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1.
PLoS One ; 15(7): e0236009, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658934

RESUMO

Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.


Assuntos
Disfunção Cognitiva/epidemiologia , Disfonia/fisiopatologia , Fala/fisiologia , Qualidade da Voz/fisiologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Suécia/epidemiologia
2.
Codas ; 32(2): e20190121, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32215472

RESUMO

PURPOSE: To create a consensus version of a speech-language pathology (SLP) script to assess the expressiveness of voice professionals. METHODS: The process was divided into three stages: stage 1 included a survey of the literature and classification of the variables found in the instruments used; in steps 2 and 3, through teamwork, expert judges (focus groups I and II) created and adapted, along with the researcher, a consensus version of the expressiveness assessment script. RESULTS: The initial list presented to the judges contained 48 variables found in the literature: 11 related to emotional and interpretation aspects, 20 associated with oral expressiveness, three related to issues of verbal expressiveness, and 14 related to nonverbal expressiveness. In stage 2, the initial version of the script of the focus group I resulted in a document with 28 parameters, distributed in three thematic assessment groups: general aspects of communication, with three parameters; aspects related to oral expressiveness, with 16 parameters; aspects associated with body expressiveness, with nine parameters. In stage 3, after adequacy by focus group II, the consensus version also resulted in 28 parameters, distributed in two thematic groups. CONCLUSION: The consensus version of the SLP expressiveness assessment script for voice professionals was finalized with 28 parameters, distributed in two thematic axes: initial impact of communication, with six parameters; expressiveness, with 22 parameters.


Assuntos
Patologia da Fala e Linguagem/instrumentação , Qualidade da Voz/fisiologia , Consenso , Humanos , Estudos Prospectivos , Patologia da Fala e Linguagem/métodos , Voz/fisiologia
3.
PLoS One ; 15(3): e0229960, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160255

RESUMO

BACKGROUND/AIM: It is widely believed that 'creaky voice' ('creak', 'vocal fry', 'glottal fry') is increasingly prevalent among some English speakers, particularly among young American women. Motivated by the widespread and cross-disciplinary interest in the phenomenon, this paper offers a systematic review of peer-reviewed research (up to January 2019) on the prevalence of creaky voice in varieties of English. The review aimed to understand whose and what speech has been studied, how creaky voice prevalence has been measured, and what the findings collectively reveal. METHOD: Literature was located by searching four electronic databases (ProQuest, PubMed, SCOPUS, Web of Science) and the proceedings of two recurrent conferences ('ICPhS' and 'SST'). Studies were included if they reported the prevalence of creaky voice in naturalistic samples of English spoken by vocally-healthy speakers. Reference lists of included studies were cross-checked. RESULTS: Only ten studies meeting inclusion criteria were identified. All studies sampled a small number of speakers and/or short durations of speech. Nine were recent studies of American-English speakers, and many of these sampled young, female, college students. Across the ten studies, creaky voice was detected using three types of methods, and prevalence was calculated using five different formulae. The findings show that prevalence varies across groups, individuals, and contexts. However, the precise nature of this variability remains unclear due to the scarcity and methodological heterogeneity of the research. CONCLUSIONS: This paper illustrated the application of systematic literature review methods in sociophonetic research-a field in which such methods are not common. The review found that creaky voice prevalence in English is not well understood, and that widespread claims of its recent increase among young American women have not been empirically confirmed. A number of specific limitations in the existing research are highlighted, which may serve as a guide for future research design.


Assuntos
Percepção da Fala/fisiologia , Fala/fisiologia , Voz/fisiologia , Fatores Etários , Humanos , Idioma , Fonação/fisiologia , Fatores Sexuais , Acústica da Fala , Medida da Produção da Fala , Fatores de Tempo , Qualidade da Voz/fisiologia
4.
Codas ; 32(2): e20180141, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049096

RESUMO

PURPOSE: Describe the self-referred personal behavior profiles of university professors and verify the association of these profiles with the self-assessment of communicative aspects and vocal symptoms. METHODS: Study conducted with 334 professors at a public university who responded to an online questionnaire regarding voice use in teaching practice. Personal behavior profile classification was the response variable, which was divided into four types: pragmatic, analytical, expressive and affable. Explanatory variables were vocal self-perception, vocal resources, and communicative aspects. Descriptive data analysis was performed with application of the Pearson's Chi-squared and Fisher's Exact tests. RESULTS: University professors identified themselves more with the affable and expressive personal behavior profiles. Overall, professors presented good self-perception about vocal and communicative aspects, in addition to having reported few vocal symptoms. Profiles differed for some of the assessed variables, namely, pragmatic professors reported high speech velocity and sporadic eye contact; expressive professors demonstrated self-perception about their voice and strong voice intensity; those in the analytical profile self-reported negative perception about vocal quality, weak voice intensity, poor articulation and rapid speaking rate; the other professors mostly reported voice tiredness symptoms and difficulty projecting the voice. CONCLUSION: University professors identify themselves mostly with the affable and expressive profiles. Self-perception analysis of the personal behavior profile in university professors showed the influence of self-reported personality characteristics on communicative skills in the classroom.


