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International Journal of Chronic... 2022Chronic obstructive pulmonary disease (COPD) is a chronic lung disease which feature is progressive airflow obstruction. Singing is a popular and convenient activity... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease which feature is progressive airflow obstruction. Singing is a popular and convenient activity that requires people to manage their lung volumes and airflow actively. Despite the well-known benefits of singing to healthy people, the specific effect still remains unclear.
OBJECTIVE
To investigate the mental and psychological benefits of singing in patients with stable COPD.
SEARCH METHODS
We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) on randomized controlled trials (RCTs) including singing exercise as the main intervention in stable COPD. We searched 8 electronic databases, including Web of Science, PubMed, Embase, Cochrane Library, Clinical Trials.gov, and the Physical Therapy Evidence Database (PEDro), CNKI, and Wanfang Database from inception until May 2022. The searching languages was English or Chinese. Data extraction using standardized templates was performed by two independent reviewers. The quality of the studies was assessed using the PEDro scale. Data synthesis was performed with Revman 5.4. The pooled effect sizes are reported by MD and 95% CI.
RESULTS
Five RCTs involving 333 patients with stable COPD were included in this meta-analysis. Singing was regarded as the main intervention in the experimental group. Meta-analysis revealed that singing improves quality of life on Short Form 36 physical component summary (SF-36 PCS) (MD = 12.63, 95% CI: 5.52 to 19.73, < 0.01) and respiratory muscle in maximal expiratory pressure (PE) (MD = 14.30, 95% CI: 0.87 to 27.73, = 0.04) in patients with COPD. However, it has limited effects on Short Form 36 mental component summary (SF-36 MCS), lung function, exercise capability, and adverse mental state.
CONCLUSION
Based on results of the meta-analysis, singing could be used to improve quality of life (SF-36 PCS) and respiratory muscles (PE) in patients with COPD.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Singing; Quality of Life; Lung
PubMed: 36407671
DOI: 10.2147/COPD.S382037 -
PloS One 2024Deep brain stimulation (DBS) reliably ameliorates cardinal motor symptoms in Parkinson's disease (PD) and essential tremor (ET). However, the effects of DBS on speech,...
BACKGROUND
Deep brain stimulation (DBS) reliably ameliorates cardinal motor symptoms in Parkinson's disease (PD) and essential tremor (ET). However, the effects of DBS on speech, voice and language have been inconsistent and have not been examined comprehensively in a single study.
OBJECTIVE
We conducted a systematic analysis of literature by reviewing studies that examined the effects of DBS on speech, voice and language in PD and ET.
METHODS
A total of 675 publications were retrieved from PubMed, Embase, CINHAL, Web of Science, Cochrane Library and Scopus databases. Based on our selection criteria, 90 papers were included in our analysis. The selected publications were categorized into four subcategories: Fluency, Word production, Articulation and phonology and Voice quality.
RESULTS
The results suggested a long-term decline in verbal fluency, with more studies reporting deficits in phonemic fluency than semantic fluency following DBS. Additionally, high frequency stimulation, left-sided and bilateral DBS were associated with worse verbal fluency outcomes. Naming improved in the short-term following DBS-ON compared to DBS-OFF, with no long-term differences between the two conditions. Bilateral and low-frequency DBS demonstrated a relative improvement for phonation and articulation. Nonetheless, long-term DBS exacerbated phonation and articulation deficits. The effect of DBS on voice was highly variable, with both improvements and deterioration in different measures of voice.
CONCLUSION
This was the first study that aimed to combine the outcome of speech, voice, and language following DBS in a single systematic review. The findings revealed a heterogeneous pattern of results for speech, voice, and language across DBS studies, and provided directions for future studies.
Topics: Deep Brain Stimulation; Humans; Parkinson Disease; Speech; Voice; Language; Essential Tremor
PubMed: 38728329
DOI: 10.1371/journal.pone.0302739 -
Brazilian Journal of Otorhinolaryngology 2018During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the... (Review)
Review
INTRODUCTION
During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective.
OBJECTIVE
The present study is a literature review to identify factors associated with voice disorders among the elderly described in population-based studies.
METHODS
A systematic review of electronic databases was carried out. The methodological quality of the studies was analyzed with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The research was conducted independently by two researchers.
RESULTS
Although two articles met the eligibility criteria, none fulfilled all the criteria for the evaluation of methodological quality. According to the two studies selected for this review, factors associated with voice disorders among the elderly included both physical and psychosocial aspects. However, the methodological discrepancies between the studies, particularly in relation to sample selection and the instruments used indicate great variability and compromise the reliability of the results.
