scholarly journals Role of Voice Therapy in Patients with Mutational Falsetto

2015 ◽  
Vol 5 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Raj Kumar ◽  
Alok Kumar Agrahari
Keyword(s):  
Acoustic Analysis ◽  
Voice Therapy ◽  
Voice Disorder ◽  
P Value ◽  
Perceptual Analysis ◽  
Emotional Component ◽  
Male Patients ◽  
The Voice ◽  
Post Therapy

ABSTRACT Background Mutational falsetto is the most common mutational voice disorder, found in all ages. Clinicians often miss this diagnosis due to unfamiliarity with the condition. The voice of a person with mutational falsetto is high pitched, weak, thin, breathy, hoarse and monopitched. Objective This study was carried out to evaluate the efficacy of voice therapy in persons with mutational falsetto. Methods Eleven male patients with ages between 18 and 26 years (mean age 22.18 years, SD 2.52) diagnosed with mutational falsetto underwent acoustical analysis using Praat Software, perceptual analysis using grade, roughness, breathiness, asthenia and strain (GRBAS) scale and psychosocial analysis using emotional component of voice handicap index (VHI). All the components were analyzed pre- and postvoice therapy. Results Improvement in acoustic analysis parameters was statistically significant with p-value less than 0.0001(pretherapy mean of fundamental frequency (F0) was 217.45 with SD 8.68, whereas post-therapy mean of F0 was 127.50 with SD 5.32). Significant improvement in perceptual analysis was seen post-therapy on GRBAS scale. Improvement in psychosocial aspect was also statistically significant with p-value less than 0.0001 (pre-therapy mean 26.18, SD 1.72 post-therapy mean 7, SD 1.15). Conclusion Voice therapy plays an important role in lowering F0 and alleviation mental agony of the patients with mutational falsetto. How to cite this article Varma A, Agrahari AK, Kumar R, Kumar V. Role of Voice Therapy in Patients with Mutational Falsetto. Int J Phonosurg Laryngol 2015;5(1):25-27

PSYCHOGENIC VOICE DISORDER: A VIEW THROUGH THE LENS OF SELF

2015 ◽  
Vol 3 (2) ◽  
pp. 206
Author(s):  
Margaret Jacobs ◽  
Leo Van Biene
Keyword(s):  
Psychological Factors ◽  
Speech Therapy ◽  
Sense Of Self ◽  
Voice Disorder ◽  
Conscious Awareness ◽  
Psychotherapeutic Intervention ◽  
Relational Trauma ◽  
Dissociative Processes ◽  
The Voice

Patients with psychogenic voice disorder (PVD), a disorder of voice in the absence of identifiable pathology, present a particular challenge to clinicians. Although the voice can usually be restored by the use of speech therapy, recurrences can only be prevented by psychotherapeutic intervention. Psychological factors have been long recognized as playing a role in these disorders, but the nature of this contribution has been unclear. Various conceptual frameworks have been used to understand this disorder. While for much of the last century, “conversion” has been seen as the primary process that underpins this disorder, little attention has been paid to the role of dissociation in this regard. This paper explores the utility of viewing PVD through a lens of Self. In so doing, PVD can be considered as a symptomatic expression of a compromised sense of Self which has its genesis in relational trauma and maladaptative defensive maneuvers. These are underpinned by complex dissociative processes which operate largely outside of conscious awareness. A clinical vignette demonstrates the utility of treating this disorder with both speech therapy techniques and a specific mode of psychotherapy, the Conversational Model, which is focused on the fostering of a sense of Self.  It will be shown that this perspective not only provides a clear view of the genesis of thisdisorder, but also describes a pathway for effective treatment.

Effects of antituberculosis treatment on self assessment, perceptual analysis and acoustic analysis of voice quality in laryngeal tuberculosis patients

2008 ◽  
Vol 122 (4) ◽  
pp. 378-382 ◽  
Author(s):  
K Yelken ◽  
M Guven ◽  
M Topak ◽  
E Gultekin ◽  
F Turan
Keyword(s):  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Folds ◽  
Median Score ◽  
Self Assessment ◽  
Tuberculosis Patients ◽  
Perceptual Analysis ◽  
Antituberculosis Treatment ◽  
The Voice ◽  
Laryngeal Tuberculosis

