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Abstract

Voice disorders are affecting everyday life in many levels, and their prevalence has been studied extensively in certain and general populations. Notably, several factors have a cohesive influence on voice disorders and voice characteristics. Several studies report that health and environmental and psychological etiologies can serve as risk factors for voice disorders. Many diagnostic protocols, in the literature, evaluate voice and its parameters leading to direct or indirect treatment intervention. This study was designed to examine the effect of tango on adult acoustic voice parameters. Fifty-two adults (26 male and 26 female) were recruited and divided into four subgroups (male dancers, female dancers, male nondancers, and female nondancers). The participants were asked to answer two questionnaires (Voice Handicap Index and Voice Evaluation Form), and their voices were recorded before and after the tango dance session. Moreover, water consumption was investigated. The study's results indicated that the voices' acoustic characteristics were different between tango dancers and the control group. The beneficial results are far from prominent as they prove that tango dance can serve stand-alone as voice therapy without the need for hydration. Also, more research is imperative to be conducted on a longitudinal basis to obtain a more accurate result on the required time for the proposed therapy.

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... Dessa forma, a análise acústica traz uma contribuição específica e uma informação não redundante em comparação aos outros procedimentos comumente utilizados na clínica vocal. Nesse contexto, a presente revisão identificou que diferentes medidas acústicas têm sido utilizadas no cenário da intervenção com indivíduos vocalmente saudáveis, incluindo medidas baseadas na frequência fundamental , medidas de intensidade (18,22,23,25,(29)(30)(31)37,39,40,(43)(44)(45)(46)49,53,(56)(57)(58)61,63,66,67,(69)(70)(71)(72)(73) , medidas cepstrais/espectrais (25,(39)(40)(41)66,70,(73)(74)(75)(76)(77) , medidas de perturbação e ruído (16,18,22,23,26,27,35,36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(49)(50)(51)(52)(54)(55)(56)(60)(61)(62)64,65,72,(78)(79)(80)(81)(82)(83)(84)(85) , índices acústicos (16,18,23,41,(43)(44)(45)49,50,52,72,73,79) e análise descritiva do espectrograma de faixa estreita (15,(17)(18)(19)(20)(26)(27)(28)(43)(44)(45)(46)51,57,59,69,70,(75)(76)(77)83,86) . A variabilidade da frequência fundamental (fo) foi o parâmetro mais destacado entre os artigos que apresentaram a avaliação acústica como medida para mensurar os efeitos das intervenções em indivíduos com vozes saudáveis. ...
... Dessa forma, a análise acústica traz uma contribuição específica e uma informação não redundante em comparação aos outros procedimentos comumente utilizados na clínica vocal. Nesse contexto, a presente revisão identificou que diferentes medidas acústicas têm sido utilizadas no cenário da intervenção com indivíduos vocalmente saudáveis, incluindo medidas baseadas na frequência fundamental , medidas de intensidade (18,22,23,25,(29)(30)(31)37,39,40,(43)(44)(45)(46)49,53,(56)(57)(58)61,63,66,67,(69)(70)(71)(72)(73) , medidas cepstrais/espectrais (25,(39)(40)(41)66,70,(73)(74)(75)(76)(77) , medidas de perturbação e ruído (16,18,22,23,26,27,35,36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(49)(50)(51)(52)(54)(55)(56)(60)(61)(62)64,65,72,(78)(79)(80)(81)(82)(83)(84)(85) , índices acústicos (16,18,23,41,(43)(44)(45)49,50,52,72,73,79) e análise descritiva do espectrograma de faixa estreita (15,(17)(18)(19)(20)(26)(27)(28)(43)(44)(45)(46)51,57,59,69,70,(75)(76)(77)83,86) . A variabilidade da frequência fundamental (fo) foi o parâmetro mais destacado entre os artigos que apresentaram a avaliação acústica como medida para mensurar os efeitos das intervenções em indivíduos com vozes saudáveis. ...
... -----41-60 minutos (83,93,94) Entre 1 e 2 horas (19,22,28,53,55,67,69,75,80,81,99,100) Entre 2 e 5 horas (24,47) Mais de 5 horas (59,68,102,107) Informação Não Disponível (17, 18, 21, (15-17, 19, 22, 25, 37, 53, 54, 71, 72, 88, 89, 94-96, 97, 99, 109) (17, 18, 34, 38, 56-58, 66, 68, 86, 87, 94, 97) 9-12 sessões (60,62,67,75,93) 13-15 sessões (106,107) 8-16 sessões (23,67) 16-20 sessões (91) Informação Não Disponível (33,39,61,64,77,90,100,102,110) (14, 20, 21, 24, 26-32, 35, 36, 40-53, 57, 59, 60, 64, 66, 70, 71, 73, 74, 76, 78-85, 92, 98, 101, 103-106, 108) Follow-up (15-19, 34, 37, 38, 56, 61-63, 65, 67-69, 72, 73, 86-89, 91, 93-97, 99, 100, 102, 107, 109) Informação Não Disponível (22,23,25,33,39,54,55,58,59,75,77,90,110) MÉTODO DE AVALIAÇÃO Autoavaliação (15-18, 22, 23, 28, 32, 33, 38, 45, 53, 55, 58, 59, 63, 66-69, 75, 77, 78, 82, 83, 87, 88, 91, 98-100, 103-107, 109, 110) JPA (17-19, 31, 46, 48, 58, 61, 70, 78, 79, 82, 88, 91, 93, 95, 96, 99, 100, 102, 106, 107) Acústica (14-17, 19-21, 23, 24, 28, 31-34, 37, 38, 40, 41,43-46, 48, 53, 54, 56-58, 60-71, 73-78, 81-83, 86-89, 91-95, 97-103, 105-107, 109, 110) Exame laríngeo (21, 26, 30, 31, 35, 65, 79-81, 88, 93, 95, 100, 102, 106, 108) Aerodinâmica (16,18,20,27,29 (14-17, 19, 23, 24-27, 33, 34, 35, 37-39, 41-43, 45, 47, 49, 50, 51, 53-56, 60, 64, 66-68, 70-73, 76, 77, 78, 79, 82, 83, 85, 87-89, 91, 95, 97, 98, 100, 105, 106) Emissão em TMF (vogal ou fricativas alveolares) (18, 25, 28, 29, 33, 66-69, 75, 81, 91, 94, 100, 102, 105, 106, 108) Vogal sustentada com variação de intensidade (20,21,33,43,45,46,51,67,87) Vogal sustentada com variação de frequência (33,38,41,43,46,65,67,71,87,97,109) Fala encadeada com variação de intensidade (31,92,93,99,104) Fala encadeada com variação de frequência (17, 20, 28, 45, 46, 48, 53-56, 58, 59-61, 70, 73, 76, 78, 83, 84, 86, 88-94, 96, 99, 101, 104, 108) Tarefa de voz cantada (17,20,48,51,57,62,63,74,83,86,88,93,97,99,102,107,109,110) Outros (22, 29, 30, 32, 36, 39-46, 49, 51, 52, 59, 62, 63, 71, 72, 78, 80, 84, 85, 87, 94, 96, 103, 104) Legenda: JPA = julgamento perceptivo-auditivo; TMF = tempo máximo de fonação (25,63,66,70,74) . Dessa forma, a intervenção vocal parece ter o efeito de aumentar a energia harmônica presente no sinal vocal após a intervenção com indivíduos vocalmente saudáveis. ...
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Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution Non-Commercial, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado. Medidas de efeito das intervenções em vozes saudáveis: uma revisão de escopo Measurements of the effect of interventions on heathly voices: a scope review RESUMO Objetivo: mapear as medidas de avaliação vocal utilizadas para verificar o efeito da intervenção em indivíduos vocalmente saudáveis. Estratégia de pesquisa: trata-se de uma revisão de escopo baseada na questão de pesquisa: "Quais as medidas de avaliação vocal utilizadas para verificar o efeito da intervenção em indivíduos vocalmente saudáveis?" A busca foi realizada de forma eletrônica nas bases de dados MEDLINE (PubMed), LILACS (BVS), Scopus (Elsevier), Web of Science (Clarivate), Embase e Cochrane. Critérios de seleção: a seleção dos estudos foi baseada na leitura dos títulos, resumos, palavras-chave e textos completos, aplicando-se os critérios de elegibilidade. Foram extraídos os dados relacionados às informações bibliográficas da publicação, características da amostra e da intervenção, os efeitos da intervenção nas medidas de autoavaliação, perceptivo-auditivas, acústicas, aerodinâmicas, eletroglotográficas, resultado do exame laríngeo, entre outros. Os dados foram resumidos e apresentados de forma quantitativa e descritiva. Resultados: foram selecionados 97 artigos, entre os 979 estudos mapeados nesta revisão. A análise acústica foi a medida mais utilizada (n=70, 72,3%) para verificar os efeitos do treinamento vocal nos estudos selecionados, seguida pela eletroglotografia (n= 55, 56,7%), autoavaliação (n= 38, 39,2%), aerodinâmica (n= 33, 34,0%), julgamento perceptivo-auditivo (n= 22, 22,7%) e exame laríngeo (n= 16, 16,5%). Conclusão: a análise acústica é a medida utilizada na maioria dos estudos para verificar o efeito da intervenção em indivíduos vocalmente saudáveis. Palavras-chave: Voz; Qualidade da voz; Treinamento da voz; Estudo dos resultados; Estudos de revisão; Voluntários saudáveis ABSTRACT Purpose: to map the vocal assessment measures used to verify the effect of the intervention in vocally healthy individuals. Research strategy: This is a scope review based on the research question: What vocal assessment measures are used to verify the effect of the intervention in vocally healthy individuals? The search was carried out electronically in MEDLINE (PubMed), LILACS (BVS), Scopus (Elsevier), Web of Science (Clarivate), Embase and Cochrane databases. Selection criteria: The selection of studies was based on reading the titles, abstracts, keywords and full texts, applying the eligibility criteria. Data related to the publication's bibliographic information, sample and intervention characteristics, the effects of the intervention on self-assessment, auditory-perceptual, acoustic, aerodynamic, electroglottographic measures, laryngeal examination results, among others, were extracted. The data were summarized and presented in a quantitative and descriptive way. Results: 97 articles were selected, among the 979 studies mapped in this review. Acoustic analysis was the most used measure (n=70, 72.3%) to verify the effects of vocal training in the selected studies, followed by electroglottography (n= 55, 56.7%), self-assessment (n= 38, 39 .2%), aerodynamics (n= 33, 34.0%), auditory-perceptual judgment (n= 22, 22.7%) and laryngeal examination (n= 16, 16.5%). Conclusion: Acoustic analysis is the measure used in most studies to verify the effect of the intervention in vocally healthy individuals. Conflito de interesses: Não. Contribuição dos autores: LMGMOM participou da concepção, execução, tabulação, análise dos dados e escrita do manuscrito; POCS participou da concepção, tabulação e supervisão do estudo; ERS, DJB, JMTD e VVR participaram da coleta e extração dos dados; AAFA participou da escrita e correção do manuscrito; LWL participou da elaboração do estudo, escrita e revisão do manuscrito. Financiamento: Nada a declarar.
