scholarly journals Vocal warm-up and breathing training for teachers: randomized clinical trial

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Lílian Paternostro de Pina Pereira ◽  
Maria Lúcia Vaz Masson ◽  
Fernando Martins Carvalho
Keyword(s):  
Clinical Trial ◽  
Speech Therapy ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Upper Respiratory Tract ◽  
Warm Up ◽  
Breathing Training ◽  
Before And After ◽  
Tract Infections ◽  
The Voice

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality.METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists.RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group.CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up.TRIAL RECORD NCT02102399, “Vocal Warm-up and Respiratory Muscle Training in Teachers”.

Impact of speech therapy on the improvement of voice quality in patients with unilateral vocal fold paralysis

2018 ◽  
Vol 7 (4) ◽  
pp. 1-7
Author(s):  
Anna Kuligowska ◽  
Barbara Jamróz ◽  
Joanna Chmielewska ◽  
Katarzyna Jędra ◽  
Tomasz Czernicki ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Acoustic Analysis ◽  
Vocal Tract ◽  
Voice Quality ◽  
Maximum Phonation Time ◽  
Before And After ◽  
Vocal Fold Palsy ◽  
The Voice

Aim of study: Evaluation of the speech therapy on voice quality in patients with unilateral vocal fold palsy. Material and methods: The study group included 11 patients, 8 women and 3 men, in age between 16 to 72 years, with unilateral vocal fold palsy, diagnosed in ENT Department of Warsaw Medical University between 2017-2018. Each person completed questionnaires: the voice disability self-assessment scale (VHI), the voice-based quality of life (VRQoL) scale, the vocal tract discomfort scale (VTD). All questionnaires were completed twice, before and after the voice therapy. In addition, the acoustic analysis of the voice, the assessment of the maximum phonation time and the breathing tract were performed twice in each patient. Each of the patients had a voice rehabilitation consisting of a series of 10 meetings. Results: Statistical analysis of the results of maximum phonation time, the self-assessment of voice disability, the quality of life depending on the voice, discomfort of the vocal tract voice acoustic analysis showed statistically significant differences in the results before and after rehabilitation (p <0.005). In addition, the improvement of the respiratory tract was observed in the majority of patients. Conclusions: Speech therapy significantly affects the voice quality of patients with unilateral laryngeal nerve palsy.

scholarly journals A Comparison of Quality of Life in Adults With Voice Disorders Before and After Voice Therapy

2019 ◽  
Vol 42 (2) ◽  
pp. 30-37
Author(s):  
Tipwaree Aueworakhunanan ◽  
Kalyanee Makarabhirom ◽  
Dechavudh Nityasuddhi
Keyword(s):  
Quality Of Life ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Voice Disorders ◽  
Voice Handicap Index ◽  
Voice Therapy ◽  
Therapy Program ◽  
Before And After ◽  
The Voice

Background: Previous studies have documented the effectiveness of voice therapy in terms of voice quality outcomes rather than quality of life outcomes. Objective: To compare the quality of life among patients with voice disorders, before and after voice therapy. Methods: Thirty-six patients with voice disorders who visited the Speech Clinic at Ramathibodi Hospital from March 2013 to January 2015 were enrolled. Thirty minutes per session within 10 weeks period of voice therapy program were used. The voice therapy approaches included direct and indirect therapy. The outcomes of this study were measured using Dr. Speech software version 5 for acoustic analysis and the Voice Handicap Index in Thai version for quality of life. Data was analyzed by descriptive and inferential statistics (Paired t test). Results: The total participants were 36 patients with a mean age of 51.31 years. They were divided to 4 groups according to the causes of voice disorders that were 18 patients for structural cause, 8 patients for functional cause, 6 patients for neurological cause, and 4 patients for inflammatory cause. The results for both voice quality and quality of life after voice therapy improved and showed statistically significant differences (P < .05). The patients with all causes of voice disorders were statistically significant differences in total the Voice Handicap Index scores (P < .05). Moreover the structural causes group exhibited statistically significant differences in all subscales (P < .05) but the others causes groups were not statistically significant differences in emotional subscale for functional causes, physical subscale for neurological causes, and functional subscale for inflammatory cause (P > .05) Conclusions: Voice therapy might be an effective treatment to decrease the severity of voice disorders in role of voice quality and quality of life, especially voice disorders from structural causes.

scholarly journals Inappropriate Azithromycin Use in Nine Primary-Care Clinics Before and After Implementation of Provider Guidance in the EMR