AbstractObjectives:To evaluate the effects of antituberculosis treatment on the voice quality of laryngeal tuberculosis patients, measured by patient self-assessment, perceptual analysis and acoustic analysis.Materials and methods:A total of 14 laryngeal tuberculosis patients were enrolled. Laryngeal tuberculosis was established either by biopsy and histopathological examination or by rapid regression of the laryngeal lesions after antituberculosis medication. Before and after treatment, all patients were evaluated perceptually (on a scale of zero to three), and 12 assessed their own voices using the voice handicap index-10 scale. Acoustic analysis was performed to allow objective evaluation.Results:Patients' ages ranged from 21 to 72 years (mean, 41). The male to female ratio was 12:2. Eight patients (57 per cent) had tuberculous involvement of the epiglottis, four (28 per cent) had involvement of the aryepiglottic fold and eight (57 per cent) had involvement of the false vocal folds. The glottis was the less commonly involved part of the larynx, including true vocal folds (28 per cent, n = 4) and posterior commissure (14 per cent, n = 2). Perceptual evaluation, on a scale of zero to three, gave the patients a median score of six; after commencement of treatment, the median score decreased to two. The mean voice handicap index-10 score decreased from 24 to 12 after treatment. An obvious improvement in acoustic analytical parameters was also found following treatment.Conclusions:Antituberculosis treatment clearly improved the voice outcomes of laryngeal tuberculosis patients, according to self-assessment, perceptual analysis and acoustic analysis.

scholarly journals Acoustic Analysis Before and After Voice Therapy for Laryngeal Pathology

2017 ◽  
Vol 13 (4) ◽  
pp. 323-327 ◽  
Author(s):  
S.S. Chhetri ◽  
R. Gautam
Keyword(s):  
Acoustic Analysis ◽  
Alternative Therapy ◽  
Vocal Folds ◽  
Objective Evaluation ◽  
Voice Therapy ◽  
Good Effect ◽  
Acoustic Parameters ◽  
Significant Difference ◽  
Before And After ◽  
The Voice

Background Voice problems caused by pathologies in vocal folds are well known. Some types of laryngeal pathologies have certain acoustic characteristics. Objective evaluation helps characterize the voice and voice problems providing supporting evidences, severity of disorders. It helps assess the response to the treatment and measures the outcomes.Objective The objective of the study is to determine the effectiveness of the voice therapy and quantify the results objectively by voice parameters.Method Study includes 61 patients who presented with different types of laryngeal pathologies. Acoustic analyses and voice assessment was done with Dr. Speech ver 4 (Tiger DRS Inc.). Acoustic parameters including fundamental frequency, jitters, shimmers, Harmonic to noise ratio (HNR), Normalized noise energy (NNE) were analyzed before and after voice therapy.Result Bilateral vocal nodules were the most common pathologies comprising 44.26%. All acoustic parameters showed a significant difference after the therapy (p<0.05) except for NNE. Dysphonia due to vocal fold polyp showed no improvement even after voice therapy (p>0.05).Conclusion Acoustic analysis provides an objective, recordable data regarding the voice parameters and its pathologies. Though, few pathology require alternative therapy rather than voice therapy, overall it has a good effect on glottic closure. As the voice therapy can improve the different indices of voice, it can be viewed as imperative part of treatment and to monitor progression.

scholarly journals Effects of a conservative in-patient voice treatment on the voice-related self-concept

2021 ◽  
Author(s):  
Bernhard Lehnert ◽  
Manfred Nusseck ◽  
Fei Lu ◽  
Annerose Keilmann
Keyword(s):  
Short Form ◽  
Voice Therapy ◽  
Self Concept ◽  
Voice Rehabilitation ◽  
Voice Treatment ◽  
Patient Voice ◽  
Male Patients ◽  
Missing Items ◽  
The Relationship ◽  
The Voice

Abstract Purpose Observational study to determine if the voice-related self-concept as measured via the Fragebogen zur Erfassung des Stimmlichen Selbstkonzepts FESS (questionnaire for the assessment of the voice self-concept) can be improved through in-patient voice therapy. Methods 234 female and 80 male patients that underwent an intensive 3- to 4-week in-patient voice treatment due to varying types of dysphonia. After imputation of missing items but not missing questionnaires, 255 patients were eligible for FESS evaluation, 313 for VHI-12 evaluation. The German questionnaire for the assessment of the voice self-concept (FESS) and the German 12-item short-form of the Voice Handicap Index (VHI-12) were administered at the beginning and at the end of the hospital stay. Before–after comparisons are made visually and via t test. Results The Voice Handicap was significantly reduced, demonstrating the effectiveness of the administered therapy. Of the three scales of the FESS, the relationship with one's own voice and the awareness of the use of one's own voice was increased and thus improved. The connection between voice and emotional changes decreased significantly but only slightly. Conclusion Conservative voice rehabilitation can not only reduce the voice handicap, but also improve the voice self-concept and the results can be measured.