... Thus, its contribution is specific, and its information is nonredundant in comparison with other procedures commonly used in vocal clinical practice. In this context, this review identified the different acoustic measures that have been used in interventions in vocally healthy individuals, including fundamental frequency (f0) measures , intensity measures (18,22,23,25,(29)(30)(31)37,39,40,(43)(44)(45)(46)49,53,(56)(57)(58)61,63,66,67,(69)(70)(71)(72)(73) , cepstral/ spectral measures (25,(39)(40)(41)66,70,(73)(74)(75)(76)(77) , perturbation and noise measures ( (16,18,23,41,(43)(44)(45)49,50,52,72,73,79) , and descriptive analysis of narrowband spectrograms (15,(17)(18)(19)(20)(26)(27)(28)(43)(44)(45)(46)51,57,59,69,70,(75)(76)(77)83,86) . F0 variability stood out among the parameters in the articles that used acoustic assessment to measure the effects of interventions in vocally healthy individuals. ...
... The most used electroglottography measures were the glottal contact quotient (15,27,29,50,54,70,73,85,(88)(89)(90)(91) , glottal closure quotient (21,28,32,33,35,40,77,(92)(93)(94)(95)(96) , and opening quotient (21,40,92) . In most (14,33,39,42,49,53,58,59,61,67,71,81,86,97,99,102,105,106,109,110) Before-and-after (15, 17-22, 25-28, 31, 32, 34-36, 40, 41, 50-52, 54-57, 60, 62, 63, 70, 72-74, 76-80, 82-85, 89-93, 95, 101) Experimental (16, 23, 24, 37, 38, 43, 44-48, 64-66, 68, 69, 75, 87, 88, 94, 96, 98, 100, 103, 104, 107, 108) Case series (29,30) Case study -----Type of intervention Direct (14-21, 23-32, 34-58, 60-66, 70-74, 76-89, 91, 92, 94-97, 99, 101-105, 107-110) Indirect (22,106) Both (33, 59, 67-69, 75, 90, 93, 98, 100) TOTAL TIME OF INTERVENTION Less than 1 minute (14,23,26,27,60,103) 1-3 minutes (15, 16, 41-43, 45, 89) 4-10 minutes (20,29,35,40,44,45,50,52,73,81,82,87,91) 11-20 minutes (32,48,51,54,88,92,97) 21-30 minutes (15,25,46,61,63,66,78,90,95,96,99,105,106) ...
... The most used electroglottography measures were the glottal contact quotient (15,27,29,50,54,70,73,85,(88)(89)(90)(91) , glottal closure quotient (21,28,32,33,35,40,77,(92)(93)(94)(95)(96) , and opening quotient (21,40,92) . In most (14,33,39,42,49,53,58,59,61,67,71,81,86,97,99,102,105,106,109,110) Before-and-after (15, 17-22, 25-28, 31, 32, 34-36, 40, 41, 50-52, 54-57, 60, 62, 63, 70, 72-74, 76-80, 82-85, 89-93, 95, 101) Experimental (16, 23, 24, 37, 38, 43, 44-48, 64-66, 68, 69, 75, 87, 88, 94, 96, 98, 100, 103, 104, 107, 108) Case series (29,30) Case study -----Type of intervention Direct (14-21, 23-32, 34-58, 60-66, 70-74, 76-89, 91, 92, 94-97, 99, 101-105, 107-110) Indirect (22,106) Both (33, 59, 67-69, 75, 90, 93, 98, 100) TOTAL TIME OF INTERVENTION Less than 1 minute (14,23,26,27,60,103) 1-3 minutes (15, 16, 41-43, 45, 89) 4-10 minutes (20,29,35,40,44,45,50,52,73,81,82,87,91) 11-20 minutes (32,48,51,54,88,92,97) 21-30 minutes (15,25,46,61,63,66,78,90,95,96,99,105,106) ...
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Purpose to map the vocal assessment measures used to verify the effect of the intervention in vocally healthy individuals. Research strategy This is a scope review based on the research question: What vocal assessment measures are used to verify the effect of the intervention in vocally healthy individuals? The search was carried out electronically in MEDLINE (PubMed), LILACS (BVS), Scopus (Elsevier), Web of Science (Clarivate), Embase and Cochrane databases. Selection criteria The selection of studies was based on reading the titles, abstracts, keywords and full texts, applying the eligibility criteria. Data related to the publication’s bibliographic information, sample and intervention characteristics, the effects of the intervention on self-assessment, auditory-perceptual, acoustic, aerodynamic, electroglottographic measures, laryngeal examination results, among others, were extracted. The data were summarized and presented in a quantitative and descriptive way. Results 97 articles were selected, among the 979 studies mapped in this review. Acoustic analysis was the most used measure (n=70, 72.3%) to verify the effects of vocal training in the selected studies, followed by electroglottography (n= 55, 56.7%), self-assessment (n= 38, 39 .2%), aerodynamics (n= 33, 34.0%), auditory-perceptual judgment (n= 22, 22.7%) and laryngeal examination (n= 16, 16.5%). Conclusion Acoustic analysis is the measure used in most studies to verify the effect of the intervention in vocally healthy individuals. Keywords: Voice; Voice quality; Voice training; Results study; Review; Healthy volunteers
... The results of the present study (limitations apply, please see section 4.4) revealed that VDP exhibit significantly higher means and medians on all three domains and on the total score of the VHI compared to the control group. This finding indicates that dysphonic patients perceive their voice differently than non-symptomatic groups [15][16][17] . Consequently, the discriminatory ability of the VHI has been confirmed. ...
... Moreover, significant differences in VHI scores were observed between all VDP groups in comparison to those of the control group. This finding was observed in populations with voice disorders compared to non-dysphonic populations 1,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][41][42][43]46 , as well as in non-symptomatic smokers 18,44,45 and other populations 15,16 . The aforesaid further demonstrates the discriminatory ability of the VHI. ...
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Voice disorders often remain undiagnosed. Many self-perceived questionnaires exist for various medical conditions. Here, we used the Greek Voice Handicap Index (VHI) to address the aforementioned problem. Everyone can fill in the VHI questionnaire and rate their symptoms easily. The innovative feature of this research is the global cut-off score calculated for the VHI. Therefore, the VHI is now capable of helping clinicians establish a more customizable treatment plan with the cut-off point identifying patients without normal phonation. For the purpose of finding the global cut-off point, a group of 180 participants was recruited in Greece (90 non-dysphonic participants and 90 with different types of dysphonia). The voice disordered group had higher VHI scores than those of the control group. In contrast to previous studies, we provided and validated for the first time the cut-off points for all VHI domains and, finally, a global cut-off point through ROC and precision-recall analysis in a voice disordered population. In practice, a score higher than the well-estimated global score indicates (without intervention) a possible voice disorder. Nevertheless, if the score is near the threshold, then the patient should definitely follow preventive measures.
... Several tools are available to assess the QoL of head and neck cancer patients. For example, there is the Voice Handicap Index (VHI) [14] that has been validated and used recently in many languages [15][16][17][18] and the Voice-related Quality of Life (V-RQOL) [19], which also has been validated in many languages [16,[20][21][22] and provides detailed assessments of speech rehabilitation outcomes [10]. They can be used to assess people with dysphonia of different etiologies, including patients who have undergone total laryngectomy. ...
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(1) Background: The present systematic study aimed to assess whether using esophageal speech (ES) as a method of vocal rehabilitation in patients after total laryngectomy enhances their quality of life (QoL) and vocal functionality based on patients’ reports. (2) Methods: Data collection was conducted from PubMed, Google Scholar, and Speech Bite, and the PRISMA Flow Diagram tool was used to record different stages of the literature search process. In the review, nine studies were included, while a bias check was carried out using the Critical Appraisal Skills Programme (CASP) checklists. Survey analysis incorporated quantitative and qualitative data, including standardized questionnaires and audio analyses. (3) Results: A technique’s effectiveness depends on the method’s functionality and the patient’s abilities. Furthermore, the findings revealed that ES use unexpectedly affects quality of life regarding patients. While statistical analysis of the studies showed that some patients reported improvement in quality of life and vocal functionality, others faced challenges such as difficulty in learning the technique, long-term intervention, and unsatisfactory phonetic performance. Some studies observed quantitative measures, such as improved Voice Impairment Index (VHI) scores and Voice-Related Quality of Life (V-RQOL) scores. However, results were not uniformly positive across studies, with a subset of patients reporting minimal improvement. (4) Conclusions: The limited literature on the effect of ES on patients’ QoL appears to influence the results in different ways. However, research data support that patients’ communication and psychological state seem to improve significantly compared to patients who have not been rehabilitated. The final assessment of the technique’s effectiveness on quality of life must depend on many factors.
... However, the NDW was significantly higher when a child was interacting with a parent. Conclusions: Findings of the research give important information on the influence of the communication partner in children's speech and could help clinicians towards choosing the right person which will interact with a child when collecting a language sample [5][6][7][8][9]. ...
Article
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Language is a way of expression which is inherent in all people. Each person is born with the ability to develop language irrespective of nationality or language. However, some children may have language disorder or they may not have typical language development [1–4]. In order to diagnose a language disorder, clinicians use formal or informal assessments. Language sample collection and analysis is an informal assessment that provides data from spontaneous speech productions on real communication environments. The main objective of the study was to find the influence of the conversational partner in Cypriot-Greek speaking children with typical language development.
... It is worth mentioning that men in nearby ages did not have substantial differences which indicates that they conceive cluttering in a similar way. In conclusion, older men have a totally different perception about this fluency disorder compared to men of younger ages and this can be useful evidence data during diagnosis [1][2][3][4][5][6][7][8][9]. ...
Article
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Fluency disorders and its etiologies was always of interest by mental health professionals. Cluttering -as a fluency disorder- is a clinical condition that needs to be diagnosed accurately and extensively. Self-perceived questionnaires are a new trend in evidence-based assessment, and gender is a factor that influences their results. Particularly, “Predictive Cluttering Inventory (PCI)” is a questionnaire that elicits information from adults with cluttering disorders. Purpose of the current study was to extract evidence-based data from typical male population using PCI.
... Conclusions: From the above it is determined that age is an important factor when it comes to co-ordination difficulties for male adults in an almost predictable way. As age progresses the perception of coordination of musculature probably becomes more of a challenge for the male population as in other researches [1][2][3][4][5][6][7][8]. ...
