voice of transgender women. Design: Pseudoexperimental (before-after) study. Materials and methods: In 36 Male to Female Transgender patients, Wendler’s glottoplasty was conducted by VOICEFEM - Voice Feminization Colombia’s team, with further speech therapy rehabilitation. This technique consists of the creation of a synechia of the vocal cords which is carried out after the de-epithelization of the vocal cords on the inner face of its anterior third, 2 stitches with Vicryl 4/0 and vaporization with electrocautery in the lateral region of vocal cords upper face, and the use of biological glue in the created synechia. The measurement of the Fundamental Frequency, Maximum Phonation time, and the completion of the TSEQ questionnaire were carried out before and after the surgery. Results: There was an increase of 112 Hz in the average of Fundamental Frequency(P<0.05) 6 months after the surgery, and a decrease of approximately 30 points in the TSEQ questionnaire results. Conclusion: Wendler’s Glottoplasty conducted by an expert surgeon, provides positive results with a significant increase for fundamental frequency in the medium term, and it is imperative to do also voice therapy rehabilitation posterior to the procedure in order to obtain the expected optimal outcome.

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