Folia Phoniatrica et Logopaedica最新文献

Introduction: This study compared the submental surface electromyography (sEMG) duration and amplitude during dry swallowing between irradiated head and neck cancer (HNC) survivors and age-matched normal individuals. Further, the relationship between submental and infrahyoid sEMG in the irradiated HNC group was explored.

Method: Forty participants (20 HNC survivors and 20 age-matched normal individuals) participated in this study. The HNC survivors had completed organ preservation cancer treatment (at least 1-month post-treatment). They were on a complete oral diet without enteral supplementation (FOIS score> 4). Submental and infrahyoid sEMG activity was calculated for three trials of saliva swallow for each participant using sEMG. The duration and amplitude parameters considered were: onset duration - duration from the onset of swallowing to the maximum amplitude, offset duration - duration from the maximum amplitude to the end of the swallowing activity, total duration, and maximum amplitude.

Results: The study found that irradiated HNC survivors exhibited prolonged temporal measures, particularly in the offset duration, which suggested a delayed descent of the hyolaryngeal complex during swallowing. Additionally, the HNC group showed a positive correlation between submental and infrahyoid sEMG. Furthermore, it was observed that the rate of increase in the duration of submental sEMG during subsequent swallowing was greater in HNC survivors which could be due to reduced salivation.

Conclusion: Compared to age-matched normal individuals, irradiated HNC survivors manifest alterations in the submental muscle activities during dry swallowing as measured using sEMG. The temporal and amplitude changes are likely to have arisen as a consequence of postradiation changes.

Introduction: Voice disorders and burnout syndrome are common among teachers. This study aimed to explore the relationship among vocal problems, burnout syndrome, and some personal work factors.

Methods: This cross-sectional descriptive study enrolled 90 nonuniversity teachers who completed the Multidimensional Vocal Scale for Teachers (EVM-D) to evaluate vocal problems and an adapted Spanish version of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to detect burnout syndrome.

Results: Overall, 16% of teachers expressed symptoms compatible with burnout, and 60% of them were in the interval above the 75th percentile of the EVM-D, i.e., they had a high risk of vocal problems. An association between burnout and more vocal problems was established among teachers, particularly between the vocal symptoms and vocal abuse dimensions with the emotional exhaustion subscale of the MBI-ES. A history of anxiety/depression and fewer years of professional experience were associated with more vocal problems. The burnout group perceived more "loss of vocal power," "vocal fatigue," "vocal effort," and "hoarseness." Vocal abuse items received the highest scores of EVM-D. However, only "shouting" in the classroom was significantly different between the groups with and without burnout.

Conclusion: Emotional exhaustion of burnout syndrome, history of anxiety/depression, and a shorter professional experience were associated with vocal problems, which could limit the performance of teachers. Reducing classroom noise, establishing strategies to avoid shouting, or strengthening personal accomplishments in teachers could be useful in breaking the cycle of vocal problems and emotional exhaustion, particularly at the beginning of their professional experience.

Introduction: Adductor spasmodic dysphonia (ADSD) is characterized by involuntary laryngeal muscle spasms. Due to the lack of a quantitative evaluation method, most measurements have demonstrated difficulty in validity and reliability for diagnosing ADSD. This study aimed to establish a novel indicator for ADSD and determine its diagnostic effects.

Methods: We investigated 98 voice samples from 49 patients with ADSD and 49 healthy participants. A sustained vowel was recorded by a high-definition audio recorder. Voice samples underwent regular acoustic evaluation and a novel global dimension (GD) method. GD, Jitter, Shimmer, HNR, Frequency shift, and CPPS were measured for both groups.

Results: Statistical analysis revealed that the GD method effectively differentiated ADSD patients from healthy participants (p < 0.001, D'>0.8). Subsequent multiclass receiver operating characteristic analysis demonstrated that GD possessed the most significant classification accuracy (area under the curve = 0.988) compared with other acoustic parameters.

