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European Journal of Public Health Dec 2018A growing body of research has found that participating in choir singing can increase positive emotions, reduce anxiety and enhance social bonding. Consequently, group...
BACKGROUND
A growing body of research has found that participating in choir singing can increase positive emotions, reduce anxiety and enhance social bonding. Consequently, group singing has been proposed as a social intervention for people diagnosed with mental health problems. However, it is unclear if group singing is a suitable and effective adjunct to mental health treatment. The current paper systematically reviews the burgeoning empirical research on the efficacy of group singing as a mental health intervention.
METHODS
The literature searched uncovered 709 articles that were screened. Thirteen articles representing data from 667 participants were identified which measured mental health and/or wellbeing outcomes of group singing for people living with a mental health condition in a community setting.
RESULTS
The findings of seven longitudinal studies, showed that while people with mental health conditions participated in choir singing, their mental health and wellbeing significantly improved with moderate to large effect sizes. Moreover, six qualitative studies had converging themes, indicating that group singing can provide enjoyment, improve emotional states, develop a sense of belonging and enhance self-confidence in participants.
CONCLUSION
The current results indicate that group singing could be a promising social intervention for people with mental health conditions. However, these studies had moderate to high risk of bias. Therefore, these findings remain inconclusive and more rigorous research is needed.
Topics: Adolescent; Adult; Female; Humans; Male; Mental Disorders; Mental Health; Middle Aged; Personal Satisfaction; Singing; Young Adult
PubMed: 29982515
DOI: 10.1093/eurpub/cky115 -
Journal of Voice : Official Journal of... Sep 2008Medical as well as paramedical treatments should be evaluated by scientific methods. This systematic review focuses on the effects of voice therapy, excluding... (Review)
Review
Medical as well as paramedical treatments should be evaluated by scientific methods. This systematic review focuses on the effects of voice therapy, excluding pharmacological or surgical treatments. In general, statistically significant positive but modest and varying therapy effects are found. Many of these effect studies cope with diverse methodological problems. Furthermore, the conclusions of most studies cannot be generalized easily or compared to one another. As a consequence, many issues in the field of effects of voice therapy have yet been unanswered.
Topics: Dysphonia; Humans; Laryngoscopy; Phonation; Phonetics; Pulmonary Ventilation; Sound Spectrography; Speech Acoustics; Stroboscopy; Treatment Outcome; Vocal Cords; Voice Disorders; Voice Training
PubMed: 17509828
DOI: 10.1016/j.jvoice.2006.10.005 -
The Cochrane Database of Systematic... Oct 2021Inability to communicate in a manner that can be understood causes extreme distress for people requiring an artificial airway and has implications for care quality and... (Review)
Review
BACKGROUND
Inability to communicate in a manner that can be understood causes extreme distress for people requiring an artificial airway and has implications for care quality and patient safety. Options for aided communication include non-vocal, speech-generating, and voice-enabling aids.
OBJECTIVES
To assess effectiveness of communication aids for people requiring an artificial airway (endotracheal or tracheostomy tube), defined as the proportion of people able to: use a non-vocal communication aid to communicate at least one symptom, need, or preference; or use a voice-enabling communication aid to phonate to produce at least one intelligible word. To assess time to communication/phonation; perceptions of communication; communication quality/success; quality of life; psychological distress; length of stay and costs; and adverse events.
SEARCH METHODS
We searched the Cochrane Library (Wiley version), MEDLINE (OvidSP), Embase (OvidSP), three other databases, and grey literature from inception to 30 July 2020.
SELECTION CRITERIA
We included randomised controlled trials (RCTs), quasi-RCTs, cluster-RCTs, controlled non-randomised parallel group, and before-after studies evaluating communication aids used in adults with an artificial airway.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures recommended by Cochrane. Two review authors independently performed data extraction and assessment of risk of bias.
MAIN RESULTS
We included 11 studies (1931 participants) conducted in intensive care units (ICUs). Eight evaluated non-vocal communication aids and three voice-enabling aids. Usual care was the comparator for all. For six studies, this comprised no aid; usual care in the remaining five studies comprised use of various communication aids. Overall, our confidence in results regarding effectiveness of communication interventions was very low due to imprecision, measurement heterogeneity, inconsistency in results, and most studies at high or unclear risk of bias across multiple domains. No non-vocal aid studies reported our primary outcome. We are uncertain of the effects of early use of a voice-enabling aid compared to routine use on ability to phonate at least one intelligible word (risk ratio (RR) 3.03, 95% confidence interval (CI) 0.18 to 50.08; 2 studies; very low-certainty evidence). Compared to usual care without aids, we are uncertain about effects of a non-vocal aid (communication board) on patient satisfaction (standardised mean difference (SMD) 2.92, 95% CI 1.52 to 4.33; 4 studies; very low-certainty evidence). No studies of non-vocal aids reported quality of life. Low-certainty evidence from two studies suggests early use of a voice-enabling aid may have no effect on quality of life (MD 2.27, 95% CI -7.21 to 11.75). Conceptual differences in measures of psychological distress precluded data pooling; however, intervention arm participants reported less distress suggesting there might be benefit, but our certainty in the evidence is very low. Low-certainty evidence suggest voice-enabling aids have little or no effect on ICU length of stay; we were unable to determine effects of non-vocal aids. Three studies reported different adverse events (physical restraint use, bleeding following tracheostomy, and respiratory parameters indicating respiratory decompensation). Adverse event rates were similar between arms in all three studies. However, uncertainty remains as to any harm associated with communication aids.
