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The Laryngoscope Dec 2021Laryngeal vibratory asymmetry occurring with paresis may result in a perceptually normal or abnormal voice. The present study aims to determine the relationships between...
OBJECTIVES
Laryngeal vibratory asymmetry occurring with paresis may result in a perceptually normal or abnormal voice. The present study aims to determine the relationships between the degree of vibratory asymmetry, acoustic measures, and perception of sound stimuli.
STUDY DESIGN
Animal Model of Voice Production, Perceptual Analysis of Voice.
METHODS
In an in vivo canine model of phonation, symmetric and asymmetric laryngeal vibration were obtained via graded unilateral recurrent laryngeal nerve (RLN) stimulation simulating near paralysis to full activation. Phonation was performed at various contralateral RLN and bilateral superior laryngeal nerve stimulation levels. Naïve listeners rated the perceptual quality of 182 unique phonatory samples using a visual sort-and-rate task. Cepstral peak prominence (CPP) was calculated for each phonatory condition. The relationships among vibratory symmetry, CPP, and perceptual ratings were evaluated.
RESULTS
A significant relationship emerged between RLN stimulation and perceptual rating, such that sound samples from low RLN levels were preferred to those from high RLN levels. When symmetric vibration was achieved at mid-RLN stimulation, listeners preferred samples from symmetric vibration over those from asymmetric vibration. However, when symmetry was achieved at high RLN levels, a strained voice quality resulted that listeners dispreferred over asymmetric conditions at lower RLN levels. CPP did not have a linear relationship with perceptual ratings.
CONCLUSIONS
Laryngeal vibratory asymmetry produces variable perceptual differences in phonatory sound quality. Though CPP has been correlated with dysphonia in previous research, its complex relationship with quality limits its usefulness as clinical marker of voice quality perception.
LEVEL OF EVIDENCE
NA, basic science Laryngoscope, 131:2740-2746, 2021.
Topics: Acoustics; Animals; Disease Models, Animal; Dogs; Dysphonia; Electric Stimulation; Female; Humans; Laryngeal Nerves; Male; Phonation; Vibration; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 34106487
DOI: 10.1002/lary.29679 -
Public Health May 2021In the face of the SARS-CoV-2 pandemic, people with dementia and their carers are contending with serious challenges to their health and wellbeing, due to risk of severe... (Review)
Review
OBJECTIVES
In the face of the SARS-CoV-2 pandemic, people with dementia and their carers are contending with serious challenges to their health and wellbeing, due to risk of severe illness, limiting of social contact and disruption to usual activities. Many forms of support for people with dementia and their carers, including singing groups, have moved online using videoconferencing. Previous research has demonstrated the benefits of group singing, which include cognitive stimulation, meaningful activity and peer support. However, although we know which aspects of the singing group experience participants find helpful, we do not know how this experience translates into an online videoconferencing format, and this is a very new field with little existing research. This article reviews the literature pertinent to online singing interventions and uses the findings to develop some suggestions for running an online singing group.
STUDY DESIGN
SCOPING REVIEW.
METHODS
Systematic literature searches were conducted in EMBASE, Medline, CINAHL, PsycINFO and Web of Science. Owing to the paucity of existing research, searches were also conducted in Google Scholar. The scope of the review covered five related areas: online music making and music therapy, telemedicine and telecare, everyday technology for people with dementia, digital arts and dementia, and use of technology for social interaction and leisure. Our analysis aimed to integrate the results to inform the implementation of online singing groups for people with dementia.
RESULTS
Scoping of evidence from discrete fields of enquiry and different disciplinary traditions can inform the delivery of online singing in dementia. This literature also yields useful insights into the role of the carer and how best to support participants to use technology. Barriers and facilitators to online singing were found to relate both to the technology and to the individual participant.
