ABSTRACT
In speech production research, talkers often perform a speech task several times per recording session with different speaking styles or in different environments. For example, Lombard speech studies typically have talkers speak in several different noise conditions. However, it is unknown to what degree simple repetition of a speech task affects speech acoustic characteristics or whether repetition effects might offset or exaggerate effects of speaking style or environment. The present study assessed speech acoustic changes over four within-session repetitions of a speech production taskset performed with two speaking styles recorded in separate sessions: conversational and clear speech. In each style, ten talkers performed a set of three speech tasks four times. Speaking rate, median fundamental frequency, fundamental frequency range, and mid-frequency spectral energy for read sentences were measured and compared across test blocks both within-session and between the two styles. Results indicate that statistically significant changes can occur from one repetition of a speech task to the next, even with a brief practice set and especially in the conversational style. While these changes were smaller than speaking style differences, these findings support using a complete speech set for training while talkers acclimate to the task and to the laboratory environment.
Subject(s)
Speech Perception , Speech , Acoustics , Noise/adverse effects , Speech IntelligibilityABSTRACT
INTRODUCTION: This study examined the immediate acoustic, auditory-perceptual, and self-perceptual effects of two semi-occluded vocal tract exercises (SOVTs): straw phonation and straw phonation into a cup of water, delivered in a remote setting. METHOD: Thirty-six participants (19 females and 17 males) completed a baseline battery of acoustic recordings, followed by one of two SOVTs, and an identical post-task battery. The procedure repeated itself to include the other SOVT. Participants were also asked to rate their self-perceived vocal effort and quality following each condition. Recordings were presented to three expert listeners for completion of auditory-perceptual analysis. RESULTS: Acoustically, a significant decrease in shimmer was noted following straw phonation. Auditory-perceptual analysis revealed a significant increase in the perception of strain following straw phonation into a cup of water. While no significant differences were found between SOVT tasks in self-perception of vocal effort, a significant increase in self-perception of vocal loudness was reported following straw phonation into a cup of water. CONCLUSION: SOVTs have a varied, yet significant short-term impact across acoustic, auditory-perceptual, and self-perceptual measures of voice production. Straw phonation provided consistently significant acoustic results, with nearly every variable improving to some degree. Results also support the notion that shimmer is an acoustic measure that is particularly susceptible to change following modest manipulation. These results, in addition to the auditory-perceptual and self-perceptual findings, have a direct impact on how SOVTs are being used clinically and may generalize to inform the way voice metrics are collected and analyzed.
Subject(s)
Speech Acoustics , Voice Quality , Voice Training , Humans , Female , Male , Adult , Young Adult , Self Concept , Phonation , Auditory Perception , Middle Aged , Vocal Cords/physiologyABSTRACT
PURPOSE: Considering the conceptual migration from vocal load and vocal loading to vocal demand and vocal demand response, this review of literature aimed to identify physiological explanations, reported measurements, and associated factors (vocal demands) reported in the literature when considering the phonatory response to a vocal demand. METHODS: A systematic review of literature, following the PRISMA Statement, was conducted using Web of Science, PubMed, Scopus, and ScienceDirect. Data were analyzed and presented in two parts. First, a bibliometric analysis, co-occurrence analysis, and content analysis were performed. Three criteria that got article inclusion were defined: (1) written in English, Spanish, and Portuguese; (2) published between 2009 and 2021; and (3) focused on vocal load and loading, vocal demand response, and voice assessment parameters. A total of 54 publications met the criteria and were included in this review. The second part included a conceptual framework based on the content analysis of three aspects of vocal demand response: (1) physiological explanations, (2) reported measurements, and (3) vocal demands. RESULTS AND CONCLUSION: As would be expected since vocal demand response is a relatively new term and not yet commonly used in literature when discussing way that the speakers respond to communicative scenarios, most of the studies reviewed (both historical and recent) still use the term of vocal load and vocal loading. Although there is a broad variety of literature discussing a wide range of vocal demands and voice parameters used to characterize the vocal demand response, results show that there is consistency across the studies. While vocal demand response is unique and intrinsic to the talker, associated factors that contribute to this response include both internal talker and external talker factors. Internal factors include muscle stiffness, viscosity in the phonatory system, vocal fold tissue damage, elevated sound pressure levels during occupational voice demands, extended periods of voice use, suboptimal body posture, difficulties in breathing technique, and sleep disturbances. Associated external factors include the working environment (noise, acoustics, temperature, humidity). In conclusion, although vocal demand response is intrinsic to the speaker, the speaker's response is affected by external vocal demands. However, due to the wide methods to evaluate vocal demand response, it has been difficult to establish its contribution to voice disorders in the general population and, specifically, among occupational voice users. This literature review identified commonly reported parameters and factors that may help clinicians and researchers define vocal demand response.