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The motor that demands of speech production can be compromised by normal aging processes and thus it could change an individual’s precision and fluency. It is important to have individualized data on the motor difficulties which any person might face throughout his/her life to make the clinical process more efficient and client-oriented. To this direction self-reported questioner provide valuable information about clients’ perception for the clinical condition they experience, such as Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC) which is a 37-items Likert scale questionnaire. This study aimed to determine the self-perceived levels of motor abilities for typical adult males.
... Background: Coordination of speech musculature is strongly associated with neurological dis-orders also resulting from natural aging. Whichever is the cause, an important part of the assessment is the use of self-reported tools [1][2][3][4][5][6][7][8] to determine the patient's needs and requests. One is the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC). ...
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Coordination of speech musculature is strongly associated with neurological disorders also resulting from natural aging. Whichever is the cause, an important part of the assessment is the use of self-reported tools [1–8] to determine the patient’s needs and requests. One is the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC). Purpose of this study was to find how females perceived their co-ordination difficulties-abilities using ADC and how this perception differed through adult lifespan.
... Conclusions: The effect of age might not be a significant parameter to be taken into account during self-assessment of speech abilities for typical females. Overall, the awareness of co-ordination difficulties seems to be present mostly as age progresses as in other researches [1][2][3][4][5][6][7][8], but more research is needed for different type of populations such as those of pathological type. ...
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Many problems arise for adults with literacy difficulties in the daily demanding environment. Those problems are probably the outcome of undetected and untreated literacy symptoms (as reading disabilities) at childhood. Recent findings suggest that such difficulties are more common amongst men than women. Considering the above, the purpose of this study was to record how typical male adults perceived their reading abilities using Adults Reading Questionnaire in order to create evidence-based data for their population in Greece.
... Conclusions: The results exposed significant contributes of the age factor in the formation of the scores. As expected, older individuals scored higher that younger subjects in most of the questions as in other questionnaires [1][2][3][4][5][6][7][8]. From this, we can conclude that women of older ages face greater difficulties during reading, maybe due to natural aging or undetected disorders. ...
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Reading abilities in women seem to alter as age progresses and as cultural framework changes. Estrogen related changes also appear to contribute in reading abilities. Moreover, research shows that analphabetism affects women more than men which results in literacy difficulties. However, it is important to determine how different ages perceive their reading abilities as such data can prove useful to clinicians. In this study, we attempted to create evidenced based data for the self-perceived levels of reading abilities for typical Greek women using Adults Reading Questionnaire.
... 150 people (men and women) will be split into three teams of 50 subjects. All the subjects should be analyzed prior to the use of SCL-90-R in order to determine if they are typical users [5][6][7]. Also, another impromptu questionnaire will be filled in for determining the type of a possible physical illness and for correlating the results of this category of subjects to possible system's unpredicted results. After the procedure, all the subjects will be evaluated again with a new impromptu questionnaire based on the system's employed Freudian Psychoanalysis' factors. ...
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In the modern era of vast communication and information dissemination the need for radical security measures must be addressed. Specifically, as the Internet has a tremendous influence on people and especially on younger ones, new threats are added to existing ones such as the Blue Whale phenomenon [1]. The latter is continuously growing with the corresponding suicide rate to equally arise while being already beyond acceptable values. Especially in some countries the percentage is really high denoting that immediate confrontation is needed. Many solutions can be found but the most proper should be found in any means of electronic monitoring and intervention. In turn, this autonomous monitoring system will exhibit empathetic characteristics. This system will have the capability of working locally but can also be connected to every network in order to alert security services for quick on-site intervention. The hardware part of the system will contain wired and wireless sensor nodes which will conduct measurements from various points of the body, as well as from various peripheral devices that are close to it. The software part will include a database and a local application to store the information acquired by sensors. In turn, the feedback will be processed algorithmically based on significant principals of psychotherapy in order the system to influence the users through multimedia interaction (empathetic approach) for the sake of their mental health. Also, additional features will be available for the sake of their relaxation or their stimulation for carrying on their work. The proposed scheme is named as Standalone Empathetic Intelligent Monitoring System (SEIMoS) which is based on Freudian psychoanalysis.
... Conclusion: EAT 10 can be used as primary assessment tool and provide evidenced data of the perceived level of a person's swallowing ability even for the typical population as in other communication abilities [1][2][3][4]. It also appears that in its current form can be standardized in ...
Conference Paper
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Swallowing disorders in adults can lead to chronic problems which could be the risk for malnutrition, choking and aspirating pneumonia. Speech and language assessment of swallowing disorders is usually conducted using imaging methods, bedside evaluation and grating self-perceived questionnaires. The purpose of the present study was to validate Eating Assessment Tool and provide evidence data for typical Greek population.
... In literature, a number of self-perceived questionnaires were developed about different mental, medical and developmental disorders giving good evidence data about the self-awareness of a someone apprehending his/her current condition [1][2][3][4]. Same for reading abilities studies, self-reported questionnaires were developed such as Adults Reading Questionnaire (ARQ). Purpose of this study was to validate ARQ in greek language and to copy reading difficulties in adults' population. ...
Conference Paper
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In literature, a number of self-perceived questionnaires were developed about different mental, medical and developmental disorders giving good evidence data about the self-awareness of a someone apprehending his/her current condition. Same for reading abilities studies, self-reported questionnaires were developed such as Adults Reading Questionnaire (ARQ). Purpose of this study was to validate ARQ in greek language and to copy reading difficulties in adults’ population.
... Greek language [38] and in turn was used in research level relevant to Greek population [39] [40] [41] [42]. Furthermore, many studies reported that self-assessment methods may be considered as potential screening tools for distinguishing between dysphonic and non-dysphonic individuals [43]- [48]. ...
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Objective(s): The cutting-edge assessment of voice disorders includes objective and subjective methods in the daily clinical practice. The latter assessment is usually performed through the administration of self-reported questionnaires. Voice Handicap Index (VHI) is one of the most widely used tools both in clinical practice and in research level. This tool-questionnaire was employed in this research along with the Voice Evaluation Template (VEF). In turn, the aim of this study was to analyse and produce the cut-off points of VHI for voice-disordered patients in Greece by using Receiver Operating Characteristic Curves (ROC Curves). Methods: Sixty-three participants (40 non-dysphonic and 23 with different types of dysphonia) were classified by ENT (Ear, Nose, and Throat) doctors and SLPs (Speech-Language Pathologists). The Hellenic VHI along with the translated Greek version of the VEF was administered to the subjects of this research. Results: The voice-disordered subjects exhibited higher overall VHI scores (in total and in its 3 subdomains) compared to the control group. Statistical significant differences were found between dysphonic and non-dysphonic participants for all VHI’s construct domains. The cut-off point of VHI total score was estimated at the value of 14.50 (sensitivity: 0.870, 1-specificity: 0.000). Moreover, the cut-off points of the three subdomains were computed as 7.50 for functional (sensitivity: 0.783, 1-specificity: 0.000), 8.50 for physical (sensitivity: 0.739, 1-specificity: 0.000) and 8.50 for emotional domain (sensitivity: 0.783, 1-specificity: 0.050). Conclusion: The preliminary statistical and ROC data analysis of VHI concluded that by using this type of assessment method, populations with or without voice disorders (in Greece) can be distinguished. Albeit this tool is a non-interventional method it could consequently offer an adequate screening and monitoring capability.
Article
Background: Voice disorders influence the quality of people's life. When the type of disorder is determined then the clinicians are capable of finding their patients' needs and address their complaints concerning their vocal problems. One of the most used tools, for assessing the patients' quality of life (in accordance with their vocal status), is the Voice Handicap Index. In this study, we determined the cut-off scores of Voice Handicap Index for population with laryngeal mass lesions such as vocal polyps and nodules. The calculated cut-off points further guide clinicians toward applying a needed interventional method/therapy even in the cases where the condition of a person could not be easily estimated. Methods: The study involved 130 participants (aged 19-74). Specifically, 90 nondysphonic people served as the control group, while 40 participants had already been diagnosed with voice disorders due to laryngeal mass lesions. Participants who were diagnosed with a laryngeal inflammation or had undergone a surgery were excluded from the study. The cut-off scores were determined through a receiver-operating characteristic (ROC) analysis. Results: The calculated cut-off points were 19.50 for the total score of VHI, 7.50 for the functional domain, and 8.50 for the physical and the emotional domain. Conclusions: The aforementioned cut-off points could be used in empowering the everyday clinical practice. Moreover, their knowledge could help the construction of an individualized therapy plan, as well as monitoring-biofeedback tool for the populations with vocal fold lesions.
Article
Objective(s) The use of subjective evaluation tools are proven useful and of high clinical value in the case of voice disordered population. For that type of evaluation, self-assessment questionnaires about the severity of the voice like Voice Handicap Index-30 (VHI-30) have been developed. The VHI-30 is the most studied tool which includes psychometrically robustness while guiding physician's therapeutic decision making. Additionally, a valid abbreviated version of VHI-30 was developed for the first time in the Greek Language which is named as Greek Voice Handicap Index-10 (GVHI-10). Consequently, the aim of our study was to validate the proposed version of the VHI-10. Methods Ninety nondysphonic individuals and 90 dysphonic patients were classified by Otolaryngologists and Speech Language Pathologists. The study's subjects were evaluated with endoscopy and stroboscopy. Also, they were administrated the GVHI-30 and the translated version of the Voice Evaluation Template (VEF). The GVHI-10 was extracted by the Greek version of VHI-30. Results The group with voice disorders exhibited higher statistical significance in all GVHI-10 scores compared to those of the control group. The GVHI-10 showed a high internal consistency (Cronbach's a = 0.915 and split-half reliability coefficient equal to 0.86), good sensitivity compared to Greek VHI-30 (r = 0.764, P = 0.000) and intraclass correlation. A total cut-off point equal to 6.50 (AUC: 0.964; P < 0.001) was also calculated. Conclusions The proposed version of GVHI-10 distinguished the perceived levels of voice between dysphonic and nondysphonic groups and between different voice disordered populations. The GVHI-10 is shown to be clinically valid and sensitive exhibiting high reliability.
Article
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Fluency disorders affects 1% of the population and over 3 million people in the United States. Cluttering is a disorder characterized by a rapid rate of speech that may appear as non-proper erratic pronunciation. Many guidelines were suggested for the evaluation of cluttering to the literature and one diagnostic procedure is the use of self-perceived questionnaires. A self-reported questionnaire for adults cluttering is the “Predictive Cluttering Inventory’’. The aim of this study was to obtain evident based information in typical female population about cluttering using PCI.
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Cluttering is a fluency disorder characterized by an abnormally rapid rate. Several studies about its diagnosis were conducted based on different processes, such as articulation’s and phonological assessments and/or collection of spontaneous speech samples. Standardized diagnostic tools had not been proposed till Davis et al. suggested the “Predictive Cluttering Inventory (PCI)” as a self-perceived questionnaire for adults. The purpose of this study is to validate PCI in typical Greek adult population.
