Do body mass index and fat volume influence vocal quality, phonatory range, and aerodynamics in females?

PURPOSE: To analyze the impact of body weight and body fat volume on selected parameters of vocal quality, phonatory range, and aerodynamics in females. METHODS: Based on measurements of body mass index in combination with body fat volume, 29 normophonic female subjects were classified as normal weight, underweight, and obese. Voice quality was investigated via auditory-perceptual ratings of breathiness, roughness, and overall dysphonia severity, via various acoustic measures and a multiparametric index. Phonatory range performance was examined using selected measures of the voice range profile and speech range profile. Measures of vocally relevant aerodynamics included vital capacity (i.e., VC), expected VC, phonation quotient, and maximum phonation time (i.e., MPT). RESULTS: Significant differences between the three weight groups were found across several measures of intensity, VC, MPT, and shimmer. As compared to the other groups, significantly higher values of maximum and minimum intensity levels, as well as sound pressure level during habitual running speech were observed for the obese group (all p-values<0.05); whereas, the underweight group had significantly lower values for VC and ratio of expected to measured VC (p-values<0.01). Furthermore, underweight subjects differed significantly as compared to normal weight subjects with lower MPT (p=0.025) and higher lowest-F0 (p=0.035). Finally the obese group showed significantly lower shimmer values than the normal weight subjects (p<0.05). CONCLUSION: Body weight and body fat volume appear to influence select objective measures of voice quality, vocal aerodynamics, and phonatory range performance.

O índice de massa corporal e o volume de gordura influenciam a qualidade vocal, extensão fonatória e aerodinâmica em mulheres? / Do body mass index and fat volume influence vocal quality, phonatory range, and aerodynamics in females?

OBJETIVO: Analisar o impacto do peso corporal e do volume de gordura corporal sobre parâmetros selecionados de qualidade vocal, tessitura fonatória e aerodinâmica em indivíduos do sexo feminino. MÉTODOS: Com base em medidas de índice de massa corporal e volume de gordura corporal, 29 indivíduos do sexo feminino, de aparelhos fônicos normais, foram distribuídos em grupos de peso normal, abaixo da média e obesos. A qualidade vocal foi investigada por meio de classificações auditório-perceptivas de soprosidade, rugosidade e severidade de disfonia por meio de várias medidas acústicas e índice multiparamétrico. O desempenho da tessitura fonatória foi examinado por meio do uso de medidas selecionadas do perfil de extensão vocal e perfil de extensão discursiva. As medidas de aerodinâmica vocalmente relevantes incluíram capacidade vital (CV), CV esperada, coeficiente fonatório e tempo de fonação máximo (TFM). RESULTADOS: Diferenças significativas entre os três grupos foram encontradas em relação a várias medidas de intensidade, CV, TFM e shimmer. Em comparação com os outros grupos, valores significativamente maiores de níveis de intensidade máxima e mínima e nível de pressão sonora durante discurso habitual foram observados no grupo obeso (todos os valores de p<0,05); já o grupo abaixo do peso apresentou valores significativamente menores para CV e para a proporção de CV esperada em relação à CV medida (valores de p<0,01). Além disso, indivíduos abaixo do peso diferiram significativamente quando comparados a indivíduos de peso normal com TFM menor (p=0,025) e F0 menor mais elevada (p=0,035). Por fim, o grupo obeso apresentou valores de shimmer significativamente menores do que os indivíduos com peso normal (p<0,05). CONCLUSÃO: O peso corporal e o volume de gordura corporal parecem influenciar certas medidas objetivas de qualidade vocal, aerodinâmica vocal e desempenho de tessitura fonatória.

PURPOSE: To analyze the impact of body weight and body fat volume on selected parameters of vocal quality, phonatory range, and aerodynamics in females. METHODS: Based on measurements of body mass index in combination with body fat volume, 29 normophonic female subjects were classified as normal weight, underweight, and obese. Voice quality was investigated via auditory-perceptual ratings of breathiness, roughness, and overall dysphonia severity, via various acoustic measures and a multiparametric index. Phonatory range performance was examined using selected measures of the voice range profile and speech range profile. Measures of vocally relevant aerodynamics included vital capacity (i.e., VC), expected VC, phonation quotient, and maximum phonation time (i.e., MPT). RESULTS: Significant differences between the three weight groups were found across several measures of intensity, VC, MPT, and shimmer. As compared to the other groups, significantly higher values of maximum and minimum intensity levels, as well as sound pressure level during habitual running speech were observed for the obese group (all p-values<0.05); whereas, the underweight group had significantly lower values for VC and ratio of expected to measured VC (p-values<0.01). Furthermore, underweight subjects differed significantly as compared to normal weight subjects with lower MPT (p=0.025) and higher lowest-F0 (p=0.035). Finally the obese group showed significantly lower shimmer values than the normal weight subjects (p<0.05). CONCLUSION: Body weight and body fat volume appear to influence select objective measures of voice quality, vocal aerodynamics, and phonatory range performance.

Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity.