CONCLUSION
Lockdown restrictions have led to much innovation, and this is likely to lead to changes in practice even after normal life resumes. The suggestions in this article will be helpful primarily for practitioners moving into online work and researchers investigating this novel area. They may also be useful to commissioners and policymakers because they reflect current knowledge about best practice.
Topics: COVID-19; Dementia; Humans; Music Therapy; Singing; Telemedicine
PubMed: 33962096
DOI: 10.1016/j.puhe.2021.03.002 -
Journal of Voice : Official Journal of... Jan 2022Measures of subglottal pressure (Ps), phonation threshold pressure (PTP), and laryngeal resistance (LR) can be used as indicators of vocal cord disorders. The gold...
INTRODUCTION
Measures of subglottal pressure (Ps), phonation threshold pressure (PTP), and laryngeal resistance (LR) can be used as indicators of vocal cord disorders. The gold standard non-invasive measurement uses labial interruption, which has been shown to have reliability inconsistencies. Mechanical interruption methods have demonstrated promise in measurement reliability. The goal of the present study is to compare retest reliability of labial and mechanical interruption methods.
METHODS
55 subjects aged 18-69 participated. Ten trials were performed for each method. For labial interruption, subjects produced five labial plosives at comfortable and quiet volumes. For mechanical interruption, subjects produced a sustained /α/ while a balloon valve interrupted phonation five times. Thirty subjects completed a second study visit identical to the first approximately two weeks (15 days ± 3.76) after the first visit. Ps, PTP, mean airflow rate, and LR were determined for each subject and retest reliability for each was analyzed.
RESULTS
The percent difference in measurement results for test-retest of Ps were 12.88% ± 10.15 for mechanical interruption and 27.56% ± 17.14 for labial interruption (P = 0.0003). The percent difference for PTP measurements were 21.46% ± 16.01 for mechanical and 17.04% ± 14.62 (P = 0.3372) for labial. Intra-subject coefficients of variation of Ps were 0.086 ± 0.046 for mechanical and 0.161 ± 0.078 for labial (P < 0.0001). For PTP, the coefficients were 0.177 ± 0.083 for mechanical and 0.186 ± 0.091 for labial (P = 0.5402). Lastly, for LR (Ps divided by mean airflow rate) the percent differences were 14.33% ± 10.06 for mechanical and 53.87% ± 43.19 for labial (P < 0.0001) with intra-subject variability of 0.115 ± 0.050 for mechanical and 0.287 ± 0.222 for labial (P < 0.0001).
CONCLUSIONS
Ps and LR measured using mechanical interruption showed more consistency for both retesting across separate study visits and intra-subject variability. PTP was similar in retesting and intra-subject variability. Continued work to improve mechanical interruption techniques is warranted as these methods offer higher reliability and consistency than the labial interruption methods.
Topics: Humans; Larynx; Phonation; Reproducibility of Results
PubMed: 32253079
DOI: 10.1016/j.jvoice.2020.02.024 -
Journal of Speech, Language, and... Jul 2021Purpose This study aims to investigate the effects of a 10-min vocal exertion task on voice and respiratory measures, to determine whether restorative strategies can...
Purpose This study aims to investigate the effects of a 10-min vocal exertion task on voice and respiratory measures, to determine whether restorative strategies can mitigate these effects after cessation of exertion, and to assess whether these strategies continue to reduce these detrimental effects when vocal exertion is resumed. Method A prospective, repeated-measures design was used. On consecutive days, 20 participants (equal men and women) completed two vocal exertion tasks separated by 10 min of restoration strategies: vocal rest or controlled phonation (low-level tissue mobilization using straw phonation). Voice and respiratory data were collected at baseline, following the first exertion task, after restoration strategies, and after the second exertion task. Outcome measures included (a) vocal effort, (b) phonation threshold pressure, (c) maximum and minimum fundamental frequencies, (d) cepstral peak prominence of connected speech, (e) lung volume initiation and termination, (f) percent vital capacity expended per syllable, and (g) number of syllables per breath group. Results A worsening of phonation threshold pressure ( < .001), vocal effort ( < .001), and increase of minimum fundamental frequency ( = .007) were observed after vocal exertion. Lung volume initiation ( < .001) and lung volume termination ( < .001) increased. These changes were largely reversed by restoration strategies, but only controlled phonation prevented exertion-induced changes in respiratory kinematic measures on a subsequent vocal exertion task. Conclusions Exertion-induced voice changes occur rapidly and may be mitigated by either controlled phonation or vocal rest. Controlled phonation is recommended as a superior strategy due to evidence of a protective effect on a successive vocal exertion task.
