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Journal of Speech, Language, and... Jul 2021Purpose Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and... (Meta-Analysis)
Meta-Analysis
Purpose Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and assess the different factors affecting their quality. Method In September 2017, 15 databases were searched to include all randomized controlled trials. A new search was done in May 2019 to include all other study design articles, which include all the new-era VPs subtypes. Network meta-analysis (NMA) was applied to all 27 outcomes, besides NMA overall and partial order setting was done by using Hasse scatter plots. values were used in NMA, where the best VPs are approaching one and the least approaches zero. Meta-analysis was done for the rest of the outcomes. Results Two hundred one articles were eligible for inclusion in our study ( = 11,918). Provox-2 was significantly the most efficient and safest device concerning the most patient preference (odds ratio [] = 33.88 [0.65, 1762.24]; = .92), the least dislodgement (risk ratio [RR] = 0.27 [0.13, 0.57]; = .79), the least airflow resistance (RR = 0.42 [0.08, 2.11]; = .84), the least granulation formation (RR = 0.73 [0.02, 26.32]; = .60), and the least VPs' inaccurate size (RR = 0.77 (0.23, 2.61); = .66). Heat and moisture exchanger addition showed a significant increase in maximum phonation time and breathing experience, with values (1 and .59), respectively. While heat and moisture exchanger addition showed a significant decline in stoma cleaning frequency, coughing frequency, forced expectoration, sputum production, sleeping problems, and loosening of adhesive, with values (.99, .72, .69, .96, 1, and 0.96), respectively, Groningen low resistance and Nijdam were considered the worst devices with both overall mean value of .44. Conclusions Provox-2 is considered the best choice as being the most preferable for patients, with the least airflow resistance, dislodgment, granulation formation, and prosthesis inaccurate size. Groningen low resistance and Nijdam were considered the worst devices according to our analysis. Supplemental Material https://doi.org/10.23641/asha.14802903.
Topics: Humans; Laryngectomy; Larynx, Artificial; Network Meta-Analysis; Voice; Voice Training
PubMed: 34185575
DOI: 10.1044/2021_JSLHR-20-00597 -
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... Jul 2023Caffeine is considered a dehydrating agent due to its diuretic effects and influences the body's fluid balance. The relationship between voice and hydration has been...
BACKGROUND
Caffeine is considered a dehydrating agent due to its diuretic effects and influences the body's fluid balance. The relationship between voice and hydration has been widely investigated and it is accepted that inadequate hydration has detrimental effects on phonation. Since dehydration negatively affects the vocal folds and caffeine is considered a dehydrating agent, it can be hypothesized that voice might be negatively affected by caffeine intake. This systematic review aims to summarize and appraise the available evidence regarding the effects of caffeine on voice.
METHODS
Randomized and non-randomized experimental studies of healthy participants were retrieved following an electronic searching of six databases in June 2020. No publication, language or date restrictions were applied. Data extraction of relevant data and risk of bias assessment was conducted independently by two reviewers.
RESULTS
Five non-randomized experimental studies were deemed eligible for inclusion. The format of the administered interventions in the included studies was either liquid (coffee) or solid (caffeine tablets). Reported outcome measures used to examine the effects of caffeine on phonation consisted of acoustic, aerodynamic and (auditory & self-) perceptual. No measures were adversely affected by caffeine consumption.
CONCLUSION
Clinicians commonly advise patients to refrain from caffeine, as caffeine intake increases diuresis with subsequent effects on fluid balance. Such imbalances can potentially induce dehydration which can be detrimental to phonation. This notion cannot be supported empirically, as the evidence is deemed unreliable and no firm conclusions can be elicited to guide clinical practice. The results of this review demonstrate the lack of research in the field and the necessity for future investigations in order to inform evidence-based practice through reliable and valid outcomes.
Topics: Humans; Caffeine; Voice Quality; Dehydration; Voice; Phonation; Randomized Controlled Trials as Topic
PubMed: 33752928
DOI: 10.1016/j.jvoice.2021.02.025 -
Journal of Voice : Official Journal of... May 2023Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice... (Review)
Review
Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice production. A systematic review of the literature was conducted using PubMed/Medline, SCOPUS, and IEEE Xplore databases. To select the papers, we used the protocol PRISMA Statement. A total of 53 publications were included in this review. This article considers a taxonomic classification of models found in the literature. We propose four categories in the taxonomy: (1) Models representing the Source (Vocal folds); (2) Models representing the Filter (Vocal Tract); (3) Models representing the Source - Filter Interaction; and (4) Models representing the Airflow - Source Interaction. We include a bibliographic analysis with the evolution of the publications per category. We provide an analysis of the number as well of publications in journals per year. Moreover, we present an analysis of the term occurrence and its frequency of usage, as found in the literature. In each category, different types of vocal production models are mentioned and analyzed. The models account for the analysis of evidence about aerodynamic, biomechanical, and acoustic phenomena and their correlation with the physiological processes involved in the production of the human voice. This review gives an insight into the state of the art related to the mathematical modeling of voice production, analyzed from the viewpoint of vocal physiology.
