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Journal of Speech, Language, and... Jun 2024This systematic review aimed to evaluate the effects of singing as an intervention for aging voice.
PURPOSE
This systematic review aimed to evaluate the effects of singing as an intervention for aging voice.
METHOD
Quantitative studies of interventions for older adults with any medical condition that involves singing as training were reviewed, measured by respiration, phonation, and posture, which are the physical functions related to the aging voice. English and Chinese studies published until April 2024 were searched using 31 electronic databases, and seven studies were included. The included articles were assessed according to the Grading of Recommendations, Assessment, Development, and Evaluations rubric.
RESULTS
Seven studies were included. These studies reported outcome measures that were related to respiratory functions only. For the intervention effect, statistically significant improvements were observed in five of the included studies, among which three studies had large effect sizes. The overall level of evidence of the included studies was not high, with three studies having moderate levels and the rest having lower levels. The intervention activities included trainings other than singing. These non-singing training items may have caused co-intervention bias in the study results.
CONCLUSIONS
This systematic review suggests that singing as an intervention for older adults with respiratory and cognitive problems could improve respiration and respiratory-phonatory control. However, none of the included studies covers the other two of the physical functions related to aging voice (phonatory and postural functions). The overall level of evidence of the included studies was not high either. There is a need for more research evidence in singing-based intervention specifically for patient with aging voice.
PubMed: 38875480
DOI: 10.1044/2024_JSLHR-23-00641 -
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 -
American Journal of Otolaryngology 2024In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation... (Meta-Analysis)
Meta-Analysis Comparative Study Review
PURPOSE
In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation therapy (RT). During the past two decades, several studies compared subjective vocal outcomes of exclusive RT with those of TLM, showing a trend towards improving results for TLM over time. However, the objective differences in terms of spectro-acoustic voice parameters between exclusive RT and TLM have been less frequently investigated. The aim of this systematic review with meta-analysis was to evaluate voice quality after TLM and RT treatment for early glottic carcinoma, based on acoustic analysis parameters including jitter, shimmer, noise to harmonic ratio, fundamental frequency and maximum phonation time.
MATERIAL AND METHODS
A search of the English published literature was conducted on the Pubmed, Scopus and Cochrane databases following PRISMA guidelines.
RESULTS
A total of 441 titles were retrieved from the search. After full-text screening and application of inclusion/exclusion criteria, 12 articles were included. We found no significant differences between TLM and RT treatment in the considered acoustic analysis parameters, except for Shimmer, with more favorable values reported in the RT group.
CONCLUSIONS
Considering the spread of the disease and expecting an improvement in long-term survival over time, well-designed and multicentric studies involving larger populations with a long-term follow up are mandatory to better assess objective voice outcomes in terms of spectro-acoustic voice parameters.
Topics: Humans; Laryngeal Neoplasms; Microsurgery; Glottis; Laser Therapy; Voice Quality; Neoplasm Staging; Treatment Outcome; Carcinoma, Squamous Cell; Speech Acoustics; Male
PubMed: 38579506
DOI: 10.1016/j.amjoto.2024.104272 -
Supportive Care in Cancer : Official... Mar 2024This systematic review aimed to assess the impact of group singing on physical function, cancer-related symptoms, well-being (emotional, physical, social, spiritual),...
PURPOSE
This systematic review aimed to assess the impact of group singing on physical function, cancer-related symptoms, well-being (emotional, physical, social, spiritual), and health-related quality of life in individuals with cancer and their caregivers.
METHODS
A search was performed using Ovid MEDLINE, Embase, Scopus and Web of Science from inception to April 2023; key words included cancer, choir, and group singing. Observational cohort, prospective or retrospective studies, randomized controlled studies, and crossover studies were included. Two teams of independent reviewers extracted data and assessed the risk of bias using the Downs and Black Tool.
RESULTS
A total of 6 studies (6 reports) met the inclusion criteria for this review, with a mix of study designs. The overall quality of the studies was poor. Group singing significantly reduced anxiety levels in those with cancer and their caregivers, while the effects on depression were variable and there was no impact on fatigue. Caregivers reported improved well-being, self-efficacy and self-esteem. Both those with cancer and their caregivers had reductions in fear, anger, confusion; and reported improvement in energy, relaxation and connectedness at longer term follow-up compared to no treatment. Those with cancer reported improvements in health-related quality of life domains of bodily pain, vitality and mental health with group singing, though the effects on caregivers were mixed.