CONCLUSION
Further prevalence studies and investigations of factors associated with voice disorders in the elderly from an epidemiological perspective, and which involve different cultures, should be carried out.
Topics: Age Factors; Aged; Aged, 80 and over; Aging; Female; Humans; Male; Publication Bias; Voice Disorders; Voice Quality
PubMed: 29331352
DOI: 10.1016/j.bjorl.2017.11.002 -
Aerosol-generating behaviours in speech pathology clinical practice: A systematic literature review.PloS One 2021To evaluate the evidence of aerosol generation across tasks involved in voice and speech assessment and intervention, to inform better management and to reduce...
OBJECTIVE
To evaluate the evidence of aerosol generation across tasks involved in voice and speech assessment and intervention, to inform better management and to reduce transmission risk of such diseases as COVID-19 in healthcare settings and the wider community.
DESIGN
Systematic literature review.
DATA SOURCES AND ELIGIBILITY
Medline, Embase, Scopus, Web of Science, CINAHL, PubMed Central and grey literature through ProQuest, The Centre for Evidence-Based Medicine, COVID-Evidence and speech pathology national bodies were searched up until August 13th, 2020 for articles examining the aerosol-generating activities in clinical voice and speech assessment and intervention within speech pathology.
RESULTS
Of the 8288 results found, 39 studies were included for data extraction and analysis. Included articles were classified into one of three categories: research studies, review articles or clinical guidelines. Data extraction followed appropriate protocols depending on the classification of each article (e.g. PRISMA for review articles). Articles were assessed for risk of bias and certainty of evidence using the GRADE system. Six behaviours were identified as aerosol generating. These were classified into three categories: vegetative acts (coughing, breathing), verbal communication activities of daily living (speaking, loud voicing), and performance-based tasks (singing, sustained phonation). Certainty of evidence ranged from very low to moderate with variation in research design and variables.
CONCLUSIONS
This body of literature helped to both identify and categorise the aerosol-generating behaviours involved in speech pathology clinical practice and confirm the low level of evidence throughout the speech pathology literature pertaining to aerosol generation. As many aerosol-generating behaviours are common human behaviours, these findings can be applied across healthcare and community settings.
SYSTEMATIC REVIEW REGISTRATION
Registration number CRD42020186902 with PROSPERO International Prospective Register for Systematic Reviews.
Topics: Aerosols; COVID-19; Cough; Phonation; SARS-CoV-2; Singing; Speech; Speech-Language Pathology; Verbal Behavior
PubMed: 33909654
DOI: 10.1371/journal.pone.0250308 -
Journal of Voice : Official Journal of... Apr 2022Voice outcome after carbon dioxide transoral laser microsurgery (COTOLMS) for glottic cancer is of prime importance. However, a comprehensive overview according to the... (Review)
Review
Voice Outcome After Carbon Dioxide Transoral Laser Microsurgery for Glottic Cancer According to the European Laryngological Society Classification of Cordectomy Types - A Systematic Review.
BACKGROUND
Voice outcome after carbon dioxide transoral laser microsurgery (COTOLMS) for glottic cancer is of prime importance. However, a comprehensive overview according to the European Laryngological Society (ELS) classification of cordectomies is still lacking. The aim of this systematic review is to summarize data on voice outcome associated with individual types of ELS glottic cordectomy after COTOLMS.
MATERIALS AND METHODS
A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The initial search identified 936 records of which 25 publications were then included. Voice outcome data (Voice Handicap Index [VHI] version 30, grade of dysphonia [G] and maximum phonation time [MPT]) were extracted per resection type. Weighted averages were calculated.
RESULTS
Data show a gradual increase in the VHI scores although they were still similar for all cordectomy types (range 14.2 to 21.5). The grade of dysphonia showed a gradual increase with increasing resection depth (range 1.0 to 1.9). There was a gradual decrease in the MPT (range 15.2 to 7.2).
CONCLUSION
Voice outcome is related to cordectomy type with mild dysphonia characterizing ELS type I, II and III cordectomies, while more extended cordectomies (ELS type IV, V and VI) result in moderate dysphonia and shortness of breath during phonation. The voice handicap experienced by patients is limited even in the more extended cordectomies.
PubMed: 35422356
DOI: 10.1016/j.jvoice.2022.03.003 -
Journal of Voice : Official Journal of... Mar 2017Research has reported the difference in a woman's voice across the different stages of the menstrual cycle. A review of the studies in singers on the influence of... (Review)
Review
OBJECTIVE
Research has reported the difference in a woman's voice across the different stages of the menstrual cycle. A review of the studies in singers on the influence of menstruation on the singing voice will enable a better understanding of these changes.