Assuntos
Autoimagem , Autoavaliação , Medida da Produção da Fala/psicologia , Qualidade da Voz/fisiologia , Estudos Transversais , Docentes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acústica da Fala , Inquéritos e Questionários , Comportamento Verbal/fisiologia , Distúrbios da Voz/classificação , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/psicologia
5.
Codas ; 32(4): e20190074, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049106

RESUMO

PURPOSE: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. METHODS: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). RESULTS: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. CONCLUSION: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.


Assuntos
Laringe/fisiopatologia , Fonação/fisiologia , Acústica da Fala , Qualidade da Voz/fisiologia , Treinamento da Voz , Idoso , Envelhecimento/fisiologia , Feminino , Ventilação de Alta Frequência/métodos , Humanos , Julgamento , Doenças da Laringe/complicações , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Patologia da Fala e Linguagem/métodos , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia
6.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 384-388, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024143

RESUMO

Introduction: The understanding of normal vocal production is essential to guide any voice professional as it is fundamental to understand the effects of the posterior glottal gap on the vocal quality. Objective: The aim of the present study was to verify the association between glottic closure, acoustic parameters, and some characteristics of the videolaryngostroboscopy of young women without vocal complaints nor laryngeal disorders. Methods: This is a cross-sectional study with 56 women between 20 and 30 years old who underwent videolaryngostroboscopy. The acoustic parameters of the vowel /a:/ were analyzed using the Praat software, Release 4.6.10 (Paul Boersman and David Weenik, Amsterdam, Netherlands). Statistical Analysis: The chi-squared, Fischer, and Kruskall-Wallis tests were applied, with 5% significance. Results: Significant occurrence of posterior glottal gap (85.71%, p < 0.001), of normal vocal folds vibration amplitude (82.14%, p < 0.001), and of absence of significant constriction of the laryngeal vestibule (98.21%, p < 0.001); no significant association of the glottic closure with the vocal acoustic parameters; no significant association of glottic closure, vocal folds vibration amplitude, and constriction of the laryngeal vestibule. Conclusion: There was a predominance of posterior glottal gap, normal vocal folds vibration amplitude, and absence of laryngeal vestibule constriction, and no relation with the acoustic parameters, suggesting that the posterior glottal gap did not generate impact on the vocal production of the young adult women studied (AU)


Assuntos
Humanos , Feminino , Adulto , Voz/fisiologia , Glote/fisiologia , Acústica da Fala , Prega Vocal/fisiologia , Qualidade da Voz/fisiologia , Estudos Transversais , Laringoscopia/métodos , Laringe/fisiologia
7.
Otolaryngol Pol ; 73(5): 25-30, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31701899

RESUMO

OBJECTIVE: The process of ageing begins after 60 years of age and is referred to as presbyphonia (Vox senium). The causes include functional or organic voice disorders, often coexisting with dry upper respiratory tract infection. INTRODUCTION: The aim of the study is the use of high-speed camera and acoustic voice analysis in diagnostics of the clinical form of presbyphonia. M aterials and methods: The study included a group of 50 men, non-smokers, age from 51 to 72, who do not use their voice professionally. High-Speed Digital Imaging and HS camera have been used, allowing evaluation of real vibrations of vocal folds, along with acoustic voice analysis using a software by DiagNova Technologies. RESULTS: VHI questionnaire has been used for self-assessment of voice disability. Visualizations of the larynx enabled recognition of hypofunctional dysphonia or atrophy of vocal folds that cause voice disorders. This was confirmed by parameters of voice acoustic evaluation: F0, NHR, narrowband spectrography. The pathological value of NHR and the presence of nonharmonic components in the range of high frequency levels indicated glottal insufficiency, recorded with the visualization technique of the larynx by HS camera. A significant shortening of maximum phonation time in relation to the control group has also been recorded. DISCUSSION: The objective examination of voice pathology is crucial in diagnosis and rehabilitation, however, subjective assessment of the patient is important in the scope of the procedure used. The patient's subjective self-rating assessment (VHI) confirmed the sense of voice disorders in elderly men, indicating the need for rapid and accurate clinical diagnosis.