Subject(s)
Voice Disorders , Voice , Humans , Voice Quality , Voice/physiology , Phonation/physiology , Vocal CordsABSTRACT
This study compared acoustic and neural changes accompanying two treatments matched for intensive dosage but having two different treatment targets (voice or articulation) to dissociate the effects of treatment target and intensive dosage in speech therapies. Nineteen participants with Parkinsonian dysphonia (11 F) were randomized to three groups: intensive treatment targeting voice (voice group, n = 6), targeting articulation (articulation group, n = 7), or an untreated group (no treatment, n = 6). The severity of dysphonia was assessed by the smoothed cepstral peak prominence (CPPS) and neuronal changes were evaluated by cerebral blood flow (CBF) recorded at baseline, posttreatment, and 7-month follow-up. Only the voice treatment resulted in significant posttreatment improvement in CPPS, which was maintained at 7 months. Following voice treatment, increased activity in left premotor and bilateral auditory cortices was observed at posttreatment, and in the left motor and auditory cortices at 7-month follow-up. Articulation treatment resulted in increased activity in bilateral premotor and left insular cortices that were sustained at a 7-month follow-up. Activation in the auditory cortices and a significant correlation between the CPPS and CBF in motor and auditory cortices was observed only in the voice group. The intensive dosage resulted in long-lasting behavioral and neural effects as the no-treatment group showed a progressive decrease in activity in areas of the speech motor network out to a 7-month follow-up. These results indicate that dysphonia and the speech motor network can be differentially modified by treatment targets, while intensive dosage contributes to long-lasting effects of speech treatments.
Subject(s)
Dysphonia , Parkinson Disease , Dysphonia/diagnostic imaging , Dysphonia/etiology , Dysphonia/therapy , Humans , Parkinson Disease/complications , Parkinson Disease/therapy , Speech , Speech Acoustics , Voice QualityABSTRACT
OBJECTIVE: Establish objective and subjective speech rate and muscle function differences between athletes with and without sports related concussion (SRC) histories and provide potential motor speech evaluation in SRC. METHODS: Over 1,110 speech samples were obtained from 30, 19-22 year-old athletes who had sustained an SRC within the past 2 years and 30 pair-wise matched control athletes with no history of SRC. Speech rate was measured via average time per syllable, average unvoiced time per syllable, and expert perceptual judgment. Speech muscle function was measured via surface electromyography over the obicularis oris, masseter, and segmental triangle. Group differences were assessed using MANOVA, bootstrapping and predictive ROC analyses. RESULTS: Athletes with SRC had slower speech rates during DDK tasks than controls as evidenced by longer average time per syllable longer average unvoiced time per syllable and expert judgment of slowed rate. Rate measures were predictive of concussion history. Further, athletes with SRC required more speech muscle activation than controls to complete DDK tasks. CONCLUSION: Clear evidence of slowed speech and increased muscle activation during the completion of DDK tasks in athletes with SRC histories relative to controls. Future work should examine speech rate in acute concussion.