METHODS/DESIGN
A systematic literature search was carried out on PubMed, CINAHL, Scopus, Cochrane, and regional electronic databases. The keywords "menstrual cycle," "voice change," and "singer" were used in different combinations. Only those articles that discussed the effect of menstrual cycle on the singing voice were included in the final review.
RESULTS
Six studies in the English language were identified and included in the review. Hormonal variations occur to a great extent during menstrual cycle, and these variations can influence the voice of singers. A great variability was found in the included studies. There are limited studies that have been carried out exploring the relationship between menstrual cycle and the singing voice.
CONCLUSION
Even though the studies included in the review point out toward the changes in the singing voice associated with menstrual cycle, there is a need for more studies to be carried out in diverse singing populations and in different outcome measures.
Topics: Acoustics; Biomechanical Phenomena; Electrodiagnosis; Female; Humans; Laryngoscopy; Larynx; Menstrual Cycle; Phonation; Singing; Voice Quality
PubMed: 27234008
DOI: 10.1016/j.jvoice.2016.04.018 -
Journal of Voice : Official Journal of... Jan 2019We aimed to critically appraise scientific, peer-reviewed articles, published in the past 10 years on the effects of hydration on voice quality in adults.
OBJECTIVES
We aimed to critically appraise scientific, peer-reviewed articles, published in the past 10 years on the effects of hydration on voice quality in adults.
STUDY DESIGN
This is a systematic review.
METHODS
Five databases were searched using the key words "vocal fold hydration", "voice quality", "vocal fold dehydration", and "hygienic voice therapy". The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. The included studies were scored based on American Speech-Language-Hearing Association's levels of evidence and quality indicators, as well as the Cochrane Collaboration's risk of bias tool.
RESULTS
Systemic dehydration as a result of fasting and not ingesting fluids significantly negatively affected the parameters of noise-to-harmonics ratio (NHR), shimmer, jitter, frequency, and the s/z ratio. Water ingestion led to significant improvements in shimmer, jitter, frequency, and maximum phonation time values. Caffeine intake does not appear to negatively affect voice production. Laryngeal desiccation challenges by oral breathing led to surface dehydration which negatively affected jitter, shimmer, NHR, phonation threshold pressure, and perceived phonatory effort. Steam inhalation significantly improved NHR, shimmer, and jitter. Only nebulization of isotonic solution decreased phonation threshold pressure and showed some indication of a potential positive effect of nebulization substances. Treatments in high humidity environments prove to be effective and adaptations of low humidity environments should be encouraged.
CONCLUSIONS
Recent literature regarding vocal hydration is high quality evidence. Systemic hydration is the easiest and most cost-effective solution to improve voice quality. Recent evidence therefore supports the inclusion of hydration in a vocal hygiene program.
Topics: Adult; Humans; Organism Hydration Status; Speech Acoustics; Voice Quality
PubMed: 29122414
DOI: 10.1016/j.jvoice.2017.10.001 -
NPJ Primary Care Respiratory Medicine Dec 2016There is growing interest in Singing for Lung Health (SLH), an approach where patients with respiratory disease take part in singing groups, intended to improve their... (Review)
Review
There is growing interest in Singing for Lung Health (SLH), an approach where patients with respiratory disease take part in singing groups, intended to improve their condition. A consensus group was convened in early 2016 to address issues including: the specific features that make SLH distinct from other forms of participation in singing; the existing evidence base via a systematic review; gaps in the evidence base including the need to define value-based outcome measures for sustainable commissioning of SLH; defining the measures needed to evaluate both individuals' responses to SLH and the quality of singing programmes. and core training, expertise and competencies required by singing group leaders to deliver high-quality programmes. A systematic review to establish the extent of the evidence base for SLH was undertaken. Electronic databases, including Pubmed, OVID Medline and Embase, Web of Science, Cochrane central register of controlled trials and PEDro, were used. Six studies were included in the final review. Quantitative data suggest that singing has the potential to improve health-related quality of life, particularly related to physical health, and levels of anxiety without causing significant side effects. There is a significant risk of bias in many of the existing studies with small numbers of subjects overall. Little comparison can be made between studies owing to their heterogeneity in design. Qualitative data indicate that singing is an enjoyable experience for patients, who consistently report that it helps them to cope with their condition better. Larger and longer-term trials are needed.