Topics: Female; Humans; Male; Phonation; Physical Exertion; Prospective Studies; Speech Acoustics; Voice; Voice Quality; Young Adult
PubMed: 34121423
DOI: 10.1044/2021_JSLHR-20-00713 -
Annals of Internal Medicine Nov 2020
Topics: Humans; Phonation; Respiration; Respiratory Insufficiency
PubMed: 32584592
DOI: 10.7326/M20-4186 -
Journal of Speech, Language, and... May 2021Purpose The excised canine larynx provides an advantageous experimental framework in the study of voice physiology. In recent years, signal processing methods have been...
Purpose The excised canine larynx provides an advantageous experimental framework in the study of voice physiology. In recent years, signal processing methods have been applied to analyze phonations in excised canine larynx experiments. However, phonations have a highly complex and nonstationary nature corresponding to different proportions of regular and chaotic signal elements. Current nonlinear dynamic methods that are used to assess the degree of irregularity in the voice fail to recognize the distribution of voice type components (VTCs). Method Based on measures of intrinsic dimension, this article presents a method to analyze the VTC distribution of phonations in excised canine larynx experiments. Thirty-nine phonation samples from 13 excised canine larynges at three different subglottal pressures were analyzed. Results Phonation produced with subglottal pressures above phonation instability pressure (PIP) and below phonation threshold pressure (PTP) resulted in high proportions of Voice Types 3 and 4, characterized by chaotic and noisy signals. Phonation produced with pressure between PTP and PIP contained mostly Type 1 voice, characterized by a regular and nearly periodic signal. Mean proportions of all VTCs varied significantly in comparisons of phonations produced with Sub-PTP and PTP as well as in comparisons of phonations produced with PTP and PIP. Conclusions Across all VTCs, the VTC profiles of normal and abnormal phonation differ significantly. Normal phonation is strongly associated with VTC (Voice Type Component 1), whereas abnormal phonation exhibits increased VTC (Voice Type Component 4). The study further demonstrates the ability of intrinsic dimension to successfully detect multiple voice types in an acoustic signal and highlights the need for expanded use of intrinsic dimension in human voice. Supplemental Material https://doi.org/10.23641/asha.14417585.
Topics: Acoustics; Animals; Dogs; Humans; Larynx; Nonlinear Dynamics; Phonation; Signal Processing, Computer-Assisted
PubMed: 33887153
DOI: 10.1044/2021_JSLHR-20-00429 -
Journal of Voice : Official Journal of... Sep 2022The vast majority of motor learning studies investigating focus of attention have found that an external focus of attention (focusing on the effect of a movement)...
OBJECTIVE
The vast majority of motor learning studies investigating focus of attention have found that an external focus of attention (focusing on the effect of a movement) results in enhanced performance and learning, compared to an internal focus of attention (focusing on the body movement itself). The present study attempts to determine if the high incidence of internal focus of attention instruction that has been reported in the realm of athletics is replicated in voice training.
METHODS
Two hundred and seventy-eight singers, who were at least 18 years old and taking voice lessons, were recruited to participate in an anonymous research survey entitled "Instructions given to singers in voice lessons." The main six questions asked singers to report phrases or instructions that their studio voice teachers gave them in regard to posture, breathing and/or support, tone clarity and/or onset of tone, space and/or resonance, articulation, and reducing tension.