Assuntos
Acústica da Fala , Gravação de Videoteipe/métodos , Distúrbios da Voz/diagnóstico , Qualidade da Voz/fisiologia , Idoso , Envelhecimento/fisiologia , Avaliação Geriátrica/métodos , Humanos , Masculino , Pessoa de Meia-Idade
8.
Otolaryngol Pol ; 73(4): 29-34, 2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-31474622

RESUMO

OBJECTIVES: The main goals of this study were to assess the most significant morphological changes and acoustic measures for the ageing process of a professional opera singer's voice. DESIGN: This investigation included 58 healthy professional opera singers, who were compared with 42 young opera singers from the control group. METHODS: All participants underwent a voice assessment protocol: ENT specialist examination and speech therapist evaluation. Acoustic parameters and subjective observations were obtained and analysed. R esults: Fundamental frequency (F0) level was distinctly decreased in the case of older female singers, but F0 in older male singers had stable levels in comparison to that in younger singers. Older singers were found not to have substantially different values of jitter than younger ones. Maximal phonation time (MPT) was longer in the older women's group when compared to the younger singers, but not relatively different in the men's group. Shimmer value presented no age-related change. Morphological changes seem to correlate with the age of subjects. C onclusions: The main characteristic of voice change with age was a decreased F0 level among older female professional singers and rather stable F0 levels in male singers. This study gives preliminary results on the ageing of voice in the population of professional opera singers.


Assuntos
Envelhecimento/fisiologia , Canto/fisiologia , Qualidade da Voz/fisiologia , Voz/fisiologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise e Desempenho de Tarefas
9.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(3): 141-150, jul.-sept. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185832

RESUMO

Introduction: those who use voice for professional purposes know how crucial it is to regulate posture, breath and voice to get the best vocal performance. Pilates, a fitness system that focuses on breathing and postural control, should be beneficial in optimizing singers' voice. The present study aims to demonstrate that the practice of Pilates improves the quality of artistic vocal production. Materials and methods: we collected a sample of 15 singing students that underwent ENT examination and filled in a first questionnaire. After that we proceeded to voice recording and acoustic analysis through software Praat. Next, together with a fully qualified Pilates teacher, we identified a few exercises acting on the respiratory muscles, that were explained and practiced during a Pilates lesson. These exercises were performed by each subject on his/her own at least three times a week for two months and together during other two Pilates group lessons. Finally, a second voice recording was performed, using the Praat software and under the very same condition of the first recording and a second self-assessment questionnaire was filled in. Results: the Kolmogorov-Smirnov test revealed that the Fo and Jitter parameters were not normally distributed, while the Shimmer and HNR resulted to be normally distributed. The averages of Shimmer and HNR parameters were thus analyzed through the T Test, while the F0 and Jitter parameters were analyzed through the Wilcoxon test. The analysis revealed that all the four parameters underwent statistically significant changes after the Pilates practice. Questionnaire results revealed that Pilates had a positive effect on voice production (15/15), especially on postural alignment (15/15) and respiratory capacity (13/15). Discussion: in our study the F0 increased after Pilates practice. This finding should be due to changes in the vocal folds length and tension, probably related to the postural exercises that had been performed, which conferred greater elasticity to the muscles. Contrariwise the Jitter parameter after exercising had decreased allowing us to conclude that Pilates helps to reduce vibratory perturbations of the vocal cords during vocal emission. This should have been obtained through a greater control of the respiratory dynamics provided by the exercises. The Shimmer parameter had also diminished, allowing us to hypothesize that the Pilates exercises, acting on the respiratory mechanisms, minimize intensity variations. On the contrary, HNR had increased suggesting that the amount of periodic signal in the voice after Pilates practice is greater than before. Since voices with a higher average HNR tend to be judged as more attractive, our results point to the fact that Pilates practice improves voice quality, as subjectively reported by the participants themselves. Conclusion: our study has highlighted the positive role of Pilates on vocal production in singing students: in a relatively short time, simple exercises - performed regularly - have shown a significant impact on vocal quality. It is likely that the very same positive effects could also be obtained by other occupational voice users