Subject(s)
Athletic Injuries , Brain Concussion , Sports , Adult , Athletes , Athletic Injuries/complications , Brain Concussion/complications , Humans , Muscles , Speech , Young AdultABSTRACT
Occupational speech users such as schoolteachers develop voice disorders at higher rates than the general population. Previous research has suggested that room acoustics may influence these trends. The research reported in this paper utilized varying acoustical conditions in a reverberant room to assess the effects on vocal parameters of healthy talkers. Thirty-two participants were recorded while completing a battery of speech tasks under eight room conditions. Vocal parameters were derived from the recordings and the statistically significant effects of room acoustics were verified using mixed-model analysis of variance tests. Changes in reverberation time (T20), early decay time (EDT), clarity index (C50), speech transmission index (STI), and room gain (GRG) all showed highly correlated effects on certain vocal parameters, including speaking level standard deviation, speaking rate, and the acoustic vocal quality index. As T20, EDT, and GRG increased, and as C50 and STI decreased, vocal parameters showed tendencies toward dysphonic phonation. Empirically derived equations are proposed that describe the relationships between select room-acoustic parameters and vocal parameters. This study provides an increased understanding of the impact of room acoustics on voice production, which could assist acousticians in improving room designs to help mitigate unhealthy vocal exertion and, by extension, voice problems.
Subject(s)
Acoustics , Speech Acoustics , Voice/physiology , Absorption, Radiation , Dysphonia/physiopathology , Female , Humans , Male , Occupational Health , Phonation/physiology , Speech Production Measurement , Voice Quality/physiologyABSTRACT
Although vocal dosimeters are often used for long-term voice monitoring, the uncertainty of the quantities measured by these devices is not always stated. In this study, two common vocal dosimetry quantities, mean vocal sound pressure level and mean vocal fundamental frequency, were measured by four vocal dosimeters (VocaLog2, VoxLog, Voice Care, and APM3200). The expanded uncertainty of the mean error in the estimation of these two quantities as measured by the four dosimeters was performed by simultaneously comparing signals acquired through a reference microphone and the devices themselves. Dosimeters, assigned in random order, were worn by the participants (22 vocally healthy adults), along with a head-mounted microphone, which acted as a reference. For each device, participants produced a sustained /a/ vowel four times and then read a text with three different vocal efforts (relaxed, normal, and raised). The measurement uncertainty was obtained by comparing data from the microphone and the dosimeters. The mean vocal sound pressure level was captured the most accurately by the Voice Care and the VoxLog while the APM3200 was the least accurate. The most accurate mean vocal fundamental frequency was estimated by the Voice Care and the APM3200, while the VoxLog was the least accurate.
Subject(s)
Speech Acoustics , Speech Production Measurement/instrumentation , Voice Quality , Adult , Healthy Volunteers , Humans , Materials Testing , Phonation , Voice Disorders/diagnosisABSTRACT
Conversational speech produced in noise can be characterised by increases in intelligibility relative to such speech produced in quiet. Listening difficulty (LD) is a metric that can be used to evaluate speech transmission performance more sensitively than intelligibility scores in situations in which performance is likely to be high. The objectives of the present study were to evaluate the LD of speech produced in different noise and style conditions, to evaluate the spectral and durational speech modifications associated with these conditions, and to determine whether any of the spectral and durational parameters predicted LD. Nineteen subjects were instructed to speak at normal and loud volumes in the presence of background noise at 40.5 dB(A) and babble noise at 61 dB(A). The speech signals were amplitude-normalised, combined with pink noise to obtain a signal-to-noise ratio of -6 dB, and presented to twenty raters who judged their LD. Vowel duration, fundamental frequency and the proportion of the spectral energy in high vs low frequencies increased with the noise level within both styles. LD was lowest when the speech was produced in the presence of high level noise and at a loud volume, indicating improved intelligibility. Spectrum balance was observed to predict LD.
Subject(s)
Noise/adverse effects , Speech Acoustics , Speech Intelligibility , Speech Perception , Voice Quality , Acoustics , Adolescent , Adult , Female , Humans , Male , Sound Spectrography , Speech Production Measurement , Time Factors , Young AdultABSTRACT
The relationship between reverberation times and the voicing and silence accumulations of continuous speech was quantified in 22 primary-school teachers. Teachers were divided into a high and a low reverberation time groups based on their classroom reverberation time (higher and lower than 0.90 s). Reverberation times higher than 0.90 s implicate higher voicing accumulations and higher accumulations of the silences typical of turn taking in dialogue. These results suggest that vocal load, which can lead to vocal fatigue, is influenced by classroom reverberation time. Therefore, it may be considered a risk factor for occupational voice users.