RESULTS
Approximately 50.83% of the total responses were classified as inducing an external focus, 39.42% were classified as internal focus, 6.48% used a combination of both internal and external focus, and 3.27% were categorized as miscellaneous.
CONCLUSIONS
The results of this study indicate that voice teachers use both external and internal attentional focus directives in the voice studio. Given the robust body of literature supporting the use of external focus, it is noteworthy that the current study found that external focus is used more often than internal focus in voice training.
Topics: Adolescent; Attention; Humans; Learning; Posture; Singing; Voice Training
PubMed: 32962940
DOI: 10.1016/j.jvoice.2020.08.035 -
Medicine Dec 2022There are many stroke patients with decreased phonation ability. Vitamin D is associated with weakness in muscle power and a decreased function of activity and is often...
There are many stroke patients with decreased phonation ability. Vitamin D is associated with weakness in muscle power and a decreased function of activity and is often accompanied by a deficiency of serum vitamin D in stroke patients. This study was conducted to evaluate the correlation between serum vitamin D level and phonetic function in subacute stroke patients. Among subacute stroke patients, patients with dysphonia were retrospectively recruited. Phonation function was assessed by acoustic analysis using the dysphonia severity index (DSI) and maximum phonation time for 4 corner vowels/a/,/i/,/u/, and/ae/. As a statistical method, the relationships of vitamin D levels with the maximum phonation time and DSI were evaluated using Pearson's correlation analysis and linear regression analysis. A total of 32 stroke patients with dysphonia were assessed. A positive correlation was found between vitamin D levels and the DSI of /a/, /u/, /i/, and/ae/. The DSI of/u/ was significantly lower in the group with vitamin D deficiency. Vitamin D level was associated with phonation function and its deficiency may be a factor in predicting phonation severity in stroke patients.
Topics: Humans; Dysphonia; Voice Quality; Retrospective Studies; Phonetics; Phonation; Stroke; Vitamin D; Vitamins; Severity of Illness Index
PubMed: 36550807
DOI: 10.1097/MD.0000000000031769 -
Journal of Voice : Official Journal of... Jul 2022Phonation threshold pressure (PTP), showing the lowest subglottal pressure producing vocal fold vibration, has been found useful for documenting various effects of...
BACKGROUND
Phonation threshold pressure (PTP), showing the lowest subglottal pressure producing vocal fold vibration, has been found useful for documenting various effects of phonatory conditions. The need for such documentation is relevant also to the teaching of singing, particularly in view of vocal demands raised in some contemporary as well as early music compositions. The aim of the present study was to test the usefulness of PTP measurement for evaluating phonatory effects of vibrato-free and ingressive singing in professional singers.
METHODS
PTP was measured at a middle, a high and a low pitch in two female and two male singers before and after recording voice range profiles (i) in habitual technique, ie, with vibrato, (ii) in vibrato-free, and (iii) in ingressive phonation. Effects on vocal fold status were examined by videolaryngostroboscopy.
RESULTS
After careful instruction of the singers, no problems were found in applying the PTP method. In some singers videolaryngostroboscopy showed effects after the experiment, eg, in terms of increased mucus and more complete glottal closure. After ingressive phonation PTP increased substantially at high pitch in one singer but changed marginally in the other singers.
CONCLUSION
The method seems useful for assessing and interpreting effects of singing in different styles and as a part of voice diagnostics. Therefore, it seems worthwhile to automatize PTP measurement.
Topics: Dysphonia; Female; Humans; Male; Phonation; Singing; Voice; Voice Quality
PubMed: 33071148
DOI: 10.1016/j.jvoice.2020.07.023 -
Archives of Endocrinology and Metabolism Aug 2019
Topics: Famous Persons; History, 19th Century; History, 20th Century; Humans; Italy; Laryngeal Nerve Injuries; Music; Singing; Thyroid Nodule; Thyroidectomy
PubMed: 31460620
DOI: 10.20945/2359-3997000000162