Logopedics Phoniatrics Vocology最新文献

Purpose: We aimed to assess if there is a significant change in voice of pregnant women by the end of third trimester.

Materials and methods: Forty-nine pregnant women were enrolled in this study between April 2019 and March 2020. Subjective and objective voice evaluation was conducted in the third trimester and three months after delivery. The Turkish version of the VHI-10 questionnaire was filled out by every participant. GRBAS scale was used for perceptual voice evaluation. Acoustic analyses were conducted by Multi-Dimensional Voice Program (MDVP) (Computerized Speech Lab, Kay Elemetrics Corporation, Lincoln Park, NJ). Fundamental frequency (fo), Jitter percent (Jitt), Shimmer percent (Shim), noise to harmonic ratio (NHR), maximum phonation time (MPT), voice turbulence index (VTI), vocal intensity, and scale parameters were categorized as predelivery (a) and postdelivery (b).

Results: Comparison of acoustic parameters of the third trimester with the third month postpartum revealed statistically significant increases for fo (p = .013), MPT (p = .008), and vocal intensity (p≤.001) as well as a significant decrease for VTI (p≤ .001). No statistically significant difference was found for NHR, Jitt, and Shim. Comparison of both VHI-10 and GRBAS scores revealed statistically significant decreases.

Conclusions: Disturbances in certain vocal parameters suggest that vocal abnormalities observed during pregnancy are mainly due to anatomical alterations of the lower respiratory system. It would be appropriate to warn pregnant women about bad vocal habits and vocal hygiene. In addition, it would be appropriate to recommend professional voice support to pregnant women who use their voices intensively due to their profession.

Introduction: Speech assessment methods used in clinical practice are varied and mainly perceptual and motor. Reliable assessment of speech disorders is essential for the tailoring of the patient's treatment plan.

Objective: To describe current clinical practices and identify the shortcomings and needs reported by French-speaking clinicians regarding the assessment of speech disorders in adult patients.

Methods: Data were collected using an online questionnaire for French-speaking speech and language pathologists (SLPs) in Belgium, France, Switzerland, Luxembourg, and Maghreb. Forty-nine questions were grouped into six domains: participant data, educational and occupational background, experience with speech disorders, patient population, tools and tasks for speech assessment, and possible lacks regarding the current assessment of speech disorders.

Results: Responses from 119 clinicians were included in the analyses. SLPs generally use "à la carte" assessment with a large variety of tasks and speech samples. About one quarter of them do not use existing assessment batteries. Those who do mostly use them partially. Pseudo-words are rarely used and are absent from standardized batteries, in contrast to the major use of words and sentences. Perceptual evaluation largely prevails (mainly overall ratings of speech "intelligibility", "severity," and "comprehensibility" and percent-correct phonemes), whereas the recording equipment for acoustic measures is not standardized and only scarcely described by the SLPs. The most commonly used questionnaire to assess the functional impact of the speech disorder is the Voice Handicap Index; one quarter of the SLPs does not use any questionnaire. Overall, the available tools are considered only moderately satisfactory. The main reported shortcomings are a lack of objectivity and reproducibility of speech measures; exhaustiveness and consideration of specific speech parameters (prosody, speech rate, and nasality); practicality of the assessment tools.

Conclusion: This study highlights a lack of standardization of the speech assessment in French-speaking adults and the need to offer new reliable tools for an optimized, accurate speech assessment. The automation of these tools would allow for rapid, reproducible, and accurate measures.

Introduction: Respiratory muscle weakness is common in patients with neuromuscular diseases (NMD). This puts them at risk for dysphagia and other pulmonary complications.

Objectives: To investigate the relationship between pulmonary function and swallowing in NMD.

Materials and methods: In this cross-sectional study, medical records of patients undergoing treatment at the Tertiary Referral Center for Neuromuscular Diseases of Hospital de Apoio de Brasília, Brazil, were reviewed. Respiratory function was assessed through spirometry (FVC and FEV1 measured) and swallowing assessed by the Dysphagia Risk Evaluation Protocol and the Functional Oral Intake Scale.