Conclusion: GD was an effective metric for objective differentiation between ADSD patients and healthy participants. This metric could assist clinicians in the diagnosis of ADSD patients.

Introduction: Online games provide a socializing environment for children aged 8-10 years, but there is a lack of information in the literature about whether children who stutter (CWS) access online gaming environments as frequently as their nonaffected peers and about their interaction habits. This study aimed to investigate the participation frequency of school-age CWS and children who do not stutter (CWNS) in online games, the speech characteristics during games, and whether they encountered bullying-like behaviors during games.

Methods: A total of 91 CWS (F/M = 18/73; age range = 8-13) and 116 CWNS (F/M = 60/56; age range 8-13) participated in this study. Children's participation habits in online, chat-based, multiplayer games were evaluated with web-based questionnaires. Differences between questionnaire responses were analyzed using the significance test for a difference in two proportions.

Results: There was no significant difference between the participation rates of CWS and CWNS in online games (z = 1.46; p = 0.14), their frequency (p > 0.05), and the time they spent in the game (p > 0.05). It was found that those who stutter preferred to use one-word expressions more than their peers who do not stutter (z = 2.03; p = 0.04), and those who stutter had higher rates of not encountering bullying-like behaviors in online games than those who do not stutter (z = 2.2; p = 0.03).

Discussion/conclusion: CWS and CWNS show similar participation habits in online, chat-based, multiplayer games with similar frequency and duration. Speech features that emerge in online games and whether these games play a role in providing CWS with a communication environment where the risk of bullying is reduced and fluency is increased may be the subject of future research.

Introduction: We examined the effects of four types of voicing on vocal tract movements by comparing the articulatory kinematics of whispered speech to habitual, loud, and soft conditions.

Methods: Participants included 10 males and 10 females with no history of communication disorders. They read six stimulus sentences in habitual, loud, soft, and whispered conditions. An electromagnetic articulograph tracked the tongue, jaw, and lip movements. Analysis focused on the words we do from a longer sentence. Vertical tongue/jaw and horizontal lip movements were measured during the production of the retracted and rounded front and back vowels in we do.

Results: Soft speech led to smaller and slower lip movements than in the habitual condition. Displacement increased for the tongue and jaw in loud and whispered speech compared to the habitual condition. Tongue and jaw velocity increased for loud but not for whispered speech compared to the habitual condition. Utterance duration increased for loud and whispered conditions.

Discussion: The increasing tongue and jaw displacement and velocity from soft to habitual to loud speech reported here is consistent with previous accounts. Whispering was less intense than soft speech, yet it involved larger tongue and jaw movements than habitual speech, possibly reflecting a speaker's focus on greater articulatory clarity when the acoustic signal is the weakest.

Introduction: The study aimed to investigate the mechanisms of impairment and recovery in graph naming functions among patients with aphasia due to cerebral infarction. Specifically, the study compared immediate effects of transcranial direct current stimulation (tDCS) treatment in patients at different stages postinfarction: the acute phase (AP) and the recovery period (RP).

Methods: Twenty-eight patients were selected, consisting of 16 in the AP and 12 in the RP, along with 18 healthy controls. Both patient groups underwent 2 weeks of tDCS treatment. Posttreatment changes in functional connectivity (FC) within language-related brain regions, as well as in graph naming abilities, were assessed in both patient groups.

Results: Both AP and RP groups exhibited significant improvements in graph naming ability following tDCS treatment. Compared to healthy controls, patients showed decreased FC in multiple brain regions of both hemispheres, particularly in the dominant hemisphere. Posttreatment assessments revealed significant increases in FC within the bilateral frontotemporal lobes for both AP and RP groups, and within the bilateral temporo-occipital regions for the AP group. Moreover, the RP group demonstrated decreased FC in the left temporal lobe posttreatment, which had shown increased FC pre-treatment.