ABSTRACT
OBJECTIVE: Previous research has concluded that teachers are at a higher-than-normal risk for voice issues that can cause occupational limitations. While some risk factors have been identified, there are still many unknowns. PATIENTS AND METHODS: A survey was distributed electronically with 506 female teacher respondents. The survey included questions to quantify three aspects of vocal fatigue as captured by the Vocal Fatigue Index (VFI): (1) general tiredness of voice (performance), (2) physical discomfort associated with voicing (pain), and (3) improvement of symptoms with rest (recovery). The effect of classroom capacity on US teachers' self-reported experience of vocal fatigue was analyzed. RESULTS: The results indicated that a classroom's capacity significantly affected teachers' reported amounts of vocal fatigue, while a teacher's age also appeared to significantly affect the reported amount of vocal fatigue. A quadratic rather than linear effect was seen, with the largest age effect occurring at around 40-45 years in all three factors of the VFI. CONCLUSION: Further factors which may affect vocal fatigue must be explored in future research. By understanding what increases the risk for vocal fatigue, educators and school administrators can take precautions to mitigate the occupational risk of short- and long-term vocal health issues in school teachers.
Subject(s)
Facility Design and Construction , Occupational Diseases/etiology , School Teachers , Schools , Teaching , Voice Disorders/etiology , Acoustics , Adult , Female , Humans , Middle Aged , Occupational Diseases/therapy , Pain/etiology , Rest , Risk Factors , Severity of Illness Index , Surveys and Questionnaires , Voice Disorders/therapy , Voice Quality , Young AdultABSTRACT
Speakers increase their vocal effort when their communication is disturbed by noise. This adaptation is termed the Lombard effect. The aim of the present study was to determine whether this effect has a starting point. Hence, the effects of noise at levels between 20 and 65 dB(A) on vocal effort (quantified by sound pressure level) and on both perceived noise disturbance and perceived vocal discomfort were evaluated. Results indicate that there is a Lombard effect change-point at a background noise level (Ln) of 43.3 dB(A). This change-point is anticipated by noise disturbance, and is followed by a high magnitude of vocal discomfort.
ABSTRACT
Vocal effort is a physiological measure that accounts for changes in voice production as vocal loading increases. It has been quantified in terms of sound pressure level (SPL). This study investigates how vocal effort is affected by speaking style, room acoustics, and short-term vocal fatigue. Twenty subjects were recorded while reading a text at normal and loud volumes in anechoic, semi-reverberant, and reverberant rooms in the presence of classroom babble noise. The acoustics in each environment were modified by creating a strong first reflection in the talker position. After each task, the subjects answered questions addressing their perception of the vocal effort, comfort, control, and clarity of their own voice. Variation in SPL for each subject was measured per task. It was found that SPL and self-reported effort increased in the loud style and decreased when the reflective panels were present and when reverberation time increased. Self-reported comfort and control decreased in the loud style, while self-reported clarity increased when panels were present. The lowest magnitude of vocal fatigue was experienced in the semi-reverberant room. The results indicate that early reflections may be used to reduce vocal effort without modifying reverberation time.