Results: Two hundred and twenty-two patients were included. Dysphagia was present in 46.8% of patients and impairment of pulmonary function in 64.0%. The mean FVC observed was 66.9% and FEV1 was 66.0%, indicating restrictive lung disease. A correlation between the decline of pulmonary and swallowing functions was observed in patients with NMDs (FVC vs. DREP, R = 0.46; FVC vs. FOIS, R = 0.42; FEV1 vs. DREP, R = 0.42; FEV1 vs. FOIS, R = 0.40, p<.01). FVC and FEV1 values tend to be lower in patients with dysphagia in the context of NMD.

Conclusions: A positive correlation between pulmonary function and swallowing outcomes was observed in patients with NMD. Despite respiratory and swallowing impairment being widely present in the population with NMD, they require different treatments according to the disease's pathophysiology. Future studies should be conducted to explore the disease-specific relationship between pulmonary function and swallowing in patients with NMD.

Purpose: Voice feminization for transgender women remains a challenge. The fundamental frequency of the voice (f_o) is one of the main parameters contributing to the perception of gender. One of the aims of voice therapy is to help transgender women acquire a new vocal motor behavior to increase their f_o. We hypothesized that ambulatory biofeedback could help extend the new vocal behavior to daily life.Materials and methods: This prospective case study assessed the impact of two weeks of ambulatory vibrotactile biofeedback (VTBF) applied to one transgender woman, following two weeks of voice therapy (three 60-minute sessions). The VTBF was activated when the participant's voice was lower than 150 Hz for more than 500 ms and was accompanied by two 60-minute counseling sessions.Results: The results showed that mean f_o monitored in daily activities tended to increase following the two weeks of voice therapy (Δ = 8 Hz or 1 semitone) and then increased significantly immediately after the two weeks of VTBF (Δ = 13 Hz or 1.5 semitones). The increase in mean f_o from day to day and the decrease in the activation percentage from the first to the second week of VTBF (Δ = 6%) indicated a gradual integration of the motor behavior, making it possible to achieve the targeted female frequency.Conclusions: The results suggest that ambulatory VTBF helped the participant to generalize the techniques acquired during the voice therapy sessions to real-life communication situations. These results are promising for therapeutic programs that integrate tools that can be used outside the clinical context. Design: Prospective case study.

Objective: To evaluate the association between musculoskeletal pain, insomnia indices, and sleep quality with voice functioning among women.

Methods: Thirty women aged between 18 and 50 years old participated in two groups: dysphonic group (DG) - composed of 15 women diagnosed with behavioral dysphonia; and control group (CG) - composed of 15 vocally healthy women. All participants answered the Musculoskeletal Pain Investigation Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI) questionnaires. Statistical tests were applied to compare groups and to relate outcome variables, with a significance of 5% (p<.05).

Results: Dysphonic women presented a higher frequency of musculoskeletal pain in the posterior neck, lower back, masseter, submandibular, and larynx regions. There was no statistically significant difference for the other compared variables. We observed that there was a difference in the comparison between pain in some head and neck regions and the quality of sleep and evidence of insomnia, both in DG and CG.

Conclusions: Dysphonic women have a higher frequency of pain in the head and neck regions when compared to vocally healthy women. There is a difference between sleep quality, insomnia, and musculoskeletal pain, regardless of the presence of vocal and laryngeal alterations.

Purpose: The present study aimed to validate the Persian version of the Functional Oral Intake Scale (FOIS-P) for stroke patients.

Materials and methods: The current study was conducted in two phases: (1) translation and cross-cultural adaptation of the FOIS into Persian and (2) validation of the FOIS-P. Phase 1 included forward translation, synthesis, back-ward translation, expert panel, and pretesting. To validate the FOIS-P, inter-rater reliability, cross-validity, and sensitivity to change of the scale were investigated. To evaluate the inter-rater reliability of the FOIS-P, two speech-language pathologists, who were blind to the study aims and procedure, applied the FOIS-P to assess the oral intake of 60 stroke survivors. The cross-validity was assessed by investigating the correlation between the FOIS scores and the Video Fluoroscopy Swallowing Study (VFSS). Also, we applied the FOIS-P on 60 patients with stroke at three different times to investigate the sensitivity to change.