CONCLUSIONS
Group singing may have favourable effects on selected symptoms, aspects of well-being, and domains of health-related quality of life specific to vitality, bodily pain, and mental health in individuals with cancer and their caregivers.
Topics: Humans; Quality of Life; Caregivers; Singing; Retrospective Studies; Prospective Studies; Depression; Neoplasms; Pain
PubMed: 38520544
DOI: 10.1007/s00520-024-08449-8 -
Infant Behavior & Development Jun 2024Musical interactions between babies and their primary caregivers are very frequent during the early years of life and their impact on dyadic interaction and infants'... (Review)
Review
Musical interactions between babies and their primary caregivers are very frequent during the early years of life and their impact on dyadic interaction and infants' development has garnered significant attention in recent literature. However, the difficulties that natural observations entail have meant that research often carries out methodological manipulations that have a significant impact on the phenomenon studied. In order to clarify how to investigate best natural musical interactions and the information that these can provide, we have carried out a systematic review to analyze the proposed scenarios and the variables analyzed in the studies published on such interactions between main caregivers and babies under three years old. We have screened 971 articles and yielded 27. We have found a higher prevalence in the literature of studies on singing interactions, between mothers and babies under 12 months of age. We have also been able to identify two extremes in terms of methodological structuring of natural interactions. Regarding the analysis variables, a few behaviors are repeated throughout the studies, being emotions, rhythmic behaviors and characterizations of the vocal emissions common between parents and babies. Synchrony is the dyadic variable with the most weight and also one of the preferred focuses of interest in the most recent literature that has undergone a shift of focus from characterization of musical interactions to the search for the mechanisms that underlie and make them specific.
Topics: Humans; Music; Infant; Caregivers; Mother-Child Relations; Child Development; Infant Behavior; Female; Singing
PubMed: 38422780
DOI: 10.1016/j.infbeh.2024.101928 -
European Archives of... Jul 2024Since new evidence regarding the impact of Wendler glottoplasty (WG) on the voice in transgender women became available in the literature in recent years, we aimed to... (Meta-Analysis)
Meta-Analysis
PURPOSE
Since new evidence regarding the impact of Wendler glottoplasty (WG) on the voice in transgender women became available in the literature in recent years, we aimed to perform an updated systematic review and meta-analysis to determine the actual safety and efficacy of WG in the process of vocal feminization.
METHODS
PubMed, Embase, and Cochrane were searched for English-language articles published until July 4, 2023. Studies were found eligible if they evaluated the impact of WG on the acoustic-aerodynamic measures and quality of voice in transgender women.
RESULTS
Twenty-three studies were identified. After exclusion of three studies due to incomplete data, 20 studies including 656 patients were included in the meta-analysis. After WG, there was a significant increase of fundamental frequency, speaking fundamental frequency, and lower limit of the frequency range (p < 0.001). Concurrently, a significant reduction of frequency range and maximum phonation time was observed (p < 0.001). No significant differences were found between the pre- and postoperative values regarding the Grade, Roughness, Breathiness, Asthenia, and Strain scale score (p = 0.339). The overall score in the Trans Woman Voice Questionnaire (TWVQ) significantly improved after WG (p < 0.001).
CONCLUSIONS
WG is an effective voice feminization method in transgender women, associated with a high procedural success and low risk of postoperative complications. Significantly improved TWVQ score after surgery suggests its positive impact on the voice-related quality of life. Postoperative decrease of maximum phonation time and frequency range does not seem to significantly impact the effectiveness of voice production.
Topics: Female; Humans; Male; Glottis; Laryngoplasty; Speech Acoustics; Transgender Persons; Voice Quality
PubMed: 38315177
DOI: 10.1007/s00405-024-08486-3 -
Journal of Voice : Official Journal of... Jan 2024The prevalence of voice disorders for people aged >65 years is four times higher than for the population at large. The most common cause of dysphonia in this group is...
BACKGROUND
The prevalence of voice disorders for people aged >65 years is four times higher than for the population at large. The most common cause of dysphonia in this group is presbyphonia, the preferred first-line treatment for which is voice therapy with a speech-language pathologist. This systematic review seeks to identify how voice therapy affects multidimensional voice outcomes in people with presbyphonia.