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Various therapies of voice disorders exist such as the kind of invasive treatments. On the contrary, a significant non-invasional method, demanding only the physical exercise of the subject, is Tango Voice Treatment Method [1]. Its beneficial results constitute this voice therapy as a standalone procedure even without hydration (not a strong factor). This research prolongs the beneficial results of this method by checking the emotional effects by administering Voice Handicap Index (VHI) [2–3]. These effects are directly associated with voice disorders and they include stress, emotional, or personality factors. It is well-known that emotional distress maybe related to voice disorders through a vicious cycle without distinguishing between them the cause and the result [4].
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Several studies have shown that smoking is the primary candidate for provoking voice disorders in adults. This unwanted condition has unfortunately other additional unwanted effects. One strong effect which is the result of this study, is relevant to psychological affected aspect of subjects which smoked [1–4]. For the purpose of conducting this research the Voice Handicap Index (VHI) emotional domain of items was administered to subjects. This domain included 10 items relevant to checking the psychological and psychosocial condition of subjects.
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Objective: The purpose of this study was to explore the concurrent validity of the Acoustic Voice Quality Index (AVQI) in a Korean population. We investigated the feasibility of its cutoff values and diagnostic accuracy in discriminating between normal and dysphonic voices. Materials and methods: A total of 1,524 native Korean subjects with normal voices (n = 113) and with voice disorders (n = 1,411) were asked to speak and sustain the vowel "a" and to read the Korean text "Walk" aloud. A 2-second mid-speech portion of the sustained vowel sound and two sentences (with 26 syllables) were edited and concatenated, and the AVQI was calculated. Additionally, two auditory-perceptual assessments, namely the Grade, Roughness, Breathiness, Asthenia, Strain scale, and the Consensus Auditory-Perceptual Evaluation of Voice were used by five speech language pathologists to rate the severity of dysphonia. Results: Both auditory-perceptual assessments showed high confidence levels among the five speech language pathologists. The AVQI correlated with grade (G) and overall severity (OS). There were statistically significant differences in AVQI, G, and OS between normal and pathological speech groups. In the receiver operating characteristic curve analysis, AVQI, G, and OS cutoff values were <3.33, <0.00, and <22.00, respectively. The receiver operating characteristic curve analysis indicated that AVQI had excellent diagnostic accuracy for discriminating between normal and dysphonic voices (area under the curve: 0.970-0.977). Conclusions: We demonstrated the concurrent validity of AVQI as a promising tool for assessing overall voice quality and quantifying dysphonia in a Korean-speaking population.
Conference Paper
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Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children till adult life [1]. Symptoms of ADHD include inattention, hyperactivity and impulsivity. The majority of previous adult ADHD studies have focused on children so that relatively little is known about ADHD symptoms and their effects in mid and late life. This study aimed with the use of Adult Self Report Scale (ASRS v-1.1) to copy the differences in the way that ADHD influences a person during his life through a pilot study on a typical adult population.
Conference Paper
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It has always been a challenge for clinicians concluding to an assessment that is both valid and accomplishable. The importance of an evident assessment is a necessity if we take into consideration that it determines the clinician’s diagnostic and therapeutic decisions. An essential part of the assessment is an individual’s self-perception of his/her situation that can be documented via self-assessment questionnaires [1-3]. The purpose of this study was to validate Sydney Swallowing Questionnaire (SSQ) and to measure the differences in the perception of deglutition process among 6 age groups in Greek language.
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Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarse-ness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cutoff points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cutoff points for individuals exhibiting voice symptoms which had been developed from laryngeal inflamma-tory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI's total cutoff point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity How to cite this paper: Tafiadis = 0.022); physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000); emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.
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Objectives/hypothesis: To examine the prevalence of voice disorders in young adults and identify sociodemographic factors, health conditions, and behaviors associated with voice disorder prevalence. Study design: Cross-sectional analysis of data from the National Longitudinal Study of Adolescent to Adult Health. Methods: During home interviews, 14,794 young adults, aged 24 to 34 years, reported their health conditions and behaviors. Presence and duration of voice disorders were reported over the past 12 months. We computed overall and stratified prevalence estimates by age, gender, race/ethnicity, medical conditions, smoking, and alcohol use. Multiple logistic regression was used to identify independent risk factors for a voice disorder while accounting for the complex sample design. Results: Six percent of participants reported a voice disorder lasting at least 3 days. Females had 56% greater odds of voice disorders than males. Number of days drinking alcohol was associated with voice disorders, but number of smoking days was not. Conditions that increased the likelihood of voice disorders included hypertension (OR = 1.42 [95% confidence interval {CI}: 1.07-1.89]), tinnitus (OR = 1.53 [95% CI: 1.06-2.20]), and anxiety/panic disorder (OR = 1.26 [95% CI: 1.00-1.60]). Results were independent of gender, alcohol consumption, upper respiratory symptoms, and lower respiratory conditions including asthma, bronchitis/emphysema, and gastrointestinal symptoms (diarrhea/nausea/vomiting). Conclusions: Voice disorders in young adulthood were associated with hypertension, tinnitus, and anxiety. Greater awareness of these relationships may facilitate voice evaluation among people who seek healthcare for these chronic conditions. Level of evidence: 2b Laryngoscope, 2016.
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Emotion regulation is a person’s active attempt to manage their emotional state by enhancing or decreasing specific feelings. Peripheral theories of emotion argue that the origins of emotions stem from bodily responses. This notion has been reformulated in neurophysiological terms by Damasio, who claimed that emotions are generated by conveying the current state of the body to the brain through interoceptive and proprioceptive afferent input. The resulting brain activation patterns represent unconscious emotions and correlate with conscious feelings. This proposition implies that through deliberate control of motor behavior and its consequent proprioception and interoception, one could regulate his emotions and affect his feelings. This concept is used in dance/movement (psycho)therapy where, by guiding to move in a certain way, the therapist helps the client to evoke, process, and regulate specific emotions. Exploration and practice of new and unfamiliar motor patterns can help the client to experience new unaccustomed feelings. The idea that certain motor qualities enhance specific emotions is utilized by the therapist also when she mirrors the client’s movements or motor qualities in order to feel what the client feels, and empathize with them. Because of the mirror neurons, feeling what the client feels is enabled also through observation and imagination of their movements and posture. This principle can be used by verbal therapists as well, who should be aware of its bi-directionality: clients seeing the therapist’s motor behavior are unconsciously affected by the therapist’s bodily expressions. Additional implications for psychotherapy, of findings regarding mirror neurons activation, are discussed.
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Objective: The aim of the present study was to determine if acoustic measures of voice, characterizing specific spectral and timing properties, predict clinical ratings of depression severity measured in a sample of patients using the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI-II). Study design: This is a prospective study. Methods: Voice samples and clinical depression scores were collected prospectively from consenting adult patients who were referred to psychiatry from the adult emergency department or primary care clinics. The patients were audio-recorded as they read a standardized passage in a nearly closed-room environment. Mean Absolute Error (MAE) between actual and predicted depression scores was used as the primary outcome measure. Results: The average MAE between predicted and actual HAMD scores was approximately two scores for both men and women, and the MAE for the BDI-II scores was approximately one score for men and eight scores for women. Timing features were predictive of HAMD scores in female patients while a combination of timing features and spectral features was predictive of scores in male patients. Timing features were predictive of BDI-II scores in male patients. Conclusion: Voice acoustic features extracted from read speech demonstrated variable effectiveness in predicting clinical depression scores in men and women. Voice features were highly predictive of HAMD scores in men and women, and BDI-II scores in men, respectively. The methodology is feasible for diagnostic applications in diverse clinical settings as it can be implemented during a standard clinical interview in a normal closed room and without strict control on the recording environment.
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Objective: The purpose of this study was to examine measures of vital capacity and phonation quotient across three age groups in women using three different aerodynamic instruments representing low-tech and high-tech options. Study design: This study has a prospective, repeated measures design. Methods: Fifteen women in each age group of 25-39 years, 40-59 years, and 60-79 years were assessed using maximum phonation time and vital capacity obtained from three aerodynamic instruments: a handheld analog windmill type spirometer, a handheld digital spirometer, and the Phonatory Aerodynamic System (PAS), Model 6600. Phonation quotient was calculated using vital capacity from each instrument. Analyses of variance were performed to test for main effects of the instruments and age on vital capacity and derived phonation quotient. Pearson product moment correlation was performed to assess measurement reliability (parallel forms) between the instruments. Regression equations, scatterplots, and coefficients of determination were also calculated. Results: Statistically significant differences were found in vital capacity measures for the digital spirometer compared with the windmill-type spirometer and PAS across age groups. Strong positive correlations were present between all three instruments for both vital capacity and derived phonation quotient measurements. Conclusions: Measurement precision for the digital spirometer was lower than the windmill spirometer compared with the PAS. However, all three instruments had strong measurement reliability. Additionally, age did not have an effect on the measurement across instruments. These results are consistent with previous literature reporting data from male speakers and support the use of low-tech options for measurement of basic aerodynamic variables associated with voice production.
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Objectives: Intermittent dysphonia within an utterance is common, but presents difficulty for both perceptual and objective voice evaluation. This study examined the ability of measures from the within-sample cepstral peak prominence (CPP) distribution to differentiate normal voices from intermittently and consistently dysphonic voices. Study design: Exploratory design. Methods: Sixty samples of the sentence "We were away a year ago" were classified as normal, intermittently dysphonic, or consistently dysphonic by four judges. Measures of CPP within each sample were obtained, and further analysis with examined CPP distribution variability and patterns of CPP outliers. Results: Whereas the mean CPP was the strongest single discriminator among the three voice types, the normal and intermittent dysphonia groups were not significantly different on CPP distribution skewness and measures of CPP distribution outliers. Both the normal and intermittently dysphonic voices differed significantly from the consistently dysphonic samples on these variables. A combination of measures of the CPP distribution was effective for a linear prediction of percent dysphonia duration for the speech samples (r = 0.825; rho = 0.81). The CPP standard deviation significantly improved the use of the mean CPP in discriminant function analyses and also the classification of the intermittently dysphonic voices. Conclusions: Auditory-perceptual judgment of dysphonic segments and the typically robust acoustic measurement of mean CPP are both ineffective for classifying intermittently dysphonic voices. However, dysphonia duration may be effectively predicted via measures of the CPP distribution, and acoustic classification of dysphonic voice types via cepstral methods may be improved with an analysis of the CPP distribution across an utterance.