Results: Inter-rater reliability of the FOIS-P was excellent according to Cohen's Kappa calculation (K = 0.89, p<.001). Investigation of cross-validity showed that there were significant correlations between the FOIS scores and presence of dysphagia, presence of aspiration, and severity of dysphagia (p<.001). The changes of the FOIS-P scores over follow-ups revealed that the FOIS-P was sensitive to the patient's oral intake changes.

Conclusions: The FOIS-P is a valid and reliable tool for assessing oral intake in stroke survivors with dysphagia. Hence, the FOIS-P may be suitable for clinical and research in the field of stroke.

Purpose: Language has been suggested to play a facilitating role for analogical reasoning tasks, especially for those with high complexity. This study aims to evaluate if differences in analogical reasoning ability between children with cochlear implants (CI) and children with typical hearing (TH) might be explained by differences in language ability.

Methods: The analogical reasoning ability (verbal; non-verbal; complex non-verbal: high relational integration demand) of children with CI (N = 15, mean age = 6;7) was compared to two groups of children with TH: age and language matched (TH-A+L, N = 23, mean age = 6;5), and age matched (TH-A, N = 23, mean age = 6;5).

Results: Children with CI were found to perform comparable to Group TH-A+L on non-verbal reasoning tasks but significantly more poorly on a verbal analogical reasoning task. Children with CI were found to perform significantly more poorly on both the non-verbal analogical reasoning task with high relational integration demand and on the verbal analogical reasoning task compared to Group TH-A. For the non-verbal analogical reasoning task with lower relational integration demand only a tendency for a difference between group CI and Group TH-A was found.

Conclusions: The results suggest that verbal strategies are influencing the performance on the non-verbal analogical reasoning tasks with a higher relational integration demand. The possible reasons for this are discussed. The verbal analogical reasoning task used in the current study partly measured lexical access. Differences between the children with CI and both groups of children with TH might therefore be explained by differences in expressive vocabulary skills.

Introduction: Fitness trainers and sporting coaches use their voices in acoustically poor conditions, for extended periods of time. Knowledge of the risk of voice problems in this cohort is emerging and has been documented in studies performed in Europe and Australia. This pilot study sought to identify the prevalence of voice problems of fitness trainers and sporting leaders in United States college towns.

Materials and methods: An online questionnaire was distributed. The survey was based on the instrument developed by Rumbach (2013), "Vocal health of GFIs" (group fitness instructors (GFIs)) and adapted to account for the wider target population of this study. The survey included questions about participants' demographic information, as well as working conditions, including acoustic environment, leading requirements, equipment provision and maintenance and vocal diagnoses and symptoms. Questions on symptomatology included voice quality and physical symptoms (e.g. throat soreness). Recruitment took place between May and September 2018.

Results: Sixty-two participants completed the survey. Three participants (5.08%) reported having received a formal diagnosis of dysphonia, yet many more reported vocal symptoms, including physical symptoms (n = 15, 24.19%) and voice disturbance (n = 8, 12.90%). Few participants had received vocal education (n = 5, 8.06%) and many thought this should be included in their formal training (n = 24, 38.71%).

Conclusions: In contrast to previous investigations, diagnosed voice disorders are less prevalent in this sample, based in US college towns. However, physical and vocal symptoms associated with voice overuse were common, suggesting that participants were unaware of their voice and the significance of the changes they reported.

Objective: The aim of this study was to obtain normative nasalance scores for Indian Tamil-speaking children.

Methods: Mean nasalance scores were obtained from 175 consecutive Tamil-speaking normal children (95 males, 80 females) aged 5-16 years during the repetition of six standardized sentences: two oral, two oronasal, and two nasal sentences. The nasal view was used to obtain nasalance scores for the standardized sentences.

Results: Group mean and standard deviation (SD) nasalance scores of children for oral, oronasal, and nasal sentence were 35.65(SD 7.20), 44.42(SD 7.37), and 57.21(SD 8.15), respectively. The mean nasalance values of children aged 9-12 years were greater than children aged 5-8 years and 13-16 years for nasal sentences (p < .001). Males were found to have significantly higher nasalance scores for oral and oronasal sentences (p < .05) although these differences were within the range of normal variation.

Conclusions: The present study provides normative nasalance scores for Tamil-speaking Indian children.