METHODS
A systematic search of CINAHL, Embase, Emcare, MEDLINE, and Google Scholar was conducted in March 2023. Comparative and noncomparative studies of voice therapy in participants aged >50 years with presbyphonia were considered for inclusion. No limitations were placed on date or language of publication. Study quality and risk of bias were assessed with the Cochrane Risk of Bias 2 tool and the Methodological Index for Non-Randomized Studies. Subgroup analysis was used to compare studies based on participant sex, intervention duration, study design, and intervention content. Interventions were specified using the Rehabilitation Treatment Specification System (RTSS) employing a consensus methodology among reviewers. The results were synthesized utilizing meta-analysis when outcomes were adequately specified and narrative analysis when they were not.
RESULTS
Twenty-three studies were included with 1050 subjects (mean age: 72.5 ± 8.6 years; 51% female). The most reported intervention was vocal function exercises. Per the RTSS, 14 interventions employed a predominantly Organ Functions approach, and the 14 remaining interventions employed a Skills & Habits approach. Meta-analysis confirmed posttherapy improvement in patient-related outcome measures of 0.93 standard mean difference (P < 0.00001, 95% confidence interval [CI]: 0.70-1.17); studies with predominantly males and with longer treatment periods were associated with larger improvements, while randomized controlled trials reported more modest improvements. Meta-analysis also identified a mean posttherapy increase in maximum phonation time (MPT) of 5.37 seconds (P < 0.00001, 95% CI: 3.52-7.22). Treatments with an Organ Functions focus resulted in greater gains in MPT than those with a Skills & Habits focus (7.52 seconds versus 2.90 seconds). Finally, meta-analysis identified reductions in acoustic perturbation measures (jitter: 0.62%, P < 0.001, 95% CI: 0.26%-0.97%; shimmer 1.05%, P < 0.00001, 95% CI: 0.67%-1.44%). Narrative synthesis further identified improvement in auditory-perceptual voice quality in all active treatment groups as well as improved glottal function in most studies that reported this.
CONCLUSIONS
Despite the uncertainty around internal validity introduced by the inclusion of a wide range of study designs, there is convincing evidence that voice therapy for presbyphonia results in significant improvement in patient-reported, aerodynamic, acoustic, and expert-rated voice outcomes. Treatments with an Organ Functions focus may better address the underlying physiological deficits of presbyphonia, although future comparative studies with multidimensional voice assessment are warranted.
PubMed: 38195333
DOI: 10.1016/j.jvoice.2023.12.010 -
Journal of Voice : Official Journal of... Dec 2023Vocal fold fat injection is a technique for treating glottic insufficiency (GI) resulting from various conditions. The use of fat as a graft has several advantages over... (Review)
Review
UNLABELLED
Vocal fold fat injection is a technique for treating glottic insufficiency (GI) resulting from various conditions. The use of fat as a graft has several advantages over other grafts. Similar pliability, and vibratory characteristics as a normal vocal fold, not causing foreign body reactions, having the potential to contain stem cells, and often can be done in the office. Long-term results, however, are unpredictable. The objective of this study is to carry out a systematic review of published articles using the technique of fat injection in the vocal folds.
STUDY DESIGN
Systematic review.
REVIEW METHODS
A literature search was conducted utilizing the combination of the following keywords "vocal folds fat injection," "laryngoplasty," and "autologous fat injection vocal folds." The criteria inclusion of the study for the systematic review were based on PICOTS (population, intervention, comparison outcome, timing, and setting) and Preferred Reporting Items for Systematic Reviews and Meta-analyses statements. Outcomes reviewed included technique, study duration, perceptual and acoustic analysis, and quality of life preoperation and 1-year postoperation.
RESULTS
A systematic review on PubMed, Cochrane, and Embase databases included 13 studies analyzing the data of 472 patients, that had fat injection laryngoplasty for treatment of GI. The causes of GI varied substantially across studies. Considerable heterogeneity across studies was found, including technique for harvest, processing the fat, site of injection, and acoustic analysis. In the studies that measured maximum phonation time (MPT) there was a significant improvement in a follow-up of at least 1 year after the injection. The patient's perception of vocal quality, measured by the Voice Handicap Index, also showed significant improvement in several studies after fat injection laryngoplasty.