Introducción: los que usan la voz con fines profesionales saben lo importante que es regular postura, respiración y voz para obtener la mejor interpretación vocal. Pilates, un sistema de fitness que se enfoca en el control de la respiración y de la postura, puede ser beneficioso para optimizar la voz de los cantantes. El presente estudio tiene como objetivo demostrar que la práctica de pilates mejora la calidad de producción vocal artística. Materiales y métodos: recolectamos 15 estudiantes de canto que se sometieron a un examen otorrinolaringológico y rellenado en un primer cuestionario. Después de eso procedimos a la grabación de voz y análisis acústico a través del software Praat. A continuación, junto con un profesor de Pilates completamente calificado, se identificaron algunos ejercicios que actúan sobre los músculos respiratorios, que fueron explicados y practicados durante una lección de pilates. Estos ejercicios fueron realizados por cada sujeto por su cuenta en por lo menos tres veces por semana durante dos meses y juntos durante otras dos clases grupales de pilates. Finalmente, se realizó una segunda grabación de voz, utilizando el software Praat y bajo el mismo se completó la misma condición de la primera grabación y un segundo cuestionario de autoevaluación. Resultados: la prueba de Kolmogorov-Smirnov reveló que los parámetros de Fo y Jitter no fueron normalmente distribuidos, mientras que Shimmer y HNR resultaron ser distribuidos normalmente. Los promedios de los parámetros Shimmer y HNR se analizaron por medio de la prueba T, mientras que los parámetros F0 y Jitter fueron analizados a través de la prueba de Wilcoxon. El análisis reveló que todos los cuatro parámetros sufrieron cambios estadísticamente significativos después de la práctica de pilates. Los resultados del cuestionario revelaron que Pilates tuvo un efecto positivo en la producción de voz (15/15), especialmente en alineación postural (15/15) y capacidad respiratoria (13/15). Discusión: en nuestro estudio, el F0 aumentó después de la práctica de pilates. Este hallazgo se debe a cambios en la longitud y tensión de los pliegues vocales, probablemente relacionados con los ejercicios posturales que se han realizado, que confieren mayor elasticidad a los músculos. En cambio, el parámetro Jitter después del ejercicio había disminuido, lo que nos permite concluir que el pilates ayuda a reducir las perturbaciones vibratorias de las cuerdas vocales durante la emisión vocal. Esto debería haberse obtenido con mayor control de la dinámica respiratoria proporcionada por los ejercicios. El parámetro Shimmer también había disminuido, permitiéndonos hipotetizar que los ejercicios de pilates, actuando sobre los mecanismos respiratorios, reducen las variaciones de intensidad. En cambio, HNR había aumentado, lo que sugiere que la cantidad de señal periódica en la voz después de la práctica de pilates es mayor que antes. Dado que las voces con un HNR medio más alto tienden a ser consideradas más atractivas, nuestros resultados apuntan al hecho de que la práctica del pilates mejora la calidad de la voz, según lo informado subjetivamente por los propios participantes. Conclusión: nuestro estudio ha destacado el papel positivo del pilates en la producción vocal en estudiantes de canto: en un tiempo relativamente corto, ejercicios simples, realizados regularmente, han demostrado un impacto considerable en la calidad vocal. Es probable que los mismos efectos positivos también puedan ser obtenidos por otros usuarios de voz profesional


Assuntos
Humanos , Técnicas de Exercício e de Movimento/métodos , Canto , Voz , Músculos Respiratórios/fisiologia , Postura/fisiologia , Resultado do Tratamento , Qualidade da Voz/fisiologia
10.
Otolaryngol Pol ; 73(3): 16-25, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31249149

RESUMO

INTRODUCTION: The aim of the study was to assess the acoustic and capacity analysis of singing voice using DiagnoScope Specialist software. MATERIAL AND METHODS: The study was conducted in 120 adults subjects, including 74 women and 46 men aged 21-5, were divided into 3 groups: I -40 subjects (treatment group) - professional vocalists, II- 40 subjects (treatment group) - semiprofessional vocalists, III- 40 subjects (control group) - students of The Military Medical Faculty at Medical University of Lodz - nonsingers. The research methodology included: primary medical history, physical examination (otolaryngological), vdeolaryngoscopic examination, the GRBAS scale for subjective voice evaluation, diagnostic voice acoustic and capacity analysis using DiagnoScope Specialist software, survey on lifestyle patterns which may affect voice quality. RESULTS: Average value of the fundamental frequency F0 was the highest in professional vocalists' group was 316,46 Hz in women and 165,09 Hz in men, in semiprofessional vocalists' group was accordingly 260,50 Hz and 149,26 Hz, in nonsingers' group was accordingly 261,23 Hz and 159, 27 Hz. Average value of Jitter parameter in professional vocalists' group was 0,30% in women and 0,54% in men, in semiprofessional vocalists' group was accordingly 0,31% and 0,57%, in nonsingers' group was 0,31% and 0,56%. Average value of Shimmer parameter in professional vocalists' group was 3,27% in women and 3,75% in men, in semiprofessional vocalists' group was accordingly 3,46% and 3,77%, in nonsingers' group was 4,33% and 4,39%. Average value of NHR index in professional vocalists' group was 3,28% in women and 6,00% in men, in semiprofessional vocalists' group was accordingly 3,23% and 6,72%, in nonsingers' group was 3,89% and 6,13%. CONCLUSIONS: Values of the parameters which are measuring the character of the voice, relative period-to-period fundamental frequency perturbations, relative period-to-period amplitude perturbation and level of buzzing together with other methods have diagnostic and predictive value in early detection of voice disorders. Capacity analysis in singing voice showed very low values of the following parameters: phonation time, true phonation time, no phonation coefficient, voice efficiency coefficient and voice capacity. Key words: The acoustic and capacity analysis, singing voice.