Conclusions: This study suggests that tDCS can effectively enhance graph naming functions in patients with postinfarction aphasia. The therapeutic effects appear to be mediated by enhancing FC within bilateral frontotemporal lobes.

Introduction: Research on voice onset time (VOT) production of stops in children with CI versus NH has reported conflicting results. Effects of age and place of articulation on VOT have not been examined for children with CI. The purpose of this study was to examine VOT production by Greek-speaking children with CI in comparison to NH controls, with a focus on the effects of age, type of stimuli, and place of articulation.

Methods: Participants were 24 children with CI aged from 2;8 to 13;3 years and 24 age- and gender-matched children with NH. Words were elicited via a picture-naming task, and nonwords were elicited via a fast mapping procedure.

Results: For voiced stops, children with CI showed longer VOT than children with NH, whereas VOT for voiceless stops was similar to that of NH peers. Also, in both voiced and voiceless stops, the VOT differed as a function of age and place of articulation across groups. Differences as a function of stimulus type were only noted for voiced stops across groups.

Conclusions: For the voiced stop consonants, which demand more articulatory effort, VOT production in children with CI was longer than in children with NH. For the voiceless stop consonants, VOT production in children with CI is acquired at a young age.

Introduction: The purpose of the current study was to evaluate speech intelligibility and speech rate in individuals with Parkinson's disease using altered auditory feedback (AAF) in comparison to age-matched healthy controls. Based on prior research, it is hypothesized that the use of AAF will improve participants' speech intelligibility.

Methods: Five individuals with Parkinson's disease (clinical group) and five age-matched healthy controls aged 50 years and above participated in this pre-/post-group experiment. All participants completed reading and monologue tasks with and without AAF. The AAF delayed the participants' auditory feedback by 150 ms and altered it by 1/20 octave. Thirty-two naïve listeners listened to the recorded participants' speech samples (with and without AAF) randomly and rated the participants' speech intelligibility.

Results: Results of the mixed model ANOVA revealed that participants in the control group had significantly higher speech intelligibility scores than the participants in the clinical group. Post hoc tests indicated that only participants in the clinical group were more intelligible with AAF than without AAF. Participants in the clinical group had better speech intelligibility when reading the passage than speaking the monologue. With regards to speech rate, participants spoke more slowly with AAF than without. Finally, there was a negative correlation between speech rate and speech intelligibility.

Discussion: The current findings support our hypothesis that AAF improves speech intelligibility in people with Parkinson's disease, though not in healthy controls. Future research should evaluate the long-term effect of AAF use on speech intelligibility in people with Parkinson's disease.

Introduction: This study aimed to develop, validate, and analyze the reliability of the Korean version of the Voice Handicap Index-Throat (VHI-Tk).

Methods: This prospective study included 103 patients in the case group with voice problems (18 with functional dysphonia, 44 with mass in the larynx, 18 with neurological voice disorder, 23 with throat problems) and 27 in the control group without voice problems. All participants completed these questionnaires at their initial visit: the Korean version of the Voice Handicap Index (K-VHI), VHI-Tk, and the Korean version of the Voice Symptom Scale (K-VoiSS). Case group patients in the case group recompleted the VHI-Tk questionnaire to assess test-retest reliability. Finally, a one-way analysis of variance was implemented to assess differences in VHI-Tk scores among the four diagnosis types in the case group.

Results: The VHI-Tk scores in the case group were significantly higher than in the control group. The VHI-Tk was significantly correlated with the subscales of K-VHI and K-VoiSS. The VHI-Tk has significant test-retest reliability, and its internal consistency is good to excellent (Cronbach's alpha correlation coefficient range: 0.895-0.901). There was significant difference in the mean VHI-Tk scores according to the four diagnosis types (throat problems group > neurological voice disorder group).

Conclusion: We validated the VHI-T questionnaire to measure self-perceived voice and throat problems among Koreans. A large sample size and various diagnosis types are required in future studies to fully validate the VHI-T for use in multiple cultures.

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.