Subject(s)
Acoustics , Facility Design and Construction , Speech Acoustics , Voice Disorders/physiopathology , Voice Quality , Adolescent , Adult , Feedback, Sensory , Female , Humans , Male , Motion , Noise/adverse effects , Perceptual Masking , Reading , Signal Processing, Computer-Assisted , Sound , Speech Production Measurement , Time Factors , Vibration , Voice Disorders/diagnosis , Voice Disorders/prevention & control , Voice Disorders/psychology , Young AdultABSTRACT
CONTEXT: Many researchers have investigated the effectiveness of different cryotherapy agents at decreasing intramuscular tissue temperatures. However, no one has looked at the effectiveness of adding salt to an ice bag. OBJECTIVE: To compare the cooling effectiveness of different ice bags (wetted, salted cubed, and salted crushed) on cutaneous and intramuscular temperatures. DESIGN: Repeated-measures counterbalanced design. SETTING: University research laboratory. PARTICIPANTS: 24 healthy participants (13 men, 11 women; age 22.46 ± 2.33 y, height 173.25 ± 9.78 cm, mass 74.51 ± 17.32 kg, subcutaneous thickness 0.63 ± 0.27 cm) with no lower-leg injuries, vascular diseases, sensitivity to cold, compromised circulation, or chronic use of NSAIDs. INTERVENTIONS: Ice bags made of wetted ice (2000 mL ice and 300 mL water), salted cubed ice (intervention A; 2000 mL of cubed ice and 1/2 tablespoon of salt), and salted crushed ice (intervention B; 2000 mL of crushed ice and 1/2 tablespoon of salt) were applied to the posterior gastrocnemius for 30 min. Each participant received all conditions with at least 4 d between treatments. MAIN OUTCOME MEASURE: Cutaneous and intramuscular (2 cm plus adipose thickness) temperatures of nondominant gastrocnemius were measured during a 10-min baseline period, a 30-min treatment period, and a 45-min rewarming period. RESULTS: Differences from baseline were observed for all treatments. The wetted-ice and salted-cubed-ice bags produced significantly lower intramuscular temperatures than the salted-crushed-ice bag. Wetted-ice bags produced the greatest temperature change for cutaneous tissues. CONCLUSIONS: Wetted- and salted-cubed-ice bags were equally effective at decreasing intramuscular temperature at 2 cm subadipose. Clinical practicality may favor salted-ice bags over wetted-ice bags.
Subject(s)
Cryotherapy/instrumentation , Ice , Sodium Chloride , Female , Humans , Leg , Male , Muscle, Skeletal , Rewarming , Skin Temperature , Temperature , Time Factors , Young AdultABSTRACT
Speakers adjust their vocal effort when communicating in different room acoustic and noise conditions and when instructed to speak at different volumes. The present paper reports on the effects of voice style, noise level, and acoustic feedback on vocal effort, evaluated as sound pressure level, and self-reported vocal fatigue, comfort, and control. Speakers increased their level in the presence of babble and when instructed to talk in a loud style, and lowered it when acoustic feedback was increased and when talking in a soft style. Self-reported responses indicated a preference for the normal style without babble noise.
Subject(s)
Acoustics , Feedback, Sensory , Judgment , Noise/adverse effects , Perceptual Masking , Speech Acoustics , Speech Perception , Voice Quality , Adolescent , Adult , Facility Design and Construction , Humans , Motion , Pressure , Vibration , Young AdultABSTRACT
Accurate definitions of both passive and active tissue characteristics are important to laryngeal muscle modeling. This report tested the efficacy of a muscle model which added active stress components to an accurate definition of passive properties. Using the previously developed three-network Ogden model to simulate passive stress, a Hill-based contractile element stress equation was utilized for active stress calculations. Model input parameters were selected based on literature data for the canine cricothyroid muscle, and simulations were performed in order to compare the model behavior to published results for the same muscle. The model results showed good agreement with muscle behavior, including appropriate tetanus response and contraction time for isometric conditions, as well as accurate stress predictions in response to dynamic strain with activation.