Assuntos
Fonação/fisiologia , Acústica da Fala , Medida da Produção da Fala/métodos , Qualidade da Voz/fisiologia , Voz/fisiologia , Adulto , Feminino , Humanos , Masculino , Canto
11.
PLoS One ; 14(6): e0218162, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31188896

RESUMO

Recent investigations analysing synchronization in singing ensembles have shown that the precision of synchronization during singing duo performances is better in the presence of visual contact between the singers than without. Research has also shown that synchronisation improves with practice across rehearsals in a newly formed singing quintet. However, whether listeners' perceptions of synchronization reflect the different patterns of synchronization that were observed during ensemble performance with and without visual contact and across rehearsals has not yet been investigated. This study aims to analyse the perception of the synchronization associated with altered visual contact and amount of rehearsal during singing duo and quintet performances respectively, for listeners with different levels of musical expertise. A set of fifty-eight singing recordings selected from duo and quintet ensemble performances, collected from previous investigations of interpersonal synchrony, was presented to 33 listeners, including non-experts (university students with little or no music training), performers in the group (singers who performed the pieces used for the study), and other musicians (advanced music students). Participants were required to listen to each trial and judge the level of "togetherness" on a sliding scale from zero to 100. Results show that listeners, irrespective of their musical training and performance experience, perceived differences in the synchronization in the duo tokens depending on the presence/absence of visual contact between singers; on the other hand, the smaller asynchrony patterns measured across rehearsals in the singing quintet recordings were not perceived. This study contributes to our understanding of perceptions of synchronization by individuals with different levels of musical expertise, and underscores the perceptual salience of synchronization, regardless of musical experience.


Assuntos
Percepção Auditiva/fisiologia , Canto/fisiologia , Adulto , Feminino , Humanos , Masculino , Música , Qualidade da Voz/fisiologia
12.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(2): 86-94, abr.-jun. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-185745

RESUMO

La laringectomía total ocasiona un cambio morfológico trascendente en el aparato vocal, que altera totalmente el mecanismo fisiológico de la voz. Objetivo: describir aspectos claves de la morfología del aparato vocal de las personas que utilizan la voz erigmofónica para su comunicación. Material y método: estudio prospectivo de 15 pacientes laringectomizados que utilizan voz erigmofónica en los que se aplicaron los test VHI-30, CAPE-V y una exploración clínica y endoscópica, destacando los aspectos morfológicos que podrían influir en la voz. Resultados: el VHI-30 revela que perciben su voz como limitación leve y moderada. El CAPE-V indica una afectación media y grave. El VHI-30 (grados leve y moderado) se relaciona significativamente con la severidad global del CAPE-V. En la exploración clínica de la cavidad oral y el traqueostoma no se observan alteraciones que se relacionen con la valoración del CAPE-V. La exploración endoscópica muestra tendencias entre volúmenes y áreas de la cavidad faríngea y del esófago con el CAPE-V, pero sin llegar a valores significativos. Las formas de botón y diafragma del segmento faringoesofágico exhiben una tendencia similar. Conclusiones: la calidad de la voz erigmofónica percibida por el explorador dependería, en cierta medida, de las características anatómicas del nuevo aparato vocal del laringectomizado


Total laryngectomy causes a morphological change in the vocal apparatus, which totally alters the physiological mechanism of the voice. Aim: the objective of this article is to describe key aspects of the vocal apparatus morphology of patients who use the esophageal voice to communicate. Material and method: prospective study of 15 patients with esophageal voice in which the VHI-30, CAPE-V and a clinical and endoscopic exploration were performed, highlighting the morphological aspects that could influence the voice. Results: the VHI-30 reveals that they perceive their voice as a mild and moderate limitation. The CAPE-V indicates a medium and severe affectation. Both tests are significantly related in the mild and severe grades of VHI with the global severity of CAPE-V. The clinical exploration of the oral cavity and tracheostoma doesn't show that its variables present a trend with CAPE-V. Endoscopic exploration shows trends in the relationship between volumes and areas of the pharyngeal cavity and esophagus with the CAPE-V, but without reaching significant values. The button and diaphragm shapes of the pharyngoesophageal segment exhibit the same tendency. Conclusions: the variables studied indicate that the quality of the esophageal voice would depend, to some extent, on the anatomical characteristics of the new laryngectomized vocal apparatus