Topics: Humans; Lung; Lung Diseases; Quality of Life; Singing
PubMed: 27906158
DOI: 10.1038/npjpcrm.2016.80 -
The Laryngoscope Jun 2024Adenotonsillectomy is one of the most common surgical procedures performed on children. Caregivers are often concerned about voice change after the procedure, and such... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Adenotonsillectomy is one of the most common surgical procedures performed on children. Caregivers are often concerned about voice change after the procedure, and such concerns remain unsettled. This meta-analysis analyzed voice change in children after adenotonsillectomy.
DATA SOURCES
The PubMed, Medline, EMBASE, and Cochrane databases.
REVIEW METHODS
The study protocol was registered on PROSPERO. Two authors independently searched for articles using keywords "adenoidectomy," "tonsillectomy, "voice," "nasalance,"and "speech." English articles specifying voice changes after adenotonsillectomy were pooled with standardized mean difference (SMD) using random-effects model. Evaluation methods were computerized acoustic voice analysis, aerodynamic analysis, nasometer, rhinomanometry, evaluations from a speech-language pathologist or otolaryngologist, and a caregiver assessment questionnaire.
RESULTS
Twenty-three studies with 2154 children were analyzed (mean age: 8.0 y; 58% boys; mean sample size: 94 children). Due to insufficient data for other outcome variables, this meta-analysis only summarized changes in the computerized acoustic voice analysis 1 month and 3 months after surgery. The computerized acoustic analysis revealed significant changes in jitter (SMD = -0.36; 95% confidence interval [CI]: -0.60 to -0.11), shimmer (SMD = -0.34; 95% CI: -0.57 to -0.11), and soft phonation index (SMD = -0.36; 95% CI: -0.57 to -0.15) at 1 month after surgery. Parameters including fundamental frequency, jitter, noise-to-harmonics ratio, and shimmer were not significantly changed at 3 months after surgery.
CONCLUSIONS
This meta-analysis observed small improvements in jitter, shimmer, and soft phonation index 1 month after surgery. No significant effects were observed in voice outcomes 3 months after surgery. Laryngoscope, 134:2538-2550, 2024.
Topics: Humans; Tonsillectomy; Adenoidectomy; Child; Voice Quality; Voice Disorders; Female; Male; Postoperative Complications
PubMed: 37909678
DOI: 10.1002/lary.31140 -
Clinical Otolaryngology : Official... Sep 2020Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are important for clinical guidance and evidence-based practice.
OBJECTIVE OF REVIEW
To quantify the evidence of treatment effectiveness on the outcome measure Voice Handicap Index with the 30-items (VHI-30) from existing randomised controlled/clinical trials (RCT) of voice therapy using the statistical approach of a network meta-analysis (NMA) with a random effects model.
TYPE OF REVIEW
Meta-analysis.
SEARCH STRATEGY
We searched in MEDLINE (PubMed, 1950 to 2019), Embase (1974 to 2019) and Science Citation Index (1994 to 2019) using five key terms. The inclusion criteria were reports of randomised controlled/clinical trials (RCTs) published in English or German which evaluated the effectiveness of a specific voice therapy treatment using VHI-30 as an outcome measure in adult participants with non-organic or organic voice disorders. Studies were excluded if participants had been diagnosed with neurological motor speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological or instrumental (eg voice amplification) treatments were considered.
EVALUATION METHOD
The primary outcome variable was VHI-30 with a score from 0 to 120. The pre-post treatment change in VHI-30 scores was an average score of 13 points related to various VHI-30 test-retest results.
RESULTS
We retrieved 464 publications (ie with duplicates) and included 13 RCTs, which evaluated nine interventions, in the final analysis. The most effective intervention with a significant and clinically relevant effect was Stretch-and-Flow Phonation (SFP) (mean pre-post difference -28.37, 95% confidence interval [CI], -43.05 to-13.68). Resonant Voice (RV), the Comprehensive Voice Rehabilitation Program (CVRP) and Vocal Function Exercises (VFE) also demonstrated significant improvements.
CONCLUSIONS
Of the nine voice interventions identified with the present NMA, SFP, RVT, CVRP, and VFE effectively improved VHI-30 scores from pre- to post-treatment. SFP proved to be the most significant and clinically relevant treatment. Further contributions of high-quality intervention studies are needed to support evidence-based practice in vocology.
Topics: Disabled Persons; Dysphonia; Humans; Network Meta-Analysis; Phonation; Treatment Outcome; Voice Quality; Voice Training
PubMed: 32534474
DOI: 10.1111/coa.13596