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Objectives: The prevalence of voice problems has been investigated in various occupations, but research investigating sports coaches' voice problems seems to be limited even if coaches are an occupational group whose work requires heavy voice use. The aim of this study was to determine the prevalence of voice problems among soccer coaches and identify risk factors that can contribute to the problems. Methods/design: The data were collected with a web questionnaire that was sent to 500 soccer coaches. Overall, 109 male coaches, who practiced soccer coaching to various extents, responded to the questionnaire. The presence of six vocal symptoms was investigated, as well as environmental factors and health-related factors that may have an influence on the voice. Results: The results showed that the prevalence of voice problems among soccer coaches was high. In total, 28.4% of the participants reported two or more frequently occurring vocal symptoms. The most common symptom was throat clearing or coughing followed by voice becomes low or hoarse. The coaches who had vocally demanding main occupations alongside their coaching tasks had an increased risk for voice problems. Moreover, a significant association was found between chronic rhinitis and frequently occurring vocal symptoms, as well as between stress and frequently occurring vocal symptoms. Conclusions: Given the extent of voice problems and the fact that soccer coaches have a vocally demanding occupation, it would be important to increase the awareness of voice use among this group. Soccer coaches are in immense need of more information about voice ergonomics during their coaching education.
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Background. Art therapy uses the creative process to encourage personal growth and alleviate symptoms of mental illness. The Art Therapy Institute provides programs for refugee adolescents from Burma to decrease their trauma-related symptoms. This article describes and discusses the methods and findings from an evaluation of this program. The challenges of assessing art therapy with this population and assessment tool gaps are explored and suggestions for future evaluations discussed. Method. Four validated clinical assessment tools were administered to 30 participants at baseline and follow-up to measure symptoms of anxiety, depression, and behavioral problems. Focus group discussions with clinicians were used to assess the evaluation. Results. Nearly all participants had experienced one or more traumatic events. At baseline, results showed a higher prevalence of depression than national rates among adolescents. Follow-up results showed improvements in anxiety and self-concept. Qualitative findings suggest that specific benefits of art therapy were not adequately captured with the tools used. Discussion. This evaluation showed some effects of art therapy; however, symptom-focused assessment tools are not adequate to capture clients’ growth resulting from the traumatic experience and this unique intervention. Future evaluations will benefit by using an art-based assessment and measuring posttraumatic growth. Keywords: child/adolescent health; community intervention; community organization; mental health; minority health; evaluation methods; outcome evaluation
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Significant developments in health applications for dance have occurred over the past 40 years. While neurological changes associated with physical exercise have been well researched and documented, dance has yet to receive the same attention and represents an area of extreme interest for further study given its many reported benefits. The objective of this review is to critically examine the existing literature on observed neurological effects of dance interventions within the elderly population. A comprehensive literature search was performed using six different databases, and included dance interventions involving ballet, ballroom, tango, several cultural dances, and dance/movement therapy, with five elderly population types comprised of both healthy individuals and those exhibiting neurological impairments. The articles were critically appraised using formal research guidelines. In total, 44 appropriate and relevant studies were identified and short listed. Together, all studies examined three major domains: (1) cognition, (2) sensorimotor performance, and (3) underlying neurobiological factors. Twenty-one studies investigated the effects of dance on cognition, 27 on sensorimotor performance (gait, static and dynamic balance), and seven evaluated the effects on underlying neurobiological factors. Post-dance intervention findings showed significant improvements in several aspects of brain function involving cognition and sensorimotor performance; however, only a few studies were found which related the significance of dance interventions to its potential affect on various neurobiological factors. There is a need for future research investigating the direct effects of dance interventions on neurobiological changes in the elderly which this review begins to address.
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Objective To examine the efficacy of creative art therapy plus conventional physical therapy, compared with physical therapy only, in increasing cognitive ability, physical functions, psychological status and quality of life of stroke patients. Design Randomized controlled trial with blinded assessor. Setting An in-patient setting Participants One hundred and eighteen stroke patients aged ⩾50 years who could communicate verbally. Interventions All participants received conventional physical therapy five days per week. An intervention group received additional creative art therapy, twice a week for four weeks, in a rehabilitation ward. Main outcomes Cognitive function, anxiety and depression, physical performance and quality of life were measured with the Abbreviated Mental Test, the Hospital Anxiety and Depression Scale, the modified Barthel Index scale and the pictorial Thai Quality of Life questionnaire, respectively. Results Mean differences for the intervention group were significantly greater than the control group for depression (−4.5, 95% CI −6.5, −2.5, p< 0.001), physical functions (1.2, 95% CI 0.1, 2.3, p= 0.043) and quality of life (8.9, 95% CI 3.8, 13.8, p< 0.001).Compared with baseline measures, both groups experienced improved cognition, physical functions and quality of life and reduced anxiety and depression. Eighty-five percent of patients were satisfied with the creative art therapy and most reported improved concentration (68.5%), emotion (79.6%), self-confidence (72.2%) and motivation (74.1%). Conclusion Creative art therapy combined with conventional physical therapy can significantly decrease depression, improve physical functions and increase quality of life compared with physical therapy alone.
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A systematic review and narrative synthesis of theories was conducted to examine the modulating effects of music listening on health-related exercise and physical activity. Searches were conducted on multiple bibliographic databases from the earliest available date until April 2013 using the key terms of music, physical activity and theory and related synonyms. Two reviewers independently screened retrieved texts using the inclusion and exclusion criteria. The quality of included texts was appraised using a checklist, and key concepts were recorded and synthesised using inductive thematic analysis. The narrative synthesis comprised 23 theoretical texts representing three contexts: therapeutic outcomes, sports and exercise performance, and auditory-motor processing. The quality appraisal demonstrated some limitations in the reporting of evidence informing theories. Analysis across all texts identified a main theme, cortical and subcortical stimulation and response, and two sub-themes, physiological arousal and subjective experience. These themes contributed to a common hypothesis that music could promote behavioural change with increased exercise adherence and participation. A meta-theory is presented, offering a framework for clinical practice and research. Music therapists might use the meta-theory to inform music listening interventions in programmes that aim to increase levels of physical activity.
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In dance movement therapy practice, it is customary and widespread that therapists use and apply concepts of grounding in their sessions and for assessing their clients’ movement profiles. Literature exists in Bioenergetics’ body oriented psychotherapy; however, theoretical foundation of grounding in dance movement therapy is sparse. This theoretical article revises key concepts of grounding and integrates them in the theory and practice of DMT. The clinical vignettes provide examples of grounding exercises applied to two specific populations, namely older people with dementia and adults with intellectual disability. Grounding exercises provide a therapeutic and creative tool that aims to strengthen the connection to one's body and to one's personal reality. Exercises regarding physical, emotional, sensory and social levels of grounding are applicable to practitioners of DMT and related fields. The theoretical foundation and application of grounding in DMT suggests that its use is especially beneficial, for example, in cases of depression, anxiety, stress, and trauma.
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Purpose Voice therapy practice and research, as in most types of rehabilitation, is currently limited by the lack of a taxonomy describing what occurs during a therapy session (with enough precision) to determine which techniques/components contribute most to treatment outcomes. To address this limitation, a classification system of voice therapy is proposed that integrates descriptions of therapeutic approaches from the clinical literature into a framework that includes relevant theoretical constructs. Method Literature searches identified existing rehabilitation taxonomies/therapy classification schemes to frame an initial taxonomic structure. An additional literature search and review of clinical documentation provided a comprehensive list of therapy tasks. The taxonomy's structure underwent several iterations to maximize accuracy, intuitive function, and theoretical underpinnings while minimizing redundancy. The taxonomy was then used to classify established voice therapy programs. Results The taxonomy divided voice therapy into direct and indirect interventions delivered using extrinsic and/or intrinsic methods, and Venn diagrams depicted their overlapping nature. A dictionary was developed of the taxonomy's terms, and 7 established voice therapy programs were successfully classified. Conclusion The proposed taxonomy represents an important initial step toward a standardized voice therapy classification system expected to facilitate outcomes research and communication among clinical stakeholders.
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To date, no instruments exist to quantify the psychosocial consequences of voice disorders. The aim of the present investigation was the development of a statistically robust Voice Handicap Index (VHI). An 85-item version of this instrument was administered to 65 consecutive patients seen in the Voice Clinic at Henry Ford Hospital. The data were subjected to measures of internal consistency reliability and the initial 85-item version was reduced to a 30-item final version. This final version was administered to 63 consecutive patients on two occasions in an attempt to assess test-retest stability, which proved to be strong. The findings of the latter analysis demonstrated that a change between two administrations of 18 points represents a significant shift in psychosocial function.
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The relationship between smoking and voice disorders is still controversial. This study has investigated the relationship between voice disorders and smoking by using a nationwide representative survey of the Korean population. Cross-sectional analysis of a national health survey. The study sample 7941 Korean adults, aged 19 years or older (3422 men and 4519 women), who participated in the fifth Korea National Health and Nutrition Examination Survey, a nationwide representative survey of the noninstitutionalized population of the Republic of Korea. Laryngeal disorders were classified into functional voice disorders (vocal cord nodule, vocal polyp, Reinke edema, and laryngitis) and organic voice disorders (sulcus vocalis, vocal cyst, laryngeal granuloma, laryngeal keratosis, laryngeal leukoplakia, laryngeal papilloma, and suspected malignant neoplasm of the larynx). Multinomial logistic regression analyses were conducted to examine the association between smoking and voice disorders. Adjusting for covariates (age, gender, education level, occupation, income, alcohol drinking, self-reported voice problems, and self-reported health status), past smokers (odds ratio (OR) = 2.97, 95% confidence interval (CI): 1.14-9.03) and current smokers (OR = 3.22, 95% CI: 1.18-10.25) compared with nonsmokers, were more likely to have organic voice disorders. However, smoking was not associated with functional voice disorders. Smoking is independently associated with organic voice disorders in the Korean general population. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Article
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To date, no instruments exist to quantify the psychosocial consequences of voice disorders. The aim of the present investigation was the development of a statistically robust Voice Handicap Index (VHI). An 85-item version of this instrument was administered to 65 consecutive patients seen in the Voice Clinic at Henry Ford Hospital. The data were subjected to measures of internal consistency reliability and the initial 85-item version was reduced to a 30-item final version. This final version was administered to 63 consecutive patients on two occasions in an attempt to assess test-retest stability, which proved to be strong. The findings of the latter analysis demonstrated that a change between two administrations of 18 points represents a significant shift in psychosocial function.
