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Arts & Health Oct 2021Supporting the wellbeing of young people is a growing issue internationally. Reviews of adult studies suggest the potential of group singing to meet this agenda. This...
Supporting the wellbeing of young people is a growing issue internationally. Reviews of adult studies suggest the potential of group singing to meet this agenda. This review aimed to examine current evidence regarding the effects of group singing on the wellbeing and psychosocial outcomes of children and young people. A systematic integrative review of electronic databases, including primary research studies which examined wellbeing or psychosocial outcomes for children and young people involved in group singing, yielded thirteen studies. Conclusions about the effectiveness of group singing could not be drawn from quantitative studies, which were of low quality. Qualitative synthesis indicates group singing may support young people's wellbeing through mechanisms of 'social connectedness' and confidence. Current conclusions are limited and additional, high quality qualitative and quantitative research is required to build on these findings. Further careful study may support the development and funding of group singing projects.
Topics: Adolescent; Adult; Child; Humans; Singing
PubMed: 32762613
DOI: 10.1080/17533015.2020.1802604 -
Journal of Voice : Official Journal of... May 2022Voice complaints associated with menopause have been reported by a substantial number of studies. However, to assess the clinical relevance of menopause to voice is... (Meta-Analysis)
Meta-Analysis Review
Voice complaints associated with menopause have been reported by a substantial number of studies. However, to assess the clinical relevance of menopause to voice is still difficult as the extent to which menopausal symptoms are reflected on voice metrics remains unclear. A comprehensive review and meta-analysis were carried out to identify voice-related metrics that change with menopause and to quantify the magnitude of those changes. Academic Search Premier, Medline, SciELO, Scopus, PubMed, and Web of Science were searched without restriction of publication year until January 2020. Cross-sectional studies comparing voice-related metrics between pre- and post-menopausal women were included. Studies assessing effects of hormonal-replacement therapy were excluded. Datasets with more than one publication were also disregarded. Methodological quality of included studies was assessed applying the Newcastle-Ottawa Scale for cross-sectional studies. Given the heterogeneous nature of the primary studies, random-effects models were applied to pool the estimates. Eight articles were considered eligible for meta-analyses, assessing the effects of menopause on 6 voice metrics: mean fundamental frequency (f), extracted from (1) speech and (2) from sustained vowel /a/; frequency perturbation measures (3) jitter, (4) shimmer and (5) noise-to-harmonics ratio; and (6) maximum phonation time. Both speech fundamental frequency and f for sustained vowel /a/ were found to be 0.94 and 1.18 semitones lower in post- as compared to pre-menopausal women, respectively. Although significant, the magnitude of these decreases is below the just noticeable interval difference and well above the cutting point for distinguishing female from male voices. No significant differences were found for jitter, shimmer, noise-to-harmonics ratio, and maximum phonation time. The evaluation of acoustic metrics that reflect a single aspect of voice production at a time may conceal the effects of hormonal shifts during menopause. In addition, several variables interplay during voice production and acoustical measures may constitute weak predictors of vocal folds' status, where changes associated to sex steroid hormones are most likely to occur.
Topics: Benchmarking; Cross-Sectional Studies; Female; Humans; Male; Menopause; Phonation; Speech Acoustics; Voice Quality
PubMed: 32660847
DOI: 10.1016/j.jvoice.2020.06.012 -
European Journal of Neurology Oct 2020Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech... (Meta-Analysis)
Meta-Analysis
Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta-analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage', monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31 dB, respectively, after 1 month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage' and monologue immediately after treatment (13.39, 6.66 and 3.19 dB). Positive improvement still existed after 24 months. There was no difference in the therapeutic effect between face-to-face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.
Topics: Dysarthria; Humans; Parkinson Disease; Speech Therapy; Treatment Outcome
PubMed: 32539227
DOI: 10.1111/ene.14399 -
Journal of Clinical Sleep Medicine :... Sep 2020To systematically survey the scientific literature concerning the effect of playing a wind instrument or singing on sleep, snoring, and/or obstructive sleep apnea. (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
To systematically survey the scientific literature concerning the effect of playing a wind instrument or singing on sleep, snoring, and/or obstructive sleep apnea.
METHODS
The PubMed, EMBASE, and Cochrane databases were searched up to December 2019. Observational studies and (Randomized) Controlled Clinical Trials that assessed sleep, snoring, or obstructive sleep apnea as clinical outcome or via a questionnaire were included. For the individual studies, the potential risk of bias was scored. Data between oral musicians and control participants were extracted. Descriptive analysis and meta-analysis were performed.
RESULTS
Six eligible studies (5 cross-sectional, 1 randomized controlled trial) were retrieved, with an estimated potential bias ranking from low to high. The sample sizes ranged from 25 to 1,105 participants. Descriptive analysis indicated that players of a double-reed instrument have a lower risk of obstructive sleep apnea and that singers snore less compared with control participants. Playing a didgeridoo showed a positive effect on apnea-hypopnea index, daytime sleepiness, and partner's rating for sleep disturbance. The descriptive analysis could not be substantiated in the meta-analysis. The magnitude of the effect was zero to small, and the generalizability was limited because of long (professional) rehearsal time or small sample size.
CONCLUSIONS
Playing a wind instrument and singing may have a small but positive effect on sleep disorders. Considering the practicality and investment of (rehearsal) time, didgeridoo and singing are the most promising interventions to reduce obstructive sleep apnea and snoring, respectively. However, the results of this review are based on few studies and the synthesis of the evidence is graded to have low certainty.
