Laryngeal Symptoms in Weightlifting Athletes.

OBJECTIVES: A preliminary investigation to explore (1) the influence of different exercise conditions on the prevalence and nature of reported sensory and auditory-perceptual voice symptoms, and (2) whether type of self-reported laryngeal behaviors used during weightlifting are related to report of laryngeal symptoms in weightlifting athletes. STUDY DESIGN: Prospective self-completion questionnaire design. METHODS: A total of 89 people (36 males, 53 females) who self-identified as individuals who regularly partook in exercise completed a self-report questionnaire administered using Qualtrics software. RESULTS: Weightlifting was part of 78.7% (n = 70/89) of participants' workout routine. Nearly half (46%, n = 12/26) of self-identified weightlifting athletes reported suffering from at least one laryngeal symptom (throat pain, change in voice, or globus sensation), which was significantly higher (P= 0.008) than that reported by the cardiovascular group (14%, n = 4/29). The most prevalent laryngeal symptom reported by 25.3% (n = 17) of participants after weightlifting was the presence of a globus sensation (ie, the feeling of something stuck in their throat). Throat pain after heavy lifting and a change in voice quality after weightlifting was reported by 22.9% (n = 16) and 11.4% (n = 8) of participants respectively. There were no significant differences (P> 0.05) between reported laryngeal symptoms and the self-reported laryngeal behaviors used during weightlifting (ie, breath hold during the lift, simultaneous release of breath during the lift, or grunting/yelling during the lift). CONCLUSIONS: As weightlifting increases in popularity, many participants may find themselves experiencing throat pain or hoarseness after heavy lifts. Whilst a particular cause of these symptoms in weightlifters cannot be identified from this study, the reported presence of pain, globus sensation, and change in voice by this group indicates the need for further research.

Perceived Desirability of Vocal Fry Among Female Speech Communication Disorders Graduate Students.

Twenty-three female Speech Communication Disorders (SCD) graduate students rated the desirability of 25 adjectives used to describe perceived speaker's affect (including attitude, emotion, etc). A three-point weighted scale-desirable = 3, in-between = 2, and undesirable = 1-was used and a "desirability score" was calculated for each of these adjectives. Afterward, students were asked to use these adjectives to describe the perceived communication affect of female speakers with voices characterized by "vocal fry" as well as seven other vocal qualities (rough, breathy, strained, loud, high pitch, low pitch, and soft/weak). Proficiency of the students in identification of each of these eight voice qualities was determined before the survey. A desirability score for each voice quality, with a focus on vocal fry, was calculated by averaging the sum of the weighted counts for each adjective used to describe that vocal quality. RESULTS: Ten adjectives were rated as desirable (eg, cool), two were rated as in-between (eg, nonaggressive), and 13 were rated as undesirable (eg, vain). Thirty-two percent used only undesirable adjectives to describe vocal fry; 64% used a mixture of desirable, in-between, and undesirable; and 5% used only desirable adjectives and one in-between adjective. The relative order of the desirability scores of the vocal qualities was low pitch (2.13), high pitch (2.11), loud (1.89), vocal fry (1.82), breathy (1.77), soft/weak (1.68), rough (1.46), and strained (1.08). A vocal quality profile for each adjective was created. Vocal fry was the primary vocal quality associated with the adjectives vain (56%), apathetic/disinterested (48%), sleepy (38%), relaxed/chill (38%), and bored/unengaged (36%). CONCLUSIONS: SCD graduate student participants rated the desirability of 25 adjectives used to describe the perceived speaker's affect (including attitude, emotion, etc), and a "desirability score" was calculated for each. Afterward, they used these adjectives to describe the perceived communication affect of female speakers with voices characterized by vocal fry. Most participants were undecided, 30% perceived it as undesirable, and only 5% perceived it as desirable. The desirability scoring system and the adjectives used in this study add to the growing literature focusing on how different vocal qualities influence the listener's perception of the speaker's affect.