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 Vocal therapy of hyperkinetic dysphonia

2014 ◽  
Vol 142 (11-12) ◽  
pp. 656-662
Author(s):  
Gordana Mumovic ◽  
Mila Veselinovic ◽  
Tanja Arbutina ◽  
Renata Skrbic
Keyword(s):  
Acoustic Analysis ◽  
Adult Patients ◽  
Voice Disorder ◽  
Acoustic Parameters ◽  
Noise Energy ◽  
Vocal Qualities ◽  
Normal Voice ◽  
Adults And Children ◽  
Vocal Professionals ◽  
The Voice

Introduction. Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01) reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p?0.025) in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (p<0.05). Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

The Patient's Opinion Regarding Different Service Delivery Models for Voice Therapy

2020 ◽  
Vol 29 (3) ◽  
pp. 1466-1474
Author(s):  
Iris Meerschman ◽  
Kristiane Van Lierde ◽  
Sofie Claeys ◽  
Evelien D'haeseleer
Keyword(s):  
Service Delivery ◽  
Individual Therapy ◽  
Voice Therapy ◽  
Voice Disorder ◽  
Short Term ◽  
Online Questionnaire ◽  
Service Delivery Models ◽  
The Voice ◽  
Delivery Models

Purpose The purpose of this study was to compare the voice patient's opinion regarding three service delivery models for voice therapy: a short-term intensive voice therapy with individual sessions (IVT-I), a short-term intensive voice therapy with group sessions (IVT-G), or a long-term traditional voice therapy with individual sessions (TVT). Method Forty-six adult voice patients who followed either IVT-I, IVT-G, or TVT were contacted by e-mail with the request to fill in an online questionnaire reviewing their opinion about the received therapy. Several items concerning satisfaction, progress, time-related variables, transfer, and need for further therapy were scored by means of visual analog scales. Participants were also asked whether or not they continued voice therapy after the study. Results There were no significant differences between the three groups regarding the patients' perception of vocal quality improvement, degree of resolution of the voice disorder, duration of one session, total therapy duration, degree of transfer, need for further therapy, and actual continuation of therapy. A higher satisfaction rate was found for patients of the IVT-I and TVT groups than patients of the IVT-G group. The IVT-I group rated the therapy as too frequent compared with the TVT group who rated the frequency as optimal. Conclusion Results suggest that patients are equally satisfied and perceive a similar progress after individual short-term intensive voice therapy and individual long-term traditional voice therapy. This finding creates flexibility in selecting time-related variables depending on the specific case and situation. Patients who received individual therapy were more satisfied than patients who received group therapy. Future larger scale investigation is needed to confirm these results.

Acoustic analysis of the voice in phonatory fistuloplasty after total laryngectomy

2000 ◽  
Vol 122 (5) ◽  
pp. 743-747 ◽  
Author(s):  
Mariano Rosique Arias ◽  
JosÉ Luis RamÓN ◽  
Matilde Campos ◽  
Juan JimÉNez Cervantes
Keyword(s):  
Total Laryngectomy ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Epidermoid Carcinoma ◽  
Esophageal Speech ◽  
Normal Voice ◽  
Carcinoma Of The Larynx ◽  
Male Patients ◽  
The Voice ◽  
Made In

A comparative study of the voice with sustained phonation of the vowel /a/ was made in 3 groups of male patients: (1) 20 patients receiving total laryngectomy for epidermoid carcinoma of the larynx who had acquired good voice quality after a phonatory fistuloplasty with a Herrmann voice prosthesis; (2) 20 patients undergoing total laryngectomy for epidermoid carcinoma of the larynx who had learned esophageal speech; and (3) 20 subjects with normal voices. Statistical analysis yielded significant differences in fundamental voice frequency between the 3 groups, with the patients with phonatory prostheses revealing the closest to a normal voice. For other parameters used, such as jitter, shimmer, and harmonics/noise ratio, voice quality with a phonatory prosthesis was similar to that obtained with esophageal speech.

scholarly journals Voice Disorder Detection via an m-Health System: Design and Results of a Clinical Study to Evaluate Vox4Health

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
Ugo Cesari ◽  
Giuseppe De Pietro ◽  
Elio Marciano ◽  
Ciro Niri ◽  
Giovanna Sannino ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Practice ◽  
Clinical Study ◽  
Health System ◽  
Acoustic Analysis ◽  
Machine Learning Techniques ◽  
Voice Disorder ◽  
Rule Based ◽  
Learning Techniques ◽  
The Voice