AUTHORS' CONCLUSIONS
Due to a lack of high-quality studies, imprecision, inconsistency of results, and measurement heterogeneity, the evidence provides insufficient information to guide practice as to which communication aid is more appropriate and when to use them. Understanding effectiveness of communication aids would benefit from development of a core outcome measurement set.
Topics: Adult; Bias; Communication; Humans; Intensive Care Units; Quality of Life; Ventilators, Mechanical
PubMed: 34637143
DOI: 10.1002/14651858.CD013379.pub2 -
Revista de Neurologia Jun 2020To systematically review all the literature, focusing on instrumental quantitative assessment of voice in patients with Parkinson's disease (PD). Furthermore, a... (Meta-Analysis)
Meta-Analysis
AIM
To systematically review all the literature, focusing on instrumental quantitative assessment of voice in patients with Parkinson's disease (PD). Furthermore, a meta-analysis was performed to identify the main characteristics of voice disturbances in PD.
PATIENTS AND METHODS
Literature searches with the keywords «Parkinson» and «voice» were conducted in PubMed, EMBASE, Cochrane Library and Web of Science. Main inclusion criteria were: clinically confirmed PD and instrumented measurement of voice parameters with acoustic analysis of voice.
RESULTS
Fourteen publications met the inclusion criteria and were included in the meta-analysis. The data within the meta-analysis revealed that several voice parameters including jitter, shimmer and fundamental frequency variation presented significant variations between patients with EP and healthy controls. Significant variations of fundamental frequency, maximum phonation time, harmonic to noise ratio, standard deviation of fundamental frequency were observed, but with a high heterogeneity between the studies. On the other hand, significant variations of noise to harmonic ratio, s/z ratio, variation of amplitude were not observed.
CONCLUSION
Acoustic analysis of voice, using an electronic system, allows the identification of changes in voice parameters for predicting the worsening of disease and for targeting specific intervention. Among the voice parameters, jitter and shimmer significantly increased in patients with PD.
Topics: Humans; Parkinson Disease; Speech Acoustics; Voice Disorders
PubMed: 32436206
DOI: 10.33588/rn.7011.2019414 -
Botulinum toxin for treating spasmodic dysphonia (laryngeal dystonia): a systematic Cochrane review.Clinical Rehabilitation Feb 2006Spasmodic dysphonia is a neurological voice disorder characterized by involuntary adductor (towards midline) or abductor (away from midline) vocal fold spasms during... (Review)
Review
BACKGROUND
Spasmodic dysphonia is a neurological voice disorder characterized by involuntary adductor (towards midline) or abductor (away from midline) vocal fold spasms during phonation which result in phonatory breaks. Botulinum toxin is currently the gold standard of treatment.
OBJECTIVE
To determine the efficacy of botulinum toxin therapy for the treatment of spasmodic dysphonia.
DESIGN
Systematic Cochrane review.
SEARCH STRATEGY
The search strategy for this review complied with Cochrane standards. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to February 2005), EMBASE (1974 to February 2005), CINAHL (through February 2005), Dissertation Abstracts International (1975 to February 2005) and PsycINFO (1975 to February 2005). The search engine FirstSearch was also used (February 2005). Reference lists for all the obtained studies and other review articles were examined for additional studies.
SELECTION CRITERIA
All randomized control trials where the participants were randomly allocated prior to intervention and in which botulinum toxin was compared to an alternative treatment, placebo or non-treated control group were included.
DATA COLLECTION AND ANALYSIS
Two reviewers independently evaluated all potential studies meeting the selection criteria noted above for inclusion.
MAIN RESULTS
Only one study in the literature met the inclusion criteria. This was the only study identified which reported a treatment/no treatment comparison. It reported significant beneficial effects for fundamental frequency (Fo), Fo range, spectrographic analysis, independent ratings of voice severity and patient ratings of voice improvement.
REVIEWER'S CONCLUSIONS
The evidence from randomized controlled trials supporting the effectiveness of botulinum toxin for management of spasmodic dysphonia is deficient. The lack of supporting evidence from randomized controlled trials results in an inability to draw unbiased generalized conclusions regarding the effectiveness of botulinum toxin for all types of spasmodic dysphonia.
Topics: Adult; Anti-Dyskinesia Agents; Botulinum Toxins; Humans; Randomized Controlled Trials as Topic; Spasm; Voice Disorders
PubMed: 16541931
DOI: 10.1191/0269215506cr931oa -
Journal of Music Therapy Mar 2017Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with... (Review)
Review
BACKGROUND
Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care.
OBJECTIVE
To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions.