CONCLUSION
Fat injection laryngoplasty seems to be safe and effective for GI for at least 12 months. Multiple studies show favorable outcomes, but the lack of control groups, the heterogeneity in inclusion criteria, nonstandardized techniques, and objective voice evaluations limit this evaluation.
PubMed: 38142186
DOI: 10.1016/j.jvoice.2023.09.029 -
American Journal of Otolaryngology 2024Sulcus Vocalis (SV) is a voice disorder characterized by the parallel invagination of the vocal fold epithelium that adheres to the vocal ligament. This condition... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sulcus Vocalis (SV) is a voice disorder characterized by the parallel invagination of the vocal fold epithelium that adheres to the vocal ligament. This condition disrupts the vibratory function, leading to glottal incompetence, hoarseness, and vocal impairment. Despite various proposed surgical techniques, a standardized treatment approach remains elusive.
METHODS
We conducted a comprehensive search across PubMed/Medline, Embase, Web of Science, Scholar, and the Cochrane Library for studies on SV treatment. The inclusion criteria comprised original studies comparing pre- and post-treatment vocal outcomes in SV patients, published in English. We excluded case reports, reviews, studies without continuous data, and patients with vocal scar/atrophy.
RESULTS
Fifteen observational studies were included (361 patients, 53.73 % male, average age 41.64 years). 80 % of these studies employed self-reported outcomes, while 81.25 % analyzed acoustic/aerodynamic data. The follow-up period varied from 4 to 44 months. All techniques significantly improved Voice Handicap Index (VHI) scores (p < 0.001). Dissective and combined techniques exhibited greater reductions in VHI-30/10 (p < 0.001). Maximum Phonation Time (MPT) improved significantly across all techniques (p < 0.001), with dissective techniques demonstrating superior MPT outcomes (p < 0.001). Jitter improved significantly for dissective and injective techniques (p < 0.001), as did Shimmer for all techniques (p < 0.001). Notably, combined techniques displayed the most significant reductions (p < 0.001).
CONCLUSIONS
Surgical treatments significantly improve subjective, aerodynamic, and acoustic outcomes in SV patients. Dissective and combined dissective/injective techniques appear to yield better perceptual and phonatory outcomes compared to injective techniques alone. Further research is necessary to establish the optimal treatment approach for SV.
Topics: Humans; Acoustics; Treatment Outcome; Vocal Cords; Voice Disorders; Voice Quality
PubMed: 38071789
DOI: 10.1016/j.amjoto.2023.104131 -
Journal of Voice : Official Journal of... Dec 2023This systematic review aims to explore the effectiveness of voice health education interventions among singers, particularly focusing on vocal hygiene treatment programs... (Review)
Review
OBJECTIVES
This systematic review aims to explore the effectiveness of voice health education interventions among singers, particularly focusing on vocal hygiene treatment programs tailored for professional voice users.
STUDY DESIGN
Systematic review.
METHODS
Preferred Reporting Items on Systematic Reviews and Meta-Analysis guidelines were followed to conduct this systematic review. Comprehensive searches were conducted in PubMed, Web of Science, Scopus, Science Direct, and Cochrane Library databases. Four articles were selected for detailed review. The studies were evaluated using the Effective Public Health Practice Project tool for quality assessment.
RESULTS
The four reviewed studies primarily utilized the pretest-posttest design to examine the effectiveness of vocal hygiene interventions on singers' vocal health. Two studies investigated the effect of hydration as a treatment method, while the remaining two focused on vocal hygiene instruction. Significant improvements were observed in various vocal health parameters, including maximum phonation time, intensity, Dysphonia Severity Index, and number of daily vocal breaks taken.
CONCLUSION
This systematic review provides valuable insights into the efficacy of vocal hygiene treatment programs for singers. The positive outcomes observed in the reviewed studies underscore the importance of voice health education tailored to singers' specific needs. However, the limited number of eligible studies and the common limitation of small sample sizes highlight the need for further research in this area. Vocal health practitioners, educators, and researchers can utilize the findings of this review to develop evidence-based vocal hygiene interventions that promote the well-being and longevity of singers' vocal performance careers.
PubMed: 38052688
DOI: 10.1016/j.jvoice.2023.10.028