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Voz Alaríngea/métodos , Qualidade da Voz/fisiologia , Distúrbios da Voz/etiologia , Laringectomia/estatística & dados numéricos , Variação Anatômica , Nasofaringe/anatomia & histologia , Complicações Pós-Operatórias
13.
J Coll Physicians Surg Pak ; 29(6): 524-527, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31133149

RESUMO

OBJECTIVE: To determine whether adenotonsillar size is a significant determinant of voice in children who have undergone adenotonsillectomy. STUDY DESIGN: Prospective cohort study. PLACE AND DURATION OF STUDY: Ear Nose Throat Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey, from July 2017 to June 2018. METHODOLOGY: A total of 57 patients, who have been diagnosed with chronic adenotonsillitis and operated for obstruction or infection, were included in the study. Patients were divided into two groups according to their palatine tonsil sizes. Each patient performed voice analysis preoperatively and one month postoperatively, recruiting both objective and subjective methods. F0, jitter % and shimmer % values were assessed with objective methods; while subjective methods evaluated pediatric voice handicap index (pVHI) scores. Pre- and post-operative F0, jitter % and shimmer % values and pVHI scores from each study group were compared. RESULTS: In each study group, pre- and post-operative F0, jitter % and shimmer % values were found to be similar. In Group A, postoperative pVHI scores were found to be significantly reduced (p<0.001). In Group B, however, pre- and postoperatively assessed pVHI scores were similar. CONCLUSION: Adenotonsillar hypertrophy in children, who underwent adenotonsillectomy, seems to be an important and positively effecting factor on the subjective, but not the objective, parameters of voice.


Assuntos
Tonsila Faríngea/cirurgia , Tonsila Palatina/anatomia & histologia , Tonsilectomia/métodos , Tonsilite/cirurgia , Qualidade da Voz/fisiologia , Adenoidectomia , Tonsila Faríngea/patologia , Criança , Feminino , Humanos , Hipertrofia , Masculino , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Estudos Prospectivos , Tonsilite/diagnóstico , Resultado do Tratamento
14.
PLoS One ; 14(5): e0216859, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31120891

RESUMO

The framework of dynamical systems offers powerful tools to understand the relation between stability and variability in human cognition in general and in speech in particular. In the current paper, we propose a dynamical systems approach to the description of German nuclear pitch accents in focus marking to account for both the categorical as well as the continuous variation found in intonational data. We report on results from 27 native speakers and employ an attractor landscape to represent pitch accent types in terms of f0 measures in a continuous dimension. We demonstrate how the same system can account for both the categorical variation (relative stability of one prosodic category) as well as the continuous variation (detailed modifications within one prosodic category). The model is able to capture the qualitative aspects of focus marking such as falling vs. rising pitch accent types as well as the quantitative aspects such as less rising vs. more rising accents in one system by means of scaling a single parameter. Furthermore, speaker group specific strategies are analysed and modelled as differences in the scaling of this parameter. Thus, the model contributes to the ongoing debate about the relation between phonetics and phonology and the importance of variation in language and speech.


Assuntos
Idioma , Modelos Biológicos , Acústica da Fala , Percepção da Fala/fisiologia , Qualidade da Voz/fisiologia , Adulto , Feminino , Humanos , Masculino
15.
J Craniofac Surg ; 30(3): 692-695, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048607

RESUMO

Vocal fold scarring is the cause of severe dysphonia and represents a therapeutic challenge; dysphagia can also be present in case of soft tissue defect due to previous oncological surgery. The ideal surgical solution should concurrently provide vocal fold augmentation and re-establishment of tissue elasticity. Nanofat technique has given so far promising results in remodeling skin scars and improving tissue pliability. The present paper describes for the first time the use of nanofat injected into the vocal fold cover for pliability restoration, combined with traditional microfat for vocal fold augmentation. Seven patients (aged 23-77 years) affected by severe dysphonia, related to extensive vocal fold scarring (3 of them were also affected by dysphagia for liquid consistencies), underwent a single procedure of concurrent microfat and nanofat vocal fold injection under direct microlaryngoscopy in general anesthesia. Results were evaluated by objective outcome measures and auto evaluation performed by questionnaires concerning the phonatory and swallowing efficiency. The voice quality and the perceived swallowing capability of all patients improved after surgery and are stable at follow-up (4-8 months). The reported preliminary data show that nanofat, due to its regenerative potential related to adipose-derived stem cells and growth factors, can be a promising adjunct to traditional fat augmentation to improve elasticity of the delicate multilayered structure of the vocal fold and to enhance its vibratory capabilities. Further experience on a wider number of patients and long-term follow-up are necessary to confirm the validity of this technique.