Subject(s)
Laryngeal Muscles/physiology , Models, Biological , Muscle Contraction , Animals , Biomechanical Phenomena , Computer Simulation , Dogs , Elasticity , Laryngeal Muscles/anatomy & histology , Stress, Mechanical , ViscosityABSTRACT
BACKGROUND: Teachers rely heavily on their voices, making them susceptible to voice disorders affecting their teaching efficacy and well-being. This study explores the role of voice as a working tool for teachers and its impact on their professional lives, a necessary step in designing intervention points. METHODS: Using a phenomenological approach, we conducted qualitative interviews with 18 teachers (13 females, 5 males) from diverse backgrounds. They represented diverse teaching areas, grade levels, and school districts. Data were analyzed through content analysis. In this process, 52 codes were identified, totaling 753 code references. FINDINGS: This study uncovered insights into the role of voice as a working tool for teachers and its impact on their professional lives. In-depth analysis of the interviews with 18 teachers resulted in 6 key themes: (1) Voice is a crucial occupational tool for teachers for instruction, engagement, and classroom management; (2) working conditions significantly impact teachers' vocal health, with environmental factors and vocal load contributing to voice problems; (3) vocal health concerns are frequently reported by teachers, emphasizing the need for comprehensive health management strategies; (4) there are notable best practices and gaps in vocal care, with teachers expressing the need for more resources and formal training; (5) amplification devices play a significant role in sustaining teachers' vocal health, although access to and use of these tools is inconsistent; and (6) voice-related problems have a significant emotional and psychosocial impact on teachers, affecting their self-perception, professional identity, and well-being. DISCUSSION: This study highlights the critical role of vocal health in teachers' professional lives, revealing its impact on teaching efficacy, well-being, and professional identity. The findings highlight the need for comprehensive support systems, including vocal health programs, resources like amplification devices, and counseling for emotional impacts. The six identified themes emphasize the necessity of holistic interventions to enhance teachers' well-being and effectiveness.
ABSTRACT
BACKGROUND: Previous research has examined the correlation between certain personality traits and specific voice disorders. These studies indicated that a predictive relationship exists between an individual's personality and their likelihood of experiencing certain types of voice disorders. The personality type classified as "extravert" was most commonly correlated with voice problems associated with high vocal use such as inflammation or nodules. AIM: The purpose of this study was to determine if a relationship exists between self-reported vocal fatigue, demographic characteristics, such as assigned sex at birth and age, perception of current voice condition, aerodynamic measures, and voice acoustic parameters with any of the five personality traits measured by the Big Five Personality Index: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. We hypothesized that vocal fatigue scores and spirometry measurements may be good predictors of specific personality traits, and therefore, can be useful measures to complement vocal assessment. METHODS: Participants in this cross-sectional correlational study included 73 full-time elementary and middle school teachers. Participants completed the Vocal Fatigue Index (VFI) and the Big Five Inventory (BFI)-10 personality index; further, microphone recordings were collected from a battery of voice tasks in addition to spirometry. Descriptive analyzes of the dependent variables (BFI personality traits) and independent variables (demographics, acoustics, spirometry, and VFI total score) were performed, calculating frequency values. Kruskal-Wallis tests were conducted to evaluate independent variables' differences across the scores of the five BFI personality traits. The association between the independent and dependent variables was then investigated using a Generalized Estimating Equations multinomial logit model. The level of significance was defined at 0.05, and the associations are expressed as betas and standard error. RESULTS AND CONCLUSION: The results suggest that high scores for the traits of extraversion and agreeableness were both predicted by lower scores on the VFI (P ≤ 0.05), indicating that individuals with lower perception of vocal fatigue may be more likely to be identified as extraverted and/or agreeable personalities. These results support previous study's conclusion as well as add additional insights that could be translated into screening protocols and additional supportive care of occupational voice users.
ABSTRACT
This study was designed to determine whether participation in a single, 1-hour focus group would spur a change in health-related behavior. All the respondents were teachers who had participated in a focus group designed to learn about teachers' understanding that voice is a working tool. In the discussions, health-related behaviors were discussed as ways to deal with possible vocal strain or injury. Two months later, a follow-up survey was distributed to these participants asking them if they recalled the discussion and if they had sought out more information and/or had changed their vocal behavior due to their participation in the focus group. The qualitative data shows that the majority of these respondents both recalled the messages and had engaged in some type of health-related behavior change due to their participation in the focus group. Behavior change included such modifications as drinking more water and use of voice-amplification equipment in the classroom. Implications of this finding are discussed.
ABSTRACT
Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.
Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.
ABSTRACT
BACKGROUND: Individuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD. METHODS: 28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms. RESULTS: IwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals. CONCLUSIONS: IwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.