Validation of a quality-of-life instrument for laryngopharyngeal reflux.

OBJECTIVES: To establish the reliability, validity, and responsiveness of a new, disease-specific assessment tool, the LPR-HRQL, which assesses patient-reported outcomes (PRO) with regard to health-related quality of life (HRQL) of patients with laryngopharyngeal reflux (LPR). DESIGN: A prospective, open-label, repeated-measures study. SETTING: Six centers in 4 states in the eastern United States. PATIENTS: Patients with LPR. INTERVENTIONS: Open-label treatment with 20 mg of omeprazole twice daily. Clinical and PRO HRQL data were collected. Several PRO instruments were administered to patients at each of several time points; these instruments included the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), a general HRQL tool; the Voice Handicap Index (VHI), a symptom-specific tool for assessing voice problems; and the QOLRAD instrument (Quality of Life in Reflux and Dyspepsia), used to assess the impact of gastroesophageal reflux disease. RESULTS: Factor analyses of the LPR-HRQL scales confirmed single dimensions for each. All LPR-HRQL items contributed to internal consistency of scales and had substantial variability permitting useful information. Substantial evidence of convergent and divergent validity with SF-36, VHI, and QOLRAD items was observed. Test-retest validity was adequate for the time interval tested. Changes in domain scores of the LPR-HRQL at 4 and 6 months documented its responsiveness. CONCLUSIONS: The LPR-HRQL displays reliability, validity, and responsiveness, has face validity, and is simple and not burdensome to administer, score, and analyze. Accordingly, it may be used to assist physicians and patients in understanding the HRQL burden of LPR and the impact of therapy.

The impact of laryngopharyngeal reflux on patient-reported quality of life.

OBJECTIVES/HYPOTHESIS: The objectives were to assess patient-reported outcomes, specifically, the health-related quality of life of patients with laryngopharyngeal reflux, and to compare those reported levels with the health-related quality of life of patients with gastroesophageal reflux disease and a general population. STUDY DESIGN: Prospective study. METHODS: As part of a prospective study to validate a health-related quality of life instrument for laryngopharyngeal reflux, patient-reported data were collected before the initiation of therapy. Use of the Short Form-36 (SF-36), a generic instrument, allowed the health-related quality of life of the patients with laryngopharyngeal reflux to be compared with benchmarks existing for patients with gastroesophageal reflux disease and a general U.S. population. RESULTS: The 117 patients with laryngopharyngeal reflux often reported multiple symptoms, most frequently, chronic throat-clearing (85.5%), globus (82.1%), and hoarseness (80.3%). Their mean health-related quality of life was statistically significantly worse than that of a general U.S. population in seven of the eight SF-36 domains. The most dramatic differences between patients with laryngopharyngeal reflux and the general population were in social functioning and bodily pain (P <.001). Mean scores for patients with laryngopharyngeal reflux were significantly lower than those for patients with gastroesophageal reflux disease in social functioning (P <.001) and vitality (P =.0017). In five of the six remaining domains, patients with laryngopharyngeal reflux reported lower mean scores than did patients with gastroesophageal reflux disease, but those differences were not statistically significant. CONCLUSION: The study's assessment of health-related quality of life suggests that laryngopharyngeal reflux has a significant negative impact on the lives of patients. Although its impact is similar in some respects to that of gastroesophageal reflux disease, laryngopharyngeal reflux has a more significant impact on patients' social functioning and vitality.

Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis.

OBJECTIVES/HYPOTHESIS: Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed. STUDY DESIGN: Prospective clinical trial. METHODS: Forty-two consecutive, nonsmoking patients with one or more reflux laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24-hour, dual-sensor pH probe testing. Twenty-nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, "lump-in-throat" sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interarytenoid irregularity. RESULTS: Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes). CONCLUSIONS: Throat clearing was the most intense symptom in the present group of patients with proven reflux laryngitis. Dual-sensor pH probe testing could not predict the severity of patient's reflux laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.