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s293
Author(s):  
Alexandria May ◽  
Allison Hester ◽  
Kristi Quairoli ◽  
Sheetal Kandiah
Keyword(s):  
Primary Care ◽  
Retrospective Chart Review ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Targeted Interventions ◽  
Primary Care Clinics ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Background: According to the CDC Core Elements of Outpatient Stewardship, the first step in optimizing outpatient antibiotic use the identification of high-priority conditions in which antibiotics are commonly used inappropriately. Azithromycin is a broad-spectrum antimicrobial commonly used inappropriately in clinical practice for nonspecific upper respiratory infections (URIs). In 2017, a medication use evaluation at Grady Health System (GHS) revealed that 81.4% of outpatient azithromycin prescriptions were inappropriate. In an attempt to optimize outpatient azithromycin prescribing at GHS, a tool was designed to direct the prescriber toward evidence-based therapy; it was implemented in the electronic medical record (EMR) in January 2019. Objective: We evaluated the effect of this tool on the rate of inappropriate azithromycin prescribing, with the goal of identifying where interventions to improve prescribing are most needed and to measure progress. Methods: This retrospective chart review of adult patients prescribed oral azithromycin was conducted in 9 primary care clinics at GHS between February 1, 2019, and April 30, 2019, to compare data with that already collected over a 6-month period in 2017 before implementation of the antibiotic prescribing guidance tool. The primary outcome of this study was the change in the rate of inappropriate azithromycin prescribing before and after guidance tool implementation. Appropriateness was based on GHS internal guidelines and national guidelines. Inappropriate prescriptions were classified as inappropriate indication, unnecessary prescription, excessive or insufficient treatment duration, and/or incorrect drug. Results: Of the 560 azithromycin prescriptions identified during the study period, 263 prescriptions were included in the analysis. Overall, 181 (68.8%) of azithromycin prescriptions were considered inappropriate, representing a 12.4% reduction in the primary composite outcome of inappropriate azithromycin prescriptions. Bronchitis and unspecified upper respiratory tract infections (URI) were the most common indications where azithromycin was considered inappropriate. Attending physicians prescribed more inappropriate azithromycin prescriptions (78.1%) than resident physicians (37.0%) or midlevel providers (37.0%). Also, 76% of azithromycin prescriptions from nonacademic clinics were considered inappropriate, compared with 46% from academic clinics. Conclusions: Implementation of a provider guidance tool in the EMR lead to a reduction in the percentage of inappropriate outpatient azithromycin prescriptions. Future targeted interventions and stewardship initiatives are needed to achieve the stewardship program’s goal of reducing inappropriate outpatient azithromycin prescriptions by 20% by 1 year after implementation.Funding: NoneDisclosures: None

scholarly journals Optimising outcome assessment of voice interventions, II: sensitivity to change of self-reported and observer-rated measures

2007 ◽  
Vol 122 (1) ◽  
pp. 46-51 ◽  
Author(s):  
I N Steen ◽  
K MacKenzie ◽  
P N Carding ◽  
A Webb ◽  
I J Deary ◽  
...  
Keyword(s):  
General Health ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Effect Sizes ◽  
Voice Therapy ◽  
Vocal Performance ◽  
Symptom Scale ◽  
Wide Range ◽  
The Voice ◽  
Responsiveness To Change

AbstractObjectives:A wide range of well validated instruments is now available to assess voice quality and voice-related quality of life, but comparative studies of the responsiveness to change of these measures are lacking. The aim of this study was to assess the responsiveness to change of a range of different measures, following voice therapy and surgery.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics.Participants:One hundred and forty-four patients referred for treatment of benign voice disorders, 90 undergoing voice therapy and 54 undergoing laryngeal microsurgery.Main outcome measures:Three measures of self-reported voice quality (the vocal performance questionnaire, the voice handicap index and the voice symptom scale), plus the short form 36 (SF 36) general health status measure and the hospital anxiety and depression score. Perceptual, observer-rated analysis of voice quality was performed using the grade–roughness–breathiness–asthenia–strain scale. We compared the effect sizes (i.e. responsiveness to change) of the principal subscales of all measures before and after voice therapy or phonosurgery.Results:All three self-reported voice measures had large effect sizes following either voice therapy or surgery. Outcomes were similar in both treatment groups. The effect sizes for the observer-rated grade–roughness–breathiness–asthenia–strain scale scores were smaller, although still moderate. The roughness subscale in particular showed little change after therapy or surgery. Only small effects were observed in general health and mood measures.Conclusion:The results suggest that the use of a voice-specific questionnaire is essential for assessing the effectiveness of voice interventions. All three self-reported measures tested were capable of detecting change, and scores were highly correlated. On the basis of this evaluation of different measures' sensitivities to change, there is no strong evidence to favour either the vocal performance questionnaire, the voice handicap index or the voice symptom scale.

scholarly journals The voice quality of sports coaches

Logopedija ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Anđela Bučević ◽  
Ana Bonetti ◽  
Luka Bonetti
Keyword(s):  
Voice Quality ◽  
Training Session ◽  
Acoustic Method ◽  
Male And Female ◽  
Significant Difference ◽  
Before And After ◽  
Sports Coaches ◽  
The Voice ◽  
Female Coaches

