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Voice Quality of Choir Singers and the Effect of a Performance on the Voice
Abstract
Background
The voice use of choir singers is understudied despite the imbalance of high vocal demands versus low vocal education, and consequently increased risk for voice problems. Also, there is a lack of information on the effects of a performance on choristers’ voices. Available studies included performances of at least one hour. To date, no studies investigated the effects of a choir performance with a duration resembling vocal warm-ups.
Purpose
The first purpose of this study was to determine the voice quality, capacities, symptoms and voice-related quality of life of choir singers. Secondly, the effect of a short choir performance, resembling warm-up duration (15 minutes), on the choristers’ voices was investigated.
Methods
A randomized controlled trial was used. Thirty adult choir singers (25 women, 5 men; mean age: 32 years) were assigned randomly to an experimental group or a control group. Participants in the experimental group sung in choir for 15 minutes immediately after their pre voice assessment, whereas the control group was instructed to have standard voice use (one-on-one conversation with the investigator, no singing) across that time span. A second voice assessment was repeated afterwards.
Results
The choir singers showed excellent voice quality and capacities with mean scores on the Dysphonia Severity Index and Acoustic Voice Quality Index of 7.5 and 2.0, respectively. Auditory-perceptually, the mean grade score was 5/100 corresponding with a normal to mildly deviant voice quality. Patient-reported outcome measures showed mean deviant scores, indicating a considerable singing voice handicap. The choir singers seem vulnerable for stress with a high occurrence rate of 76.7% (23/30). Compared with the control group, the Dysphonia Severity Index significantly improved, whereas the self-perceived presence of vocal fatigue and complaints increased after 15 minutes of choir singing. Fundamental frequency increased in both groups, being more outspoken in the experimental group.
Conclusions
Choir singers show excellent voice quality and capacities, that further improve after a short choir performance of 15 minutes. Vocal fatigue and complaints, on the other hand, already increased after that short time span. Realizing that vocal load is much higher in real-life rehearsals, competitions and performances, choristers deserve and need a qualitative voice training and a strict follow-up. Future research should focus on effective vocal warm-up and cool-down programs for this population.
... In addition, it offers cognitive stimulation, produces the feeling of well-being during the performance of activities (9) and improves the mental health of this group (10) . It is worth mentioning that singing can develop in individuals who practice it greater respiratory support, resonance balance and intensity modulation (10,11) , in addition to increasing vocal tessitura (12) and offer gains to the vocal performance and performance of these subjects (13,14) . ...
... Of the dimensions evaluated in this instrument, the score of the "defect " dimension obtained the highest result, indicating possible permanent or temporary anatomical, structural, psychological, physiological loss or abnormality in the individuals evaluated (18) , a result that adds to those in the literature that already points out that vocal difficulties are related to the restrictive period resulting from the new coronavirus pandemic (4) . This fact may be associated with the decrease in singing rhythm and vocal performance experienced by most participants (13) , since important components of the vocal aspects, such as performing vocal warm-ups and group presentations, were impaired during this period, and this practice is essential for the vocal quality and capacity of the choristers (14) . ...
... The choristers who maintained their singing activities individually or collectively had significantly lower scores in the "incapacity" dimension of the IDCM than those who did not maintain them, which reveals a greater ability to perform activities normally expected for those who continued singing. This reality highlights the importance of singing practice for the development of musical skills and competencies in singers (11,12,14) and points out the difficulties faced by a considerable part of amateur choralists when continuing this practice in the face of the limitations that the virtual choir model brought (15) . ...
Purpose
To investigate the association between measures of voice handicap, symptoms of common mental health disorders and the restriction of singing activities that occurred during the Covid-19 pandemic in amateur choristers.
Methods
This is a cross-sectional, analytical, descriptive and quantitative study. To collect data were used an initial characterization questionnaire, the Modern Singing Handicap Index (MSHI) protocol and the SRQ-20, an adaptation of the Self Reporting Questionnaire, all of which were made available online. The research sample consisted of 46 participants belonging to amateur choirs from two higher education institutions.