Topics: Humans; Phonation; Biomechanical Phenomena; Vocal Cords; Voice; Acoustics
PubMed: 33678534
DOI: 10.1016/j.jvoice.2021.02.014 -
Logopedics, Phoniatrics, Vocology Apr 2022Occupational voice users such as teachers, singers, and broadcasters have high vocal demands increasing the risk for developing voice disorders. Among occupational voice... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Occupational voice users such as teachers, singers, and broadcasters have high vocal demands increasing the risk for developing voice disorders. Among occupational voice users, the literature has report gender differences in vocal doses as part of vocal demands. However, these differences have not been quantified.
OBJECTIVE
To determine differences per gender on vocal doses among different groups of occupational voice users.
METHODS
A systematic review of literature and meta-analysis were conducted on publications about vocal dose among occupational voice users. In total, 242 potential articles were found. After screening of titles and abstracts, 16 papers were included for full revision in the systematic review of literature. For the meta-analysis, 7 out of 16 papers were included.
RESULTS
Females had higher phonation time percentage compared with males (mean difference = 1.44, value = .16). Nevertheless, this difference was not statistically significant. Among call centre operators, there was no difference in time doses associated with gender. Sport teachers had high values in time dose percentage, dissipation, and radiated energies.
CONCLUSIONS
The meta-analysis shows variations in time doses, which could be associated with the vocal demand responses for females compared with males in occupational voice settings. Future investigations are required for establishing safe limits criteria for vocal doses, as well as vocal functioning in different working context.
Topics: Female; Humans; Male; Phonation; Sex Factors; Voice; Voice Disorders; Voice Quality
PubMed: 33522325
DOI: 10.1080/14015439.2021.1873415 -
Disability and Rehabilitation Jun 2022This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication...
PURPOSE
This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing.
MATERIALS AND METHODS
A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication.
RESULTS
21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; 321). Treatment approaches included singing therapy ( = 10), loudness therapy ( = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) ( = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches.
CONCLUSION
There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.IMPLICATIONS FOR REHABILITATIONGroup therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease.Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures.Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD. CRD42015029374.
Topics: Adult; Dysarthria; Humans; Language Therapy; Parkinson Disease; Singing; Speech Therapy
PubMed: 33356634
DOI: 10.1080/09638288.2020.1859629 -
International Journal of Pediatric... Feb 2021To evaluate outcomes of injection laryngoplasty (IL) and laryngeal reinnervation for the treatment of pediatric Unilateral Vocal Fold Paralysis (UVFP), especially on... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate outcomes of injection laryngoplasty (IL) and laryngeal reinnervation for the treatment of pediatric Unilateral Vocal Fold Paralysis (UVFP), especially on swallowing and quality of voice.
METHODS
A literature review was performed in Medline/PubMed and Cochrane Library, following PRISMA guidelines, with no constraints on publication date. We included studies in English, Portuguese or Spanish about surgical treatment for UVFP on the pediatric population (0-21 years) that documented outcomes for one of the following techniques: IL or laryngeal reinnervation. Study characteristics, patient demographics, technical aspects of each procedure, complications, and outcomes for voice and swallowing were extracted. A meta-analysis with inverse variance, random-effects model was performed.
RESULTS
The PRISMA approach yielded 22 studies, totaling 267 patients. Seven reinnervation articles were included in meta-analysis for maximum phonation time (MPT) and quality of voice measured by Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scale. Cardiac surgery had caused UVFP in 62.8% (142/226) of the cases. The main indication for IL was aspiration and for reinnervation was dysphonia. For IL, there was an improvement of 84.5% (confidence interval [CI] 82.6-88.4%) in swallowing and 81.4% (CI 74.6-88.1%) in voice. For reinnervation, there was an improvement of 91.6% (CI 88.2-94.9%) in swallowing and 96.8% (CI 95.5-98.0%) in voice. We found an increase of 6.19 s (CI 1.00 to 11.38) in MPT and a mean difference in GRBAS sum of -3.53 points (CI -6.15 to -0.91) after reinnervation.
CONCLUSION
Retrospective cohort studies suggest that injection laryngoplasty and reinnervation are both effective in improving swallowing and voice in children with UVFP. There was clinical evidence of improvement in the MPT and GRBAS scale meta-analysis in patients undergoing reinnervation.
Topics: Child; Dysphonia; Humans; Laryngoplasty; Retrospective Studies; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords
PubMed: 33333340
DOI: 10.1016/j.ijporl.2020.110553 -
Journal of Voice : Official Journal of... Jan 2023The voice is an important marker of the transition process to the new gender identity of the transgender person. For 20% of patients seeking voice feminization, voice... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The voice is an important marker of the transition process to the new gender identity of the transgender person. For 20% of patients seeking voice feminization, voice therapy is not completely satisfactory, and surgery should be considered, with endoscopic glottoplasty being the current practice. While the increase in fundamental frequency (F0) after glottoplasty has been well described, no systematic review of the literature or meta-analysis regarding other acoustic parameters and quality of voice has been performed yet.