Assuntos
Tecido Adiposo/transplante , Cicatriz/cirurgia , Disfonia/cirurgia , Prega Vocal/fisiopatologia , Adulto , Idoso , Anestesia Geral , Cicatriz/fisiopatologia , Deglutição/fisiologia , Disfonia/etiologia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Qualidade da Voz/fisiologia , Adulto Jovem
16.
J Speech Lang Hear Res ; 62(2): 215-228, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30950696

RESUMO

Purpose Normative data for many objective voice measures are routinely used in clinical voice assessment; however, normative data reflect vocal output, but not vocalization process. The underlying physiologic processes of healthy phonation have been shown to be nonlinear and thus are likely different across individuals. Dynamic systems theory postulates that performance behaviors emerge from the nonlinear interplay of multiple physiologic components and that certain patterns are preferred and loosely governed by the interactions of physiology, task, and environment. The purpose of this study was to descriptively characterize the interactive nature of the vocalization subsystem triad in subjects with healthy voices and to determine if differing subgroups could be delineated to better understand how healthy voicing is physiologically generated. Method Respiratory kinematic, aerodynamic, and acoustic formant data were obtained from 29 individuals with healthy voices (21 female and eight male). Multivariate analyses were used to descriptively characterize the interactions among the subsystems that contributed to healthy voicing. Results Group data revealed representative measures of the 3 subsystems to be generally within the boundaries of established normative data. Despite this, 3 distinct clusters were delineated that represented 3 subgroups of individuals with differing subsystem patterning. Seven of the 9 measured variables in this study were found to be significantly different across at least 1 of the 3 subgroups indicating differing physiologic processes across individuals. Conclusion Vocal output in healthy individuals appears to be generated by distinct and preferred physiologic processes that were represented by 3 subgroups indicating that the process of vocalization is different among individuals, but not entirely idiosyncratic. Possibilities for these differences are explored using the framework of dynamic systems theory and the dynamics of emergent behaviors. A revised physiologic model of phonation that accounts for differences within and among the vocalization subsystems is described. Supplemental Material https://doi.org/10.23641/asha.7616462.


Assuntos
Fonação/fisiologia , Voz/fisiologia , Adolescente , Adulto , Fenômenos Biomecânicos , Feminino , Voluntários Saudáveis , Humanos , Kentucky , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Respiração , Acústica da Fala , Prega Vocal/diagnóstico por imagem , Qualidade da Voz/fisiologia , Adulto Jovem
17.
J Speech Lang Hear Res ; 62(2): 283-296, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30950701

RESUMO

Purpose Conversational entrainment, the phenomenon whereby communication partners synchronize their behavior, is considered essential for productive and fulfilling conversation. Lack of entrainment could, therefore, negatively impact conversational success. Although studied in many disciplines, entrainment has received limited attention in the field of speech-language pathology, where its implications may have direct clinical relevance. Method A novel computational methodology, informed by expert clinical assessment of conversation, was developed to investigate conversational entrainment across multiple speech dimensions in a corpus of experimentally elicited conversations involving healthy participants. The predictive relationship between the methodology output and an objective measure of conversational success, communicative efficiency, was then examined. Results Using a real versus sham validation procedure, we find evidence of sustained entrainment in rhythmic, articulatory, and phonatory dimensions of speech. We further validate the methodology, showing that models built on speech signal entrainment measures consistently outperform models built on nonentrained speech signal measures in predicting communicative efficiency of the conversations. Conclusions A multidimensional, clinically meaningful methodology for capturing conversational entrainment, validated in healthy populations, has implications for disciplines such as speech-language pathology where conversational entrainment represents a critical knowledge gap in the field, as well as a potential target for remediation.


Assuntos
Comunicação , Fala/fisiologia , Adulto , Eficiência/fisiologia , Feminino , Humanos , Masculino , Fonação/fisiologia , Qualidade da Voz/fisiologia , Adulto Jovem
18.
J Speech Lang Hear Res ; 62(2): 318-323, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30950703

RESUMO

Purpose The aim of this study was to investigate secondary voice outcomes and detraining effects of 2 head and neck strengthening exercises, which have been used in swallowing rehabilitation, that is, the head-lift exercise (HLE) and the recline exercise (RE), in healthy older adults. Method Twenty-seven healthy older adults (between 60 and 85 years of age) were randomized to perform either the RE or the HLE for a 6-week period. Isometric and isokinetic portions of the exercise were performed 3 times daily. Patients were evaluated at baseline, postexercise, and following a 6-week detraining period. Acoustic outcome measures included the highest and lowest frequencies of vocal range on pitch glides (measured in hertz) and cepstral peak prominence on sustained vowels and connected speech. Self-perceptual measures included perceived phonatory effort. Results Twenty-two individuals completed their assigned exercise regimen. No significant differences between exercise groups were observed at baseline for age, body mass index, or body fat percentage. A significant postexercise increase was seen in the highest frequency of vocal range on pitch glide, t(2, 56.79) = -10.28, p ≤ .0001, for both groups. This increase was not fully maintained following the 6-week detraining period; however, data remained significantly above baseline at this time point, t(2, 57.01) = -4.70, p ≤ .0001. Seventeen of the individuals who made postexercise gains were followed postdetraining. On average, these 17 individuals maintained 51% of their postexercise gains in the highest frequency of vocal range. No differences were observed between exercise groups. In addition, no significant changes in the lowest frequency of vocal range, cepstral peak prominence on sustained vowels or connected speech, or perceived phonatory effort were observed following the exercise regimens. Conclusions Both the HLE and the RE produced gains in the highest frequency of vocal range in healthy older adults. This finding is promising; however, further research is required to understand how suprahyoid muscle strengthening influences upper pitch range and whether this relationship has potential clinical implications for patients with dysphonia.


Assuntos
Terapia por Exercício/métodos , Qualidade da Voz/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Cabeça , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Pescoço , Percepção , Fonação/fisiologia , Autoimagem , Acústica da Fala
19.
Can J Neurol Sci ; 46(3): 287-294, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30905324

RESUMO

OBJECTIVE: To systematically evaluate how different deep brain stimulation of the subthalamic nucleus (STN-DBS) amplitude, frequency, and pulse-width electrical parameter settings impact speech intensity, voice quality, and prosody of speech in Parkinson's disease (PD). METHODS: Ten individuals with PD receiving bilateral STN-DBS treatments were seen for three baseline and five treatment visits. The five treatment visits involved an examination of the standard clinical settings as well as manipulation of different combinations of frequency (low, mid, and high), pulse width (low, mid, and high), and voltage (low, mid, and high) of stimulation. Measures of speech intensity, jitter, shimmer, harmonics-noise ratio, semitone standard deviation, and listener ratings of voice quality and prosody were obtained for each STN-DBS manipulation. RESULTS: The combinations of lower frequency, lower pulse width, and higher voltage settings were associated with improved speech outcomes compared to the current standard clinical settings. In addition, decreased total electrical energy delivered to the STN appears to be associated with speech improvements. CONCLUSIONS: This study provides preliminary evidence that STN-DBS may be optimized for Parkinson-related problems with voice quality, speech intensity, and prosody of speech.


Assuntos
Estimulação Encefálica Profunda/métodos , Doença de Parkinson/terapia , Fala/fisiologia , Núcleo Subtalâmico/fisiologia , Qualidade da Voz/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Distúrbios da Fala/etiologia
20.
PLoS One ; 14(2): e0212608, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30811477

RESUMO

We investigate the involvement of Working Memory Capacity (WMC, the cognitive resource necessary for controlled elaborate thinking) in voice behavior (speaking up with suggestions, problems, and opinions to change the organization). While scholars assume voice requires elaborate thinking, some empirical evidence suggests voice might be more automatic. To explain this discrepancy, we distinguish between voice quantity (frequency of voice) and voice quality (novelty and value of voiced information) and propose that WMC is important for voice quality, but less for voice quantity. Furthermore, we propose that frequent voicers rely less on WMC to reach high voice quality than people who voice rarely. To test our ideas, we conducted three studies: a between-participant lab-study, a within-participant experiment, and a multi-source field-study. All studies supported our expectation that voice quantity is unrelated to WMC, and that voice quality is positively related to WMC, but only for those who rarely voice. This indicates that the decision to voice (quantity) might be more automatic and intuitive than often assumed, whereas its value to the organization (quality), relies more on the degree of cognitive elaboration of the voicer. It also suggests that frequent and infrequent voicers use distinct cognitive pathways to voice high-quality information: frequent voicers improvise, while infrequent voicers elaborate.


Assuntos
Cognição/fisiologia , Tomada de Decisões/fisiologia , Memória de Curto Prazo/fisiologia , Qualidade da Voz/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Acústica da Fala , Adulto Jovem
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