PURPOSE: Auditory-perceptual evaluation of dysphonia may be influenced by the type of speech/voice task used to render judgements during the clinical evaluation, i.e., sustained vowels versus continuous speech. This study explored (a) differences in listener dysphonia severity ratings on the basis of speech/voice tasks, (b) the influence of speech/voice task on dysphonia severity ratings of stimuli that combined sustained vowels and continuous speech, and (c) the differences in inter-rater reliability of dysphonia severity ratings between both speech tasks. METHODS: Five experienced listeners rated overall dysphonia severity in sustained vowels, continuous speech and concatenated speech samples elicited by 39 subjects with various voice disorders and degrees of hoarseness. RESULTS: Data confirmed that sustained vowels are rated significantly more dysphonic than continuous speech. Furthermore, dysphonia severity in concatenated speech samples is least determined by the sustained vowel. Finally, no significant difference was found in inter-rater reliability between dysphonia severity ratings of sustained vowels versus continuous speech. CONCLUSION: Based upon the results, both types of speech/voice tasks (i.e., sustained vowel and continuous speech) should be elicited and judged by clinicians in the auditory-perceptual rating of dysphonia severity.

Epidemiology of voice disorders in teachers and nonteachers in Brazil: prevalence and adverse effects.

PURPOSE: This epidemiological study compared the frequency and adverse effects of voice disorders in Brazilian teachers and nonteachers. METHODS: A standardized interview/questionnaire was administered to 3,265 participants; 1,651 teachers; and 1,614 nonteachers recruited from all 27 Brazilian states. RESULTS: Prevalence of reporting a current voice disorder was 11.6% for teachers and 7.5% for nonteachers, respectively (χ2(1)=16.1, P<0.001). Sixty-three percent of teachers and 35.8% of nonteachers reported having experienced a voice problem at some point during their lifetime (χ2(1)=246.6, P<0.001). Teachers reported a higher number of current (3.7) and past (3.6) voice symptoms as compared with nonteachers (1.7 current, 2.3 past) and more often attributed these symptoms to their occupation (P<0.001). Teachers, as compared with nonteachers (1) more frequently reported that their voice limited their ability to do certain tasks within their current occupation (29.9% of teachers vs 5.4% of nonteachers; P<0.001); (2) experienced more voice-related absenteeism over the past year (12.1% of teachers missed 5 or more days of work vs 2.4% of nonteachers; P<0.001); and (3) more often considered changing occupations in the future because of voice problems (16.7% of teachers vs 0.9% of nonteachers; P<0.001). The magnitude of voice-related dysfunction among teachers was similar across Brazilian states, and regional characteristics did not appear to significantly influence the results. CONCLUSION: This large epidemiological study comparing teachers and nonteachers confirms that teaching at school is a high-risk occupation for developing voice disorders. These voice disorders contribute to reduced job performance, attendance, and force many Brazilian teachers to consider changing occupations in the future because of their voice.

Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity / Vogais sustentadas e fala encadeada na avaliação perceptivo-auditiva daintensidade da disfonia

PURPOSE: Auditory-perceptual evaluation of dysphonia may be influenced by the type of speech/voice task used to render judgements during the clinical evaluation, i.e., sustained vowels versus continuous speech. This study explored (a) differences in listener dysphonia severity ratings on the basis of speech/voice tasks, (b) the influence of speech/voice task on dysphonia severity ratings of stimuli that combined sustained vowels and continuous speech, and (c) the differences in inter-rater reliability of dysphonia severity ratings between both speech tasks. METHODS: Five experienced listeners rated overall dysphonia severity in sustained vowels, continuous speech and concatenated speech samples elicited by 39 subjects with various voice disorders and degrees of hoarseness. RESULTS: Data confirmed that sustained vowels are rated significantly more dysphonic than continuous speech. Furthermore, dysphonia severity in concatenated speech samples is least determined by the sustained vowel. Finally, no significant difference was found in inter-rater reliability between dysphonia severity ratings of sustained vowels versus continuous speech. CONCLUSION: Based upon the results, both types of speech/voice tasks (i.e., sustained vowel and continuous speech) should be elicited and judged by clinicians in the auditory-perceptual rating of dysphonia severity.

OBJETIVO: A avaliação perceptivo-auditiva da disfonia pode ser influenciada pelo tipo de tarefa utilizada para eliciar o julgamento clínico, como vogais sustentadas versus fala. Este estudo explorou a classificação da intensidade de disfonia, analisando (a) as diferenças encontradas entre os resultados das tarefas de voz e fala, (b) a influência da tarefa usando estímulos combinados de vogais sustentadas e fala, e (c) as diferenças na confiabilidade interavaliadores de acordo com as tarefas analisadas. MÉTODOS: Cinco avaliadores experientes classificaram a intensidade da disfonia em amostras de vogais sustentadas e fala encadeada de 39 sujeitos com vários distúrbios vocais e diferentes graus de alteração. RESULTADOS: Os dados confirmaram que as vogais sustentadas foram avaliadas como mais desviadas em relação às tarefas de fala. Além disso, a intensidade da disfonia em amostras de fala concatenada é menos influenciada pela vogal sustentada. Finalmente, não houve diferenças na confiabilidade interavaliadores entre as classificações da intensidade da disfonia quando comparados os resultados da análise de vogais sustentadas e fala. CONCLUSÃO: Com base nos resultados, os dois tipos de tarefas (vogal sustentada e fala) devem ser utilizados para o julgamento clínico na avaliação perceptivo-auditiva da intensidade da disfonia.