Topics: Cross-Sectional Studies; Humans; Singing; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Snoring
PubMed: 32536365
DOI: 10.5664/jcsm.8628 -
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 -
European Journal of Physical and... Feb 2021Speech difficulties, such as dysarthria or aphasia, in addition to motor impairments are frequently seen in post-stroke patients. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Speech difficulties, such as dysarthria or aphasia, in addition to motor impairments are frequently seen in post-stroke patients.
EVIDENCE ACQUISITION
Literature searches with the keywords: "stroke" and "dysarthria" and "diagnosis" and "stroke" and "dysarthria" and "assessment" were conducted using PubMed, EMBASE, Cochrane Library, and Web of Science databases to perform the systematic review about the methods used to measure the severity of dysarthria in subjects post-stroke. The search was performed by two authors from 15 January to 22 February 2020. The research identified a total of 402 articles for the search using the keywords "stroke" and "dysarthria," and "diagnosis" and 84 references for the search using the keywords "stroke" and "dysarthria" and "assessment." Sixty-nine selected articles were analyzed by the reviewers. Thirty-seven publications met the inclusion criteria and were included in the systematic review. Thirty-two articles were excluded for several reasons: 1) 12 involved individuals with aphasia or other speech problems different from dysarthria; 2) 12 examined different topics from our aim; and 3) eight did not include post-stroke cases.
EVIDENCE SYNTHESIS
The systematic review identified methods for measuring the severity of post-stroke dysarthria. The meta-analysis showed the acoustic parameters affected in dysarthria secondary to stroke and the differences in these parameters after speech therapy.
CONCLUSIONS
The alternating and sequential motion rate (AMR- Pə, AMR-Tə, AMR-Kə, and SMR-PəTəKə) and maximum phonation time were significantly improved after speech rehabilitation.
Topics: Dysarthria; Humans; Speech Therapy; Stroke Rehabilitation
PubMed: 32519528
DOI: 10.23736/S1973-9087.20.06242-5 -
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 -
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 -
American Journal of Otolaryngology 2020The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice...
OBJECTIVE
The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice therapy and surgery. This review seeks to examine voice outcomes after surgery for presbyphonia.
DATA SOURCES
Three electronic databases (PreMed, ScienceDirect, Embase) were reviewed for articles published between 1 January 1900 and 1 June 2019.
REVIEW METHODS
Original English-language studies examining surgical treatment of presbyphonia in elderly patients (≥65 years) were included according to PRISMA. Two researchers independently analyzed articles. Outcome measures were extracted from and qualitatively compared across studies.
RESULTS
Of the 118 articles identified, five satisfied eligibility criteria. In all studies, diagnosis of presbyphonia was based on videostroboscopy. 85 patients (61M, 21F) were evaluated. 37.6% underwent implantation thyroplasty (IT), 48.2% underwent injection augmentation (IA), 7.1% underwent both, and 7.1% underwent basic-fibroblastic growth factor (b-FGF) injection. Average patient age was 71.3 years. Average follow-up time was 5.4 months. Three months post-intervention, IT patients self-reported greater improvement in quality of life (QoL) metrics compared to IA patients. Aerodynamic measures, like mean phonation time, were significantly improved in IT and IA, but not b-FGF-injected patients. All patients experienced improvements in the auditory perception of voice three months post-intervention.
CONCLUSION
Surgical modalities currently utilized for presbyphonia include IT and IA, with bFGF-injection being trialed abroad. IT patients reported enhanced QoL relative to IA and bFGF-injected patients. Overall there is a paucity of high-power, prospective studies that explore the efficacy of these modalities. Moreover, wide variability exists in reported outcomes among published studies.
Topics: Age Factors; Aged; Aged, 80 and over; Aging; Auditory Perception; Female; Fibroblast Growth Factor 2; Follow-Up Studies; Humans; Injections; Laryngoplasty; Male; Phonation; Quality of Life; Treatment Outcome; Voice; Voice Disorders
PubMed: 32409162
DOI: 10.1016/j.amjoto.2020.102532 -
Logopedics, Phoniatrics, Vocology Jul 2021Unilateral vocal folds paralysis is a disorder that affects a patient's quality-of-life by disturbing their phonation, breathing, and swallowing activities. This... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Unilateral vocal folds paralysis is a disorder that affects a patient's quality-of-life by disturbing their phonation, breathing, and swallowing activities. This systematic review aimed to estimate the efficacy of voice treatment on the vocal fold motility in adult patients with unilateral vocal folds paralysis.
METHODS
PubMed, CINAHL, CENTRAL, and Web of Science were searched for retrospective and prospective cohort, case-control, and cross-sectional with comparative studies with adults that were published between 1 January 2008 to 31 December 2018. After applying the inclusion and exclusion criteria a total of 10 studies containing morpho-functional evaluation results were included in the analysis. Pooled data analysis of the motility of the vocal folds before and after voice therapy allowed inferring about the efficacy of voice therapy intervention in patients with unilateral vocal folds paralysis. A random-effect model was used to estimate the effect size. Publication bias was considered.
RESULTS
The pooled data analysis of the visual-perceptual measures revealed that vocal fold motility improved in 72% (95% CI: 64.0-80.0) of all patients after the therapeutic interventions. The inconsistency index ( = 18.35%) of the studies included in this meta-analysis revealed an extremely low heterogeneity. Funnel plot and Cochran's Q test showed no publication bias. The systematic review was limited to only English language articles.
CONCLUSION
This meta-analysis supports the evidence that voice therapy intervention can have a positive effect on the vocal fold motility, that is, they can improve the glottal gap closure, irrespective of the exercises and techniques used.
Topics: Adult; Cross-Sectional Studies; Humans; Language Therapy; Outcome Assessment, Health Care; Prospective Studies; Retrospective Studies; Speech; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 32406287
DOI: 10.1080/14015439.2020.1762730