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Objectives To determine whether emotional expression, alexithymia, illness behavior, and coping strategies differed between women with muscle tension voice disorder (MTVD) and those without voice disorder and between women with and without mucosal pathology of the vocal folds, and to explore possible links between psychosocial constructs and clinical features in women with MTVD. Study Design and Method A within-subjects design matched 20 women with MTVD and 20 women without voice disorder on validated self-report measures of the psychosocial constructs. The effect of mucosal pathology was assessed using between-groups analyses. Correlations assessed relationships between psychosocial constructs and clinical features. Results Comparisons between women with MTVD and those without voice disorder showed an elevated sense of illness identity and greater belief in the presence of somatic illness in women with MTVD. There was a trend toward women with MTVD showing lower levels of emotional awareness. Women without vocal fold pathology reported lower levels of emotional awareness than those with pathology, whereas women with pathology reported greater use of a mixed pattern of adaptive and maladaptive coping strategies than those with no pathology. Low vocal load was associated with higher scores on alexithymia, higher numbers of vocal symptoms were associated with the use of adaptive coping, and greater impact of symptoms was associated with higher levels of emotional awareness and greater belief in the presence of somatic illness. Conclusions These findings encourage further investigation of relationships between emotional awareness, illness behavior, and coping in women with functional voice disorders.
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Introduction: Smoking affect voice quality in a long period of time, but other factors may compromise it, such as professional using of voice, habits, alcohol dependence and GERD. The aim was associate the influence of these factors on vocal parameters. Study design: Contemporary cohort study with cross-sectional. Materials and methods: Eighty adults of 35 to 60 years old had participated in this study, they had been divided into two groups, smokers (GF) and control (GC). There was application of questionnaire and voices were recorded. Praat software has been used for voice assessment and Man-Whitney, chi-square and logistic regression has been used for statistical analysis. Results: The GF had a higher incidence of alcohol dependence, coughing, throat clearing and professional voice using. Respecting to the acoustic parameters: noise-to-harmonic ratio (NHR), jitter and shimmer, the GF presented higher values. Relating these data to the questionnaire, it's noticed that female gender have influence over all acoustic parameters, GERD have influence over jitter and smoking can affect fundamental frequency, jitter, shimmer and NHR. Conclusion: Smoking interferes in acoustics parameters isolated and associated with alcohol dependence, GERD, cough, throat clearing, gender and professional using of voice.
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Previous studies indicate that mindfulness interventions and physical activities can produce positive effects on mood disorders; such activities may be options for individuals who search for non-traditional therapies, or whenever mainstream psychological treatments are not effective. We explored the effects of tango dance, meditation, and exercise (circuit training) in individuals with self-reported depression. Participants were randomly placed into meditation, exercise, tango dance, or control-wait-list groups. Sixty-four participants completed the 8-week program and were assessed before, after, and at 1-month follow-up. The dependent variables were depression, anxiety, stress, fatigue, and insomnia (symptoms measures), and self-efficacy, satisfaction with life, and mindfulness (positive psychology measures). Treatment scores were compared with the control group scores. The meditation group showed benefits at follow-up for depression, stress, and satisfaction with life. The exercise group showed decreased depression and increased self-efficacy at post-test, but only self-efficacy was persistent at follow-up, whereas stress was just significant at follow-up. The tango group showed decreased depression and insomnia and increased satisfaction with life and mindfulness at post-test. All, except for satisfaction with life, were persistent at follow-up, while stress and anxiety improved only at follow-up. As expected, the control group maintained similar scores across pre-test and post-test, and at follow-up. Tango dance was shown to induce a broader and more persistent range of benefits. Meditation produced lasting benefits only when well-learned and practiced, whereas exercise generated rapid benefits, but, except for self-efficacy, temporary. Such differences may provide valuable information when promoting these activities to best match the individual needs within this population.
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The present study examines the emotional and hormonal responses to tango dancing and the specific influences of the presence of music and partner on these responses. Twenty-two tango dancers were assessed within four conditions, in which the presence of music and a dance partner while dancing were varied in a 2 × 2 design. Before each condition and 5 minutes thereafter, participants provided salivary samples for analysis of cortisol and testosterone concentrations and completed the Positive and Negative Affect Schedule. The data suggest that motion with a partner to music has more positive effects on emotional state than motion without music or without a partner. Moreover, decreases of cortisol concentrations were found with the presence of music, whereas increases of testosterone levels were associated with the presence of a partner. The authors' work gives evidence of short-term positive psychobiological reactions after tango dancing and contributes to understanding the differential influence of music and partner.
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Recent research shows that tango dance is an absorbing and effective strategy to reduce levels of depression, while also increasing well-being. This study investigates the feasibility, acceptability, and adherence to a tango programme for individuals with age-related macular degeneration (ARMD). Depression is closely intertwined with the ARMD diagnosis, since the loss of central vision has a profoundly negative impact on the person’s quality of life. Seventeen participants were randomised to tango dance (1.5 h, 2 times/week for 4 weeks) or wait-list control condition. Demographic questions and Visual Function Questionnaire were taken at pre-test. Self-rated symptoms of depression, self-esteem, and satisfaction-with-life were assessed at pre-test and post-test. Tango group participants showed significant reductions in depression and significantly increased satisfaction-with-life and self-esteem at post-test relative to the controls, and reported physical improvement, including increased balance. Tango dance was demonstrated to be a feasible and positive activity for this population.
Article
Cigarette use is a preventable cause of mortality and diseases. The World Health Organization states that Europe and especially Greece has the highest occurrence of smoking among adults. The prevalence of smoking among women in Greece was estimated to be over 30% in 2012. Smoking is a risk factor for many diseases. Studies have demonstrated the association between smoking and laryngeal pathologies as well as changes in voice characteristics. The purpose of this study was to estimate the effect of early smoking habit on young adult female voices and if they perceive any vocal changes using two assessment methods. The Voice Handicap Index and the acoustic analyses of voice measurements were used, with both serving as mini-assessment protocols. Two hundred and ten young females (110 smokers and 100 nonsmokers) attending the Technological Educational Institute of Epirus in the School of Health and Welfare were included. Statistically significant increases for physical and total scores of the Voice Handicap Index were found in the smokers group (P < 0.05). Significant changes were observed for the acoustic parameters between smoker and nonsmoker groups. The results of this study indicated observable signs of change in the voice acoustic characteristics of young adults with early smoking habits.
Article
The relationship between smoking and alterations of the vocal tract and larynx is well known. This pathology leads to the degradation of voice performance in daily living. Multiple assessment methods of vocal tract and larynx have been developed, and in recent years they were enriched with self-reported questionnaires such as Voice Handicap Index (VHI). This study determined the cutoff points of VHI’s total score and its three domains for young female smokers in Greece. These estimated cutoff points could be used by voice specialists as an indicator for further clinical evaluation (foreseeing a potential risk of developing a vocal symptom because of smoking habits).Asample of 120 female nondysphonic smokers (aged 18–31) was recruited. Participants filled out the VHI and Voice Evaluation Form. VHI’s cutoff point of total score was calculated at the value of 19.50 (sensitivity: 0.780, 1-specificity: 0.133). Specifically, the construct domain of functional was 7.50 (sensitivity: 0.900, 1-specificity: 0.217), for physical it was 8.50 (sensitivity: 0.867, 1-specificity: 0.483), and for emotional it was 7.50 (sensitivity: 0.833, 1-specificity: 0.200) through the use of receiver operating characteristic. Furthermore, VHI could be used as a monitoring tool for smokers and as a feedback for smoking cessation.
Article
Students' groups (eg, teachers, speech language pathologists) are presumably at risk of developing a voice disorder due to misuse of their voice, which will affect their way of living. Multidisciplinary voice assessment of student populations is currently spread widely along with the use of self-reported questionnaires. This study compared the Voice Handicap Index domains and item scores between female students of speech and language therapy and of other health professions in Greece. We also examined the probability of speech language therapy students developing any vocal symptom. Two hundred female non-dysphonic students (aged 18–31) were recruited. Participants answered the Voice Evaluation Form and the Greek adaptation of the Voice Handicap Index. Significant differences were observed between the two groups (students of speech therapy and other health professions) through Voice Handicap Index (total score, functional and physical domains), excluding the emotional domain. Furthermore, significant differences for specific Voice Handicap Index items, between subgroups, were observed. In conclusion, speech language therapy students had higher Voice Handicap Index scores, which probably could be an indicator for avoiding profession-related dysphonia at a later stage. Also, Voice Handicap Index could be at a first glance an assessment tool for the recognition of potential voice disorder development in students. In turn, the results could be used for indirect therapy approaches, such as providing methods for maintaining vocal health in different student populations.
Article
Objectives To estimate the prevalence and the associated factors with voice disorders (VDs) in older adults living in nursing homes. Study design Cross-sectional. Methods A sample of 117 Brazilian individuals of both sexes and preserved cognitive function, aged >59 years, living in 10 nursing homes, was studied. VDs were screened using the validated tool “Rastreamento de Alterações Vocais em Idosos” (RAVI—Screening for Voice Disorders in Older Adults). Associated factors included variables related to socioeconomic and demographic profile; nursing home; general health; ear, nose, and throat conditions; lifestyle; functionality; and psychosocial status. Bivariate analysis was performed by Pearson's chi-square or Fisher's exact test. Multivariate analysis was performed by multiple binomial regression. The significance level was 5%. Results The prevalence of VDs was 39.3% (95% confidence interval [CI] = 30.4–48.1). There was no significant difference in prevalence according to age and sex. Multivariate analysis revealed that the prevalence of VDs were independently associated with anxiety symptoms (prevalence ratio [PR] = 1.97, 95% CI = 1.17–3.29), smoking (PR = 1.56, CI = 1.02–2.38), general daily inactivity (PR = 1.62, CI = 1.10–2.38), temporomandibular disorder (PR = 1.68, CI = 1.11–2.54), choking (PR = 1.53, CI = 1.06–2.20), and self-reported hearing loss (PR = 1.52, CI = 1.04–2.21). Conclusion VDs are common among older adults with preserved cognitive function living in nursing homes. The associated factors with VDs in this population can be prevented, diagnosed, controlled, or treated. Screening procedures and early intervention should be considered.
Although dramatic postnatal changes in maternal behavior have long been noted, we are only now beginning to understand the neurobiological mechanisms that support this transition. The present paper synthesizes growing insights from both animal and human research to provide an overview of the plasticity of the mother's brain, with a particular emphasis on the oxytocin system. We examine plasticity observed within the oxytocin system and discuss how these changes mediate an array of other adaptations observed within the maternal brain. We outline factors that affect the oxytocin-mediated plasticity of the maternal brain and review evidence linking disruptions in oxytocin functions to challenges in maternal adaptation. We conclude by suggesting a strategy for intervention with mothers who may be at risk for maladjustment during this transition to motherhood, while highlighting areas where further research is needed.