The aim of this research paper was to examine the voice quality of sports coaches using the objective (acoustic) method. A total of 28 sports coaches (mean age 28.58, SD=5.08), from the City of Zagreb participated in this research. Recordings of the phonation of the vowel /a/ before and after one training session were obtained and analyzed using the PRAAT Program. Mean, minimal and maximal values of fundamental frequency, shimmer, jitter and harmonics-to-noise ratio were observed. The statistical analyses showed no statistically significant difference in acoustic voice quality of male and female coaches before and after the training session, or between male and female coaches. However, intra-individual differences among participants were observed, which may be significant in terms of their potential to affect the quality of their voices in the future.

scholarly journals Voice re-education and its evaluation through digital signal processing: A case study

Loquens ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 040
Author(s):  
Zulema Santana-López ◽  
Óscar Domínguez-Jaén ◽  
Jesús B. Alonso ◽  
María Del Carmen Mato-Carrodeguas
Keyword(s):  
Voice Quality ◽  
Quality Measurement ◽  
Digital Signal ◽  
Communication Process ◽  
Time Frequency ◽  
Voice Signal ◽  
Functional Dysphonia ◽  
Before And After ◽  
Voice Pathologies ◽  
The Voice

Voice pathologies, caused either by functional dysphonia or organic lesions, or even by just an inappropriate emission of the voice, may lead to vocal abuse, affecting significantly the communication process. The present study is based on the case of a single patient diagnosed with myasthenia gravis (Erb-Goldflam syndrome). In this case, this affection has caused, among other disruptions, a dysarthria. For its treatment, a technique for the education and re-education of the voice has been used, based on a resonator element: the cellophane screen. This article shows the results obtained in the patient after applying a vocal re-education technique called the Cimardi Method: the Cellophane Screen, which is a pioneering technique in this field. Changes in the patient’s voice signal have been studied before and after the application of the Cimardi Method in different domains of study: time-frequency, spectrum, and cepstrum. Moreover, parameters for voice quality measurement, such as shimmer, jitter and harmonic-to-noise ratio (HNR), have been used to quantify the results obtained with the Cimardi Method. Once the results were analyzed, it has been observed that the Cimardi Method helps to produce a more natural and free vocal emission, which is very useful as a rehabilitation therapy for those people presenting certain vocal disorders.

S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P136-P136
Author(s):  
Faustino Nunez ◽  
Maria Jesus Caminero ◽  
Jose-Luis Llorente-Pendas ◽  
Carlos Suarez-Nieto
Keyword(s):  
Laser Surgery ◽  
Voice Quality ◽  
Well Being ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Subjective Analysis ◽  
Maximum Phonation Time ◽  
Self Evaluation ◽  
The Voice

Objectives 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. Methods We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. Results Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p < 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p < 0,005). No significant differences were found in the physical scales. Conclusions There is a reduced impact in patient's perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy.

Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls

2019 ◽  
Vol 47 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Johannes C. Nossent ◽  
Warren Raymond ◽  
Helen Keen ◽  
David B. Preen ◽  
Charles A. Inderjeeth
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Serious Infection ◽  
Serious Infections ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Objective.Clinical data suggest that infections can trigger IgA vasculitis (IgAV), but longterm observations are lacking. We compared rates, types, and microorganisms for serious infection before and after diagnosis for children with IgAV and non-exposed controls.Methods.Using population-based administrative linked health datasets we estimated incidence rates (IR) for serious infection per 1000 person-months for patients with IgAV (n = 504, age 5 yrs, 59.1% males) and controls matched for age, sex, and year of presentation (n = 1281, age 6 yrs, 66% males). Time zero (T0) was the date of IgAV diagnosis or equivalent date in controls, lookback (median 38 mos) was the period prior to T0, and followup (median 239 mos) was the period after T0.Results.During lookback, prevalence of serious infection was similar in patients with IgAV and controls (11.5% vs 9.5%, respectively), but patients with IgAV had a higher rate of upper respiratory tract infections [incidence rate ratio (IRR) 1.79; 95% CI 1.39–2.31] with shorter time between first serious infection and T0 (27 vs 43 mos; p = 0.02). During followup, patients were at a constant increased risk for serious infections (IRR 1.46, 95% CI 1.35–1.58). These rates were higher during followup: sepsis (IRR 12.6), pneumonia (IRR 6.19), upper respiratory tract infections (IRR 2.36), and skin infections (IRR 1.85). There was little overlap between patients with serious infections in the lookback and followup periods.Conclusion.In patients with childhood IgAV there is an increased longterm risk for a broader spectrum of infections, which is unrelated to serious infections prior to diagnosis or treatment. This suggests disease-specific factors may have a lasting effect on immune competence in childhood IgAV.

scholarly journals Quality of life in tongue cancer treated patients before and after speech therapy: a randomized clinical trial

2020 ◽  
Author(s):  
Jordana Balbinot ◽  
Caroline Santana Real ◽  
Cecília Corte de Melo ◽  
Sílvia Dornelles ◽  
Sady Selaimen da Costa
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Speech Therapy ◽  
Tongue Cancer ◽  
Before And After
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