Objectives. The current study presents a clinical evaluation of Vox4Health, an m-health system able to estimate the possible presence of a voice disorder by calculating and analyzing the main acoustic measures required for the acoustic analysis, namely, the Fundamental Frequency, jitter, shimmer, and Harmonic to Noise Ratio. The acoustic analysis is an objective, effective, and noninvasive tool used in clinical practice to perform a quantitative evaluation of voice quality. Materials and Methods. A clinical study was carried out in collaboration with medical staff of the University of Naples Federico II. 208 volunteers were recruited (mean age, 44.2 ± 13.9 years), 58 healthy subjects (mean age, 36.7 ± 13.3 years) and 150 pathological ones (mean age, 47 ± 13.1 years). The evaluation of Vox4Health was made in terms of classification performance, i.e., sensitivity, specificity, and accuracy, by using a rule-based algorithm that considers the most characteristic acoustic parameters to classify if the voice is healthy or pathological. The performance has been compared with that achieved by using Praat, one of the most commonly used tools in clinical practice. Results. Using a rule-based algorithm, the best accuracy in the detection of voice disorders, 72.6%, was obtained by using the jitter or shimmer value. Moreover, the best sensitivity is about 96% and it was always obtained by using jitter. Finally, the best specificity was achieved by using the Fundamental Frequency and it is equal to 56.9%. Additionally, in order to improve the classification accuracy of the next version of the Vox4Health app, an evaluation by using machine learning techniques was conducted. We performed some preliminary tests adopting different machine learning techniques able to classify the voice as healthy or pathological. The best accuracy (77.4%) was obtained by the Logistic Model Tree algorithm, while the best sensitivity (99.3%) was achieved using the Support Vector Machine. Finally, Instance-based Learning performed the best specificity (36.2%). Conclusions. Considering the achieved accuracy, Vox4Health has been considered by the medical experts as a “good screening tool” for the detection of voice disorders in its current version. However, this accuracy is improved when machine learning classifiers are considered rather than the rule-based algorithm.

scholarly journals ACUTE DIARRHEA

2015 ◽  
Vol 22 (03) ◽  
pp. 281-284
Author(s):  
Farzana Shaikh ◽  
Sikandar Ali Bhand ◽  
Parkash Kumar ◽  
Mohammad Akbar Nizamani
Keyword(s):  
Acute Diarrhea ◽  
Respiratory Infections ◽  
Saccharomyces Boulardii ◽  
P Value ◽  
Case Group ◽  
Post Intervention ◽  
Loose Motion ◽  
Duration Of Hospitalization ◽  
Male Patients

Acute diarrhea is the fourth-ranking cause of death in children under the ageof 5 years. after neonatal causes, malaria, and acute respiratory infections. Objectives: Todetermine the role of Saccharomyces boulardii in the treatment of acute diarrhea. Design:Comparative study. Period: Six months, Mar to Aug 2013. Setting: Pediatric Unit II- LiaquatUniversity Hospital Jamshoro/ Hyderabad. Patients and methods: It consisted of 100 patients,of acute diarrhea with age between 3 months to 5 years reported to pediatric unit and fulfilledthe inclusion criteria. Cases were given low osmolar ORS, Zinc & Saccharomyces boulardii250mg twice daily for three days and controls were given low osmolar ORS and Zinc. P-value≤0.05 was considered as significant. Results: The results showed that 51 patients were maleand 49 patients were female. 27 male patients were in control and 24 were in case group. 23female patients were in control and 26 were in case group. The overall mean age of studysubjects was 26.73±12.65 months. Among reported patients most of the patients 84% werereported on 1st day. All reported patients had a complaint of loose motion with 73% also hadvomiting. All patients had watery loose motion. The mean duration was 4.20±1.70 days withthe mean frequency of 9.82±6.16 times. Among the patients 96 patients were hospitalized and97 patients were given I/V fluid. Among reported patients 10 were without dehyderation, 8 hadsome dehyderation, and 82 had severe dehyderation. 52 had acceptability of probiotics. Theresults were evaluated according to 1st, 2nd, and 3rd day post intervention. Among 50 patientsof case group, 18 patients were compliance. 49 patients had decrease in duration. The sameresults were observed in the decrease in frequency. Consistency was improved in 39 patients.The duration of hospitalization was reduced in 36 patients. It was observed that improvement inthe duration, frequency, and consistency was mostly observed on 2nd day of post intervention.Conclusions: The role of S. boulardii as a good biotherapeutic agent allowing to prevent and/ortreat several grastrointestinal diseases. In comparison to probiotic bacteria, the use of probioticyeast is beneficial when the treatment is combined to antibiotherapy.

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