OBJECTIVE
To define the effect of endoscopic glottoplasty on acoustic measures and quality of voice by assessing F0, maximum phonation time (MPT), frequency range, and grade of dysphonia.
METHODS
A literature review was performed in Medline/PubMed, Cochrane, Science Direct, LILACS, and Google Scholar, following PRISMA guidelines, with no constraints on publication date. We included studies in English, Portuguese or Spanish that assessed transgender women who underwent endoscopic glottoplasty. All the included articles were measured in terms of their methodological quality.
RESULTS
The PRISMA approach yielded 14 studies, totaling 566 patients. There was significant heterogeneity between studies regarding follow-up time, surgical technique and perioperative care. Thirteen studies were submitted to meta-analysis. The results showed significant changes in pre- to postglottoplasty mean differences of F0 = 78.49 Hz (95%CI: 75.69-81.30), MPT = -1.11 seconds (95%CI -1.67 to -0.54), frequency range = -3.55 semitones (95%CI -5.74 to -1.36) and grade of dysphonia on the GRBAS scale = 0.44 (95%CI 0.27-0.61).
CONCLUSION
Glottoplasty is effective in significantly increasing fundamental frequency, but slightly decreases MPT, frequency range and vocal quality measured by the grade of dysphonia on the GRBAS scale.
Topics: Female; Humans; Male; Acoustics; Dysphonia; Gender Identity; Transsexualism; Voice; Larynx
PubMed: 33277130
DOI: 10.1016/j.jvoice.2020.11.005 -
Clinical Rehabilitation May 2021To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease.
DESIGN
Systematic review and meta-analysis of randomized controlled trials.
METHODS
We performed a literature search of randomized controlled trials using PubMed, Web of Science, Science Direct and Cochrane database (last search October 2020). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. The data were pooled and a meta-analysis was completed for sound pressure levels, perceptual intelligibility and inflection of voice fundamental frequency.
RESULTS
We selected 15 high to moderate quality studies, which included 619 patients with Parkinson's disease. After pooling the data, 7 studies, which compared different speech language therapies to no treatment, control groups and 3 of their variables, (sound pressure level, semitone standard deviation and perceptual intelligibility) were included in the analysis.Results showed significant differences in favor of SLT for sound pressure level sustained phonation tasks (standard mean difference = 1.79; 95% confidence interval = 0.86, 2.72; ⩽ 0.0001). Significant results were also observed for sound pressure level and semitone standard deviation in reading tasks (standard mean difference = 1.32; 95% confidence interval = 1.03, 1.61; ⩽ 0.0001). Additionally, sound pressure levels in monologue tasks showed similar results when SLT was compared to other treatments (standard mean difference = 0.87; 95% confidence interval = 0.46, 1.28; ⩽ 0.0001).
CONCLUSION
This meta-analysis suggests a beneficial effect of SLT for reducing Hypokinetic Dysarthria in Parkinson's disease, improving perceptual intelligibility, sound pressure level and semitone standard deviation.
Topics: Dysarthria; Humans; Language Therapy; Parkinson Disease; Speech Therapy
PubMed: 33233932
DOI: 10.1177/0269215520976267 -
Cells Nov 2020Unilateral vocal fold paralysis (UVFP) is a common disorder that may cause glottal closure insufficiency and then hoarseness of voice and aspiration during swallowing.... (Meta-Analysis)
Meta-Analysis
Unilateral vocal fold paralysis (UVFP) is a common disorder that may cause glottal closure insufficiency and then hoarseness of voice and aspiration during swallowing. We conducted a systematic review and meta-analysis to evaluate whether hyaluronic acid (HA) injection laryngoplasty (IL) is an effective treatment for patients with UVFP. Comprehensive systematic searches were undertaken using PubMed, EBSCO Medline, and Cochrane Library databases. We appraised the quality of studies according to preset inclusion and exclusion criteria. The lengths of follow-up were divided into "short-term" (3 months or shorter), "medium-term" (6 months), and "long-term" (12 months or longer). We performed random-effect meta-analysis to estimate the changes in voice-related quality of life, perceptual evaluation by grading systems, voice lab analysis of maximal phonation time, and normalized glottal gap area, before and after HA IL. Fourteen studies were eligible for the final analysis. The results showed that patients' glottal closure insufficiency could be improved; maximal phonation time could be prolonged; perceptual evaluations of the voice and quality of life were better after HA IL, but the duration of treatment effect varied among different studies. In conclusion, HA IL is an effective treatment for UVFP, which may achieve a long-term effect and therefore reduce the likelihood of requiring permanent medialization thyroplasty.
Topics: Humans; Hyaluronic Acid; Injections; Laryngoplasty; Surveys and Questionnaires; Vocal Cord Paralysis; Vocal Cords
PubMed: 33167303
DOI: 10.3390/cells9112417