DESIGN
Systematic review of published randomized controlled trials and observational studies examining singing or playing wind instruments to improve respiratory function in individuals with long-term neurological conditions.
METHODS
Articles meeting specified inclusion criteria were identified through a search of the Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, CAIRSS for Music, WHO International Clinical Trials Registry Platform Search Portal, and AMED databases as early as 1806 through March 2015. Information on study design, clinical populations, interventions, and outcome measures was extracted and summarized using an electronic standardized coding form. Methodological quality was assessed and summarized across studies descriptively.
RESULTS
From screening 584 references, 68 full texts were reviewed and five studies included. These concerned 109 participants. The studies were deemed of low quality, due to evidence of bias, in part due to intervention complexity. No adverse effects were reported. Overall, there was a trend toward improved respiratory function, but only one study on Parkinson's disease had significant between-group differences.
CONCLUSIONS
The positive trend in respiratory function in people with long-term neurological conditions following singing or wind instrument therapy is of interest, and warrants further investigation.
Topics: Bias; Humans; Music; Nervous System Diseases; Observational Studies as Topic; Randomized Controlled Trials as Topic; Respiration; Singing
PubMed: 28391305
DOI: 10.1093/jmt/thx001 -
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 -
Medical Problems of Performing Artists Jun 2020Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim...
BACKGROUND
Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim of this systematic review was to evaluate the effectiveness and efficacy of OMT in adult musicians.
METHODS
A systematic literature search included the electronic databases PubMed/MEDLINE, Medpilot, EBSCOhost, BioMedCentral, OSTMED-Dr, osteopathic-research.com, PEDro, hand searches, and contact to European osteopathic academies. Interventional and observational studies published between January 1999 and January 2019, of professional or amateur musicians who were either healthy or had MCD treated by OMT, were included. The quality of the randomized controlled trials (RCTs) was assessed by the Physiotherapy Evidence Database (PEDro) Scale ranging between 0 and 10 points.
RESULTS
Only 5 studies were identified investigating OMT in musicians, including 1 RCT (cross-over design), 3 clinical controlled trials, and 1 case report. The internal validity of the RCT was assessed as 6 points. OMT was reported to have a positive impact on healthy singers, improving phonation time, voice quality, and voice range. It also improved the cervical range of motion in violinists. No adverse events were observed, although only the cross-over RCT reported partly an assessment of adverse events.
CONCLUSIONS
The evidence for OMT in adult musicians is very limited. Prospective controlled clinical trials investigating OMT in musicians are required.
Topics: Adult; Health Status; Humans; Manipulation, Osteopathic; Musculoskeletal Diseases; Music; Occupational Injuries; Prospective Studies; Treatment Outcome
PubMed: 32479587
DOI: 10.21091/mppa.2020.2017 -
Journal of Speech, Language, and... Jan 2018Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards...
PURPOSE
Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers.
METHOD
A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population-investigation-outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction.
RESULTS
Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth.
CONCLUSION
Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.
Topics: Humans; Singing; Speech Acoustics; Speech Production Measurement; Voice
PubMed: 29344619
DOI: 10.1044/2017_JSLHR-S-17-0145 -
Complementary Therapies in Medicine Aug 2016To investigate the effect of group singing on health related quality of life (HRQoL) for adult, amateur singers with chronic health conditions. (Review)
Review
OBJECTIVE
To investigate the effect of group singing on health related quality of life (HRQoL) for adult, amateur singers with chronic health conditions.
METHODS
A literature search for experimental and observational studies and qualitative studies published before February 2014 was undertaken using the following databases: ASSIA (Proquest), CINAHL (Ebsco), EMBASE (OVID), HMIC (OVID), MEDLINE (OVID), MEDLINE in Process (OVID), OpenGrey, PsycINFO (OVID) and PubMed for Epub ahead of print studies. Social Science searches included: Web of Science, Proquest, and Scopus (Elsevier). The records were screened independently by two reviewers. Studies were critiqued using Critical Appraisal Skills Programme tools.
RESULTS
The literature search identified 573 papers, from which 18 were included (5 quantitative, 5 qualitative, 8 mixed-methods studies). These included a variety of patient populations including chronic respiratory disease, neurological conditions and mental health. The quantitative studies lacked consistency: two of the seven controlled studies demonstrated additional HRQoL benefits with singing compared to controls, while three of six uncontrolled studies showed improved HRQoL. Qualitative methods were recorded in variable depth. The qualitative data presented a range of benefits of group singing including increased confidence, increased mood and social support. Few negative effects of singing were reported.
CONCLUSION
This systematic review indicates that group singing interventions may have beneficial effects on HRQoL, anxiety, depression and mood. Studies were heterogeneous with significant methodological limitations, allowing only a weak recommendation for group singing as an intervention for adults with chronic health problems. The undertaking of larger controlled and in-depth qualitative studies is warranted.
Topics: Affect; Anxiety; Chronic Disease; Depression; Humans; Mental Health; Qualitative Research; Quality of Life; Singing; Social Support
PubMed: 27515869
DOI: 10.1016/j.ctim.2016.03.017