Article
Objectives: Good voice quality is an asset to professional voice users, including radio performers. We examined whether (1) voices could be reliably categorized as good for the radio and (2) these categories could be predicted using acoustic measures. Participants and methods: Male radio performers (n = 24) and age-matched male controls performed "The Rainbow Passage" as if presenting on the radio. Voice samples were rated using a three-stage paired-comparison paradigm by 51 naive listeners and perceptual categories were identified (Study 1), and then analyzed for fundamental frequency, long-term average spectrum, cepstral peak prominence, and pause or spoken-phrase duration (Study 2). Results: Study 1: Good inter-judge reliability was found for perceptual judgments of the best 15 voices (good for radio category, 14/15 = radio performers), but agreement on the remaining 33 voices (unranked category) was poor. Study 2: Discriminant function analyses showed that the SD standard deviation of sounded portion duration, equivalent sound level, and smoothed cepstral peak prominence predicted membership of categories with moderate accuracy (R(2) = 0.328). Conclusions: Radio performers are heterogeneous for voice quality; good voice quality was judged reliably in only 14 out of 24 radio performers. Current acoustic analyses detected some of the relevant signal properties that were salient in these judgments. More refined perceptual analysis and the use of other perceptual methods might provide more information on the complex nature of judging good voices.
Article
Objective: This study aims to (1) determine the cutoff values of the overall severity (OS) of vocal deviation on the visual analog scale (VAS) based on the ratings of the numerical scale (NS); and (2) verify the power of discrimination of these cutoff values according to different degrees of vocal deviation. Study design: This is a prospective study. Methods: The auditory-perceptual evaluation was performed by four speech-language pathologists who used two protocols with different scalar properties: the VAS and the 4-point NS. Vocal samples from142 women and 69 men, plus 10% of repetition, with and without vocal complaints, ranging from 19 to 60 years were included. The analyzed speaking task was the counting from 1 to 10. For both protocols, the judges rated the OS. Results: Based on the correspondence between the two scales, the cutoff values of the OS on the VAS obtained were 35.5, 50.5, and 90.5 points. The 35.5 value corresponds to the cutoff point between normal variability and mild/moderate vocal deviations; the 50.5 value corresponds to the cutoff point between mild/moderate and moderate vocal deviations; the 90.5 value corresponds to the cutoff point between moderate and severe deviations. Areas under the receiver operating characteristic curve for the three cutoff values were 0.918, 0.948, and 0.970, respectively. Conclusions: The cutoff values of the OS on the VAS were obtained, and the areas under the ROC curve showed that all the three cutoff points had excellent accuracy that represents a higher power of discrimination of different degrees of vocal deviations.
Article
Objectives: The application of systemic hydration as an instrument for optimal voice quality has been a common practice by several professional voice users over the years. Although the physiological action has been determined, the benefits on acoustic and perceptual characteristics are relatively unknown. The present study aimed to determine whether systemic hydration has beneficial outcomes on the voice quality of future professional voice users. Study design: A within-subject, pretest posttest design is applied to determine quantitative research results of female singing students between 18 and 32 years of age without a history of voice pathology. Methods: Acoustic and perceptual data were collected before and after a 2-hour singing rehearsal. The difference between the hypohydrated condition (controlled) and the hydrated condition (experimental) and the relationship between adequate hydration and acoustic and perceptual parameters of voice was then investigated. Results: A statistical significant (P = 0.041) increase in jitter values were obtained for the hypohydrated condition. Increased maximum phonation time (MPT/z/) and higher maximum frequency for hydration indicated further statistical significant changes in voice quality (P = 0.028 and P = 0.015, respectively). Conclusion: Systemic hydration has positive outcomes on perceptual and acoustic parameters of voice quality for future professional singers. The singer's ability to sustain notes for longer and reach higher frequencies may reflect well in performances. Any positive change in voice quality may benefit the singer's occupational success and subsequently their social, emotional, and vocational well-being. More research evidence is needed to determine the parameters for implementing adequate hydration in vocal hygiene programs.
Article
Interest in the clinical use of mindfulness practices has expanded rapidly in recent years. To provide. a direction for future research in this area, this article identifies the primary scientific and clinical questions regarding the clinical application of mindfulness practice. In particular, the following questions are addressed: What is mindfulness? What are the consequences of separating mindfulness from its spiritual and cultural origins? Is mindfulness training an efficacious treatment intervention? What are the active or essential ingredients of mindfulness training? Can mindfulness enhance clinical practice apart from its role as a clinical intervention? How does mindfulness work? How should therapists be trained in order to deliver mindfulness interventions competently? Is mindfulness training amenable to widespread dissemination?
Article
Objectives. To compare the discriminatory power of the Multi-Dimensional Voice Program (MDVP) and Praat in distinguishing the gender of euphonic adults. Study Design. Cross-sectional Methods. Recordings of 100 euphonic volunteers, 50 males and 50 females, producing a sustained vowel /a/ were analyzed with the MDVP and Praat software. Results. Both computer programs identified significant differences between males and females in absolute jitter (MDVP p< 0.00001, and Praat p< 0.00001), and shimmer in dB (MDVP p= 0.006, and Praat p= 0.001). In our recordings, there was a discrepancy in the shimmer between the two voice analysis programs: females had lower shimmer in dB values than males using the MDVP, and vice versa using Praat. Using the scale proposed by Hosmer and Lemeshow, we found no gender discrimination for shimmer in dB with either the MDVP (AUC= 0.658) or Praat (AUC= 0.682). In our series, on the other hand, MDVP absolute jitter achieved an acceptable discrimination between males and females (AUC= 0.752), and Praat absolute jitter an outstanding discrimination (AUC= 0.901). The discriminatory power of Praat absolute jitter was significantly higher than that of the MDVP (p= 0.003). Absolute jitter sensitivity and specificity were also higher for Praat (83% and 80%) than for the MDVP (74% and 49%). Conclusions. Differences attributable to a subject’s gender and to the software used to measure acoustic parameters should be carefully considered in both research and clinical settings. Further studies are needed to test the discriminatory power of different voice analysis programs when differentiating between normal and dysphonic voices.
Article
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
Article
Objective: Many studies focused on teachers' voice problems and most of them were conducted using questionnaires, whereas little research has investigated the relationship between self-reported voice disorders and objective quantification of voice. This study intends to explore the relationship of acoustic measurements according to self-reported symptoms and its predictive value of future dysphonia. Study design: This is a case-control study. Methods: Voice samples of 80 female teachers were analyzed, including 40 self-reported voice disorders (VD) and 40 self-reported normal voice (NVD) subjects. The acoustic measurements included jitter, shimmer, and noise-to-harmonics ratio (NHR). Levene's t test and logistic regression were used to analyze the differences between VD and NVD and the relationship between self-reported voice conditions and the acoustic measurements. To examine whether acoustic measurements can be used to predict further voice disorders, we applied a receiver operating characteristic (ROC) curve to determine the cutoff values and the associated sensitivity and specificity. Results: The results showed that jitter, shimmer, and the NHR of VD were significantly higher than those of NVD. Among the parameters, the NHR and shimmer demonstrated the highest correlation with self-reported voice disorders. By using the NHR ≥0.138 and shimmer ≥0.470 dB as the cutoff values, the ROC curve displayed 72.5% of sensitivity and 75% of specificity, and the overall positive predictive value for subsequent dysphonia achieved 60%. Conclusions: This study demonstrated a significant correlation between acoustic measurements and self-reported dysphonic symptoms. NHR and ShdB are two acoustic parameters that are more able to reflect vocal abnormalities and, probably, to predict subsequent subjective voice disorder. Future research recruiting more subjects in other occupations and genders shall validate the preliminary results revealed in this study.
Article
While the subject of the use of touch in psychotherapy has been widely debated, the field of dance/movement therapy (DMT) has participated negligibly in the conversation, and includes no mention of touch in its code of ethics to date. This highlights a significant and intriguing gap in the field given that there is sufficient evidence that touch may be commonly used in DMT. This qualitative research study is based on interviews with three experienced dance/movement therapists regarding their applications of and choices surrounding the use of touch in their DMT sessions. The study is intended to be an initial exploration into how the issue of touch is approached and used in the DMT session. Several incipient themes are identified and discussed, and the need for more research and involvement by the DMT field is emphasized.
Article
The main aim of this study was to assess the prevalence of Vocal Tract Discomfort (VTD) in the Flemish population without self-perceived voice disorders using the VTD scale and to examine the relationship between vocal load and VTD symptoms. In addition, consistency between the VTD scale and the Voice Handicap Index (VHI) and the Corporal Pain scale was evaluated. A total of 333 participants completed the VTD scale, the VHI, and the Corporal Pain scale. Patient information about study and voice-related hobbies (for students), state of (non)professional voice user (for employees), smoking, shouting, allergy, and voice therapy was taken into account. A median number of three VTD symptoms was reported, and 88% of the participants showed at least one symptom of VTD. Dryness (70%), tickling (62%), and lump in the throat (54%) were the most frequently occurring symptoms. The frequency and severity of VTD were significantly higher in participants who followed voice-related studies, played a team sport, were part of a youth movement, shouted frequently, and received voice therapy in the past (P < 0.05). Finally, low correlations were obtained between frequency and severity of the VTD scale and total VHI score (r = 0.226-0.411) or frequency and intensity of the Corporal Pain scale (r = 0.016-0.408). The prevalence of VTD is relatively high in the Flemish population without self-perceived voice disorders, although the frequency and severity of the symptoms are rather low. Vocal load seems to influence the frequency and severity of VTD. Finally, the VTD scale seems to reveal clinically important information that cannot be gathered from any other protocol. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Article
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease which may adversely affect phonatory function. This study aimed to establish the prevalence, risks, and quality of life effects of voice disorders in RA. This is a cross-sectional, descriptive epidemiology study. One hundred individuals with RA underwent a telephone interview to determine the frequency, severity, risks associated with, and quality of life burden of voice disorders. The results were analyzed using summary statistics, frequencies, chi-square tests, regression analysis, and risk ratios (P < 0.05). Thirty-five percent of participants with RA reported a current voice disorder which was chronic and long-standing in most cases. The prevalence of a current voice disorder did not significantly differ across age, sex, medication use, voice use patterns, medical history, or RA severity. These chronic voice disorders produced significant adverse effects on both voice-related quality of life and short form 36 health-related quality of life scales. Specific voice symptoms such as "voice-related discomfort" and "chronic throat dryness" contributed disproportionately to the quality of life burden. Of those participants with a voice disorder, only 37% had ever sought professional help to improve their voice. These results indicate that voice disorders are common in RA and produce significant adverse effects on quality of life. Further research is necessary to better understand the origin of these disorders and their potential response to treatment. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Article
To analyze the symptoms of vocal tract discomfort in patients with different voice disorders. This study was descriptive, observational, and cross-sectional. A total of 210 subjects with vocal complaints and prior medical assessment were divided into five groups according to diagnosis: no laryngeal lesion, lesion to membranous portion, voice disorder of neurological origin, incomplete glottal closure without organic or neurologic cause, and voice disorder secondary to gastroesophageal reflux. All participants responded to the vocal tract discomfort scale at the time of assessment. Patients had a mean of 4.01 ± 0.70 symptoms, with sore throat being the most commonly reported. Compared with patients in other groups, patients with lesions in the membranous portion of the vocal folds and those with voice disorder due to gastroesophageal reflux showed an increased number of symptoms. Voice disorders of reflux were shown to result in a higher frequency of sore throat and lump in the throat than in those with neurological etiology. The intensity of the lump in the throat was higher in patients with reflux than in patients with neurologic voice disorders. There was a difference between the number, frequency, and intensity of symptoms of vocal tract discomfort based on the type of voice disorder. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Article
The purpose of this paper is to underlie the kinship between creativity and compartmentalized dissociation (CD), and explore clinical implications for treatment. After examining the distinction between detachment and CD, the paper presents the main developmental pathways that lead to pathological presentations of CD, highlighting the role of creativity and fantasy proneness. The paper defines the potential benefits of using creative approaches specifically focusing on dance/movement therapy (DMT) in the treatment of CD. These dance/movement interventions address some of the therapeutic tasks with people with CD, such as the identification and mapping of alters and the improvement of communication, collaboration and coordination among them. The paper finally applies choreographic and performance lenses to the integration and mastery of therapeutic transitions, specifically looking to alters’ transformation and fusion. In this process the paper looks both at the benefits of the use of the body and movement, as well as stresses potential caveats in working with this population.