Results
The mean total score for the MSHI and SRQ-20 were high and were positively correlated with each other. There was no difference between the MSHI and SRQ-20 scores between individuals who self-reported Covid-19 infection or not. Individuals who stated that the answers offered in the survey were influenced by the social restrictions caused by the pandemic had higher scores than those who did not make this statement. There was no correlation with singing time and voice handicap and the presence of symptoms of mental health disorders, measured by the MSHI and SRQ-20, respectively. Choristers who maintained their singing activities individually or collectively showed less vocal and emotional damage.
Conclusion
Amateur choristers reported voice disadvantage and common mental health disorders possibly related to social restrictions caused by the Covid-19 pandemic. The observed rates, however, do not seem to be associated with the virus infection itself, but with the limitations imposed by social restrictions during the pandemic period.
Keywords:
Voice; Singing; Covid-19; Self-evaluation; Mental disorders
... Além disso, oferece estimulação cognitiva, produz a sensação de bem-estar durante a realização das atividades (9) e melhora a saúde mental desse grupo (10) . Vale ressaltar que o canto pode desenvolver nos indivíduos que o praticam maior suporte respiratório, equilíbrio da ressonância e modulação de intensidade (10,11) , além de aumentar a tessitura vocal (12) e oferecer ganhos ao desempenho vocal e performance desses sujeitos (13,14) . ...
... Das dimensões avaliadas nesse instrumento, o escore da dimensão "defeito" obteve o maior resultado, apontando possível perda ou anormalidade anatômica, estrutural, psicológica, fisiológica permanente ou temporária nos indivíduos avaliados (18) , resultado que soma-se aos da literatura que já aponta que dificuldades vocais estão relacionadas ao período restritivo decorrente da pandemia do novo coronavírus (4) . Esse fato pode estar associado à diminuição do ritmo de canto e desempenho vocal experimentada pela maioria dos participantes (13) , visto que componentes importantes dos aspectos vocais, como a realização de aquecimento vocal e as apresentações em grupo, foram prejudicados nesse período, sendo essa prática essencial para a qualidade e capacidade vocal dos coralistas (14) . ...
... Os coralistas que mantiveram suas atividades de canto de forma individual ou coletiva tiveram pontuação na dimensão "incapacidade" do IDCM significativamente menor do que os que não as mantiveram, o que revela maior habilidade de realizar atividades normalmente esperadas para aqueles que continuaram cantando. Essa realidade evidencia a importância da prática do canto para o desenvolvimento de habilidades e competências musicais nos cantores (11,12,14) e aponta as dificuldades enfrentadas por parte considerável dos coralistas amadores ao dar continuidade a essa prática diante das limitações que o modelo de coro virtual trouxe (15) . ...
RESUMO Objetivo Investigar a associação entre medidas de desvantagem vocal, sintomas de transtornos mentais comuns e a restrição das atividades de canto ocorrida durante a pandemia de Covid-19 em coralistas amadores. Métodos Estudo descritivo, analítico, transversal, de natureza quantitativa. Para coleta de dados, foram utilizados um questionário de caracterização inicial, o protocolo de Índice de Desvantagem para o Canto Moderno (IDCM) e o SRQ-20, adaptação do Self Reporting Questionnaire, todos eles disponibilizados de forma on-line. A amostra da pesquisa foi constituída por 46 participantes pertencentes aos corais amadores de duas instituições de ensino superior. Resultados As médias do escore total do IDCM e SRQ-20 foram elevadas e estiveram correlacionadas positivamente entre si. Não houve diferença entre as pontuações do IDCM e SRQ-20 para os indivíduos que referiram a infecção por Covid-19, ou não. Indivíduos que afirmaram em suas respostas que sofreram influência da restrição social causada pela pandemia apresentaram escores mais altos do que aqueles que não fizeram essa afirmação. Não houve correlação com o tempo de canto e a desvantagem vocal e a presença de sintomas de transtornos mentais, mensuradas pelo IDCM e SRQ-20, respectivamente. Coralistas que mantiveram suas atividades de canto individual ou coletivamente apresentaram menores prejuízos vocais e emocionais. Conclusão coralistas