Does the Daily Practice of a Structured Voice Exercise Protocol Affect the Fitness Instructor's Self-Perceived Vocal Effort, Vocal Fatigue, and Voice Handicap?

Abstract

Purpose: Identify an optimal "Fitpro Voice Protocol" and display the ease of applicability of this protocol in fitness professional's daily life. This study also aimed to demonstrate the impact of this protocol on the fitpro's vocal quality, vocal fatigue, vocal effort, and self-perceived voice handicap.

Methods: Thirty-six group fitness instructors teaching at least four classes per week were randomized into three voice protocol groups. All participants completed baseline questionnaires, an audio recording of The Rainbow Passage, and were required to follow a specific vocal health protocol and voice-related exercise routine. Protocols involved semioccluded vocal tract exercise (SOVTE) progressions and functional group-fitness specific voice exercises using conversation training therapy concepts and cup phonation. SOVTEs within groups included straw phonation in water (Group One), straw phonation outside water (Group Two), and use of the SingRing (Group Three). Differences in questionnaires and CAPE-V measures from baseline to day 14 were tested within groups using paired t tests or Wilcoxon Signed Rank tests. General linear regression models were used to test for differences between groups.

Results: Twenty-five participants completed the study. Positive intervention-related changes were observed in patient reported outcome measures (voice handicap, vocal effort, vocal fatigue) and auditory perception of voice when comparing these outcomes across time points at baseline and 14days (within groups and between groups). Most improvement occurred with consistent practice longer than 1week. Group One (N = 7) displayed the most improvement in VHI-10 scores, Group Three (N = 9) displayed the most improvement in scores on the VES, Groups One and Three displayed the most improvement in VFI scores, Group Two displayed the most improvement on CAPE-V scores. Group Two (N = 9) VFI Part Two significantly decreased from baseline mean (SD) 7.15 (5.64) to day 14 mean 5.11 (3.72), P = 0.019. Group Three VES significantly decreased from baseline mean (SD) 6.17 (1.90) to day 14 mean 1.44 (1.67), P = 0.043. Poststudy surveys were distributed to participants immediately following study completion and 5months postcompletion with results showing participant perceptions, learnings, and adherence.

Conclusions: Fitness professionals agree that consistent performance of a voice protocol positively impacts the voice. Overall conclusions reveal consistent positive changes (as compared to baseline) in the instructors' self-perceptions of vocal effort, vocal fatigue, and voice handicap, as well as positive changes in their perceptual vocal quality. This study indicates that all three group protocols proved to positively impact the voices of fitness professionals (although some more than others relative to specific outcome measures), and therefore these protocols have the potential to improve their voices (and related instruction) within the fitness studio and within their daily lives. Additionally, the study results reveal that a structured protocol is easily performed within the fitness professional's daily life and adherence was maintained during the study and at a 5-month poststudy follow-up. The findings of improvement in all participants amplify the importance of/need for structured voice exercises and vocal trainings for fitness instructors to prevent voice disorders, enhance class experience, and ensure healthy careers within this industry.