Article
Objective To correlate change in Voice Handicap Index (VHI)-10 scores with corresponding voice laboratory measures across five voice disorders. Study Design Retrospective study. Methods One hundred fifty patients aged >18 years with primary diagnosis of vocal fold lesions, primary muscle tension dysphonia-1, atrophy, unilateral vocal fold paralysis (UVFP), and scar. For each group, participants with the largest change in VHI-10 between two periods (TA and TB) were selected. The dates of the VHI-10 values were linked to corresponding acoustic/aerodynamic and audio-perceptual measures. Change in voice laboratory values were analyzed for correlation with each other and with VHI-10. Results VHI-10 scores were greater for patients with UVFP than other disorders. The only disorder-specific correlation between voice laboratory measure and VHI-10 was average phonatory airflow in speech for patients with UVFP. Average airflow in repeated phonemes was strongly correlated with average airflow in speech (r = 0.75). Acoustic measures did not significantly change between time points. Conclusions The lack of correlations between the VHI-10 change scores and voice laboratory measures may be due to differing constructs of each measure; namely, handicap versus physiological function. Presuming corroboration between these measures may be faulty. Average airflow in speech may be the most ecologically valid measure for patients with UVFP. Although aerodynamic measures changed between the time points, acoustic measures did not. Correlations to VHI-10 and change between time points may be found with other acoustic measures.
Article
Objectives To establish psychometric indicators of the Voice Handicap Index (VHI) (Latvian version) and their relationship to the psychometric indicators of the original items. Study Design Parallel group design. Methods The VHI was translated and adapted to Latvian. The translated version of the VHI (Lat-VHI) was completed by 54 patients with voice disorders and by 73 subjects without voice disorders forming the control group. A test-retest group included 54 subjects without voice problems, able to complete the questionnaire twice. The test-retest stability, internal consistency of items of the Lat-VHI, and content and convergent validity of the Latvian version of the VHI were analyzed. Results The interclass correlation coefficient ratio of all scales indicated statistically significant (P < 0.001) test-retest reliability for the Lat-VHI. High internal consistency was observed among the Lat-VHI total scale (α = .96), functional (α = .92), physical (α = .86), and emotional scale (α = .91) in the patient group. The Pearson moment correlation coefficient indicates a high correlation among the Lat-VHI total scale and subscales (r > 0.94), as well as a high correlation among subscales (r > 0.81) in the patient group. Convergent validity of the Lat-VHI was determined by comparing the Lat-VHI results with the Voice Disorder Severity scale results. Statistically significant correlation (r = 0.78, P < 0.001) was discovered in the patient group. Conclusions The Latvian version of the VHI is a psychometrically validated instrument whose indicators correspond to the psychometric indicators of the original sample.
Article
To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with theVHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD.
Article
Chronic and compounding exposure to traumatic events, especially within the context of early attachment relationships, can result in symptoms of dissociation commonly seen in dissociative disorders, personality disorders, and post-traumatic stress disorders. This theoretical article proposes an application of dance/movement therapy as facilitative of right brain integration in adult clients who present with trauma-related dissociative symptoms. Findings from trauma psychology, neuroscience, and dance/movement therapy literature are used to create an attachment-oriented theoretical foundation for how dance/movement therapy might support the integration of dissociated somatic, emotional, and psychological experiences. A model for case-conceptualization and treatment planning is proposed according to a trauma treatment framework consisting of three phases: safety and stabilization, integration of traumatic memory, and development of the relational self. Within this phase-oriented theoretical framework, dance/movement therapy interventions such as body-to-body attunement, kinesthetic mirroring, interactive regulation, self-awareness, symbolism and expression, and interactional movement are examined as applications that may support bottom-up integration and resolution of psychological trauma. Limitations and suggestions for future research are also discussed.
Article
This systematic review aims to evaluate the effects of dance (movement) therapy and ballroom dances as therapeutic interventions for adults with physical and mental illnesses in comparison to other interventions or care as usual. A systematic literature search for randomized controlled trials examining dance therapy and ballroom dances published between 1995 and 2011 was carried out in the electronic databases MEDLINE and PsycINFO. 13 publications reporting results from 11 randomized trials (predominantly from USA and Scandinavia) were identified with mostly small samples. They examined breast cancer (n = 2), dementia (n = 1), Parkinson's disease (n = 2), heart failure (n = 1), diabetes type 2 (n = 1), depression (n = 3) and fibromyalgia (n = 1). Dance (movement) therapy had a positive impact for patients with breast cancer, improving quality of life, shoulder range of motion and body image. In patients with depression psychological distress was reduced by dance therapy. Ballroom dances improved balance and coordination in patients with Parkinson's disease and disease-specific quality of life in patients with heart failure. Dance (movement) therapy and ballroom dances seem beneficial for patients with breast cancer, depression, Parkinson's disease, diabetes and heart failure. However, further good quality research is needed to gain more profound insight into the efficacy of these treatment options.
Article
In this theoretical article, we link literature from different disciplines such as the neurosciences and psychology, dance/movement therapy, dance studies, and philosophy, in order to show that interactional, coordinated movement forms an important base for the development of empathy and prosocial behavior. The presented body of literature suggests that specific elements of joint movement and dance, namely imitation, synchronous movement and motoric cooperation, are suitable for fostering empathic abilities, especially in people with empathy deficits.In the second part of the article, we present a newly conceptualized dance and movement intervention for people with empathy dysfunction, tailored to its first application for people with autism spectrum disorders. Through enhancing and refining kinesthetic empathy skills, we hypothesize within an integrative concept of empathy, that both emotional and cognitive empathic processes such as empathic concern and perspective taking can be fostered. With a first treatment outcome study of the presented intervention that we will conduct in the near future with people on the autistic spectrum, we aim at evaluating the program and contributing to the understanding of dance and movement approaches for people with empathy deficits.
Article
In this review we summarize the results and conclusions of five studies as presented in a symposium at the 42nd annual meeting of the International Society for Psychoneuroendocrinology, in New York in September 2012. Oxytocin administration has received increasing attention for its role in promoting positive social behavior and stress regulation, and its potential as a therapeutic intervention for addressing various aspects of psychiatric disorders. However, it has been noted that the observed effects are not uniformly beneficial. In this paper we present five new studies each concluding that contextual and interindividual factors moderate the effects of oxytocin, as well as peripheral oxytocin levels. These findings are in accordance with the recent idea that oxytocin administration may increase sensitivity to social salience cues and that the interpretation of these cues may be influenced by contextual (i.e. presence of a stranger versus friend) or interindividual factors (i.e. sex, attachment style, or the presence of psychiatric symptoms). When social cues in the environment are interpreted as "safe" oxytocin may promote prosociality but when the social cues are interpreted as "unsafe" oxytocin may promote more defensive and, in effect, "anti-social" emotions and behaviors. Likewise, oxytocin appears to promote such agonistic tendencies in individuals who are chronically pre-disposed to view the social milieu in uncertain and/or in negative terms (e.g., those with borderline personality disorder, severe attachment anxiety and/or childhood maltreatment). In all, these studies in pre-clinical animal, healthy humans and patients samples further reinforce the importance of considering both contextual and interindividual factors when trying to understand the role of oxytocin as a biological substrate underlying social bonding and stress regulatory processes and when studying the effects of oxytocin administration in particular in patients with (increased risk for) psychiatric disorders.
Article
Laryngeal aerodynamic and acoustic characteristics of African American voice production were examined from vowel samples produced by ten adult female and ten adult male speakers. The data were compared with that for a control group consisting of ten adult female and ten adult male White speakers, matched for age, height, and weight. All measures were analyzed using Cspeech 4.0. Aerodynamic measurements, extracted from a glottal airflow waveform, included maximum flow declination rate, alternating glottal airflow, minimum glottal airflow, and airflow open quotient. Acoustic measures included fundamental frequency and sound pressure level. No significant mean differences between the African American and White speakers were found, except for maximum-flow declination rate. The White speakers produced significantly higher declination rates than the African American speakers. The factor of sex for the African American speakers was statistically significant for the measures of maximum-flow declination rate, alternating glottal airflow, open quotient, and fundamental frequency, consistent with the functioning of the White speakers. The results suggest that during vowel production, where the vocal tract is in a fairly static position, acoustic and aerodynamic characteristics for African American and White Speakers are comparable.
Article
Evaluation of the vibratory margin of the vocal fold is essential for accurate diagnosis and treatment of voice patients. Traditionally, physicians have performed this evaluation using their subjective impressions of the sound of the voice in conjunction with laryngoscopy under continuous light. Strobovideolaryngoscopy is a valuable addition to the diagnostic armementarium. It allows the physician to perform a proper physical examination of the vibratory margin. A review of 486 strobovideolaryngoscopy procedures in 343 voice patients during a 2-year period reveals that stroboscopic information influenced diagnosis or treatment in approximately one-third of the entities diagnosed.
Article
This book examines the field of dance therapy from its inception in the 1940's to the present. A detailed analysis is conducted of the theory and practice of the major pioneers. The book covers biographical reports and the influence of many dance therapy leaders. Laban Movement Analysis (LMA) is discussed as well as dance therapy in specific patient/client settings. Appended are: (1) listing of survey repondents; (2) information on the American Dance Therapy Association; and (3) the Dance Therapy questionnaire. A 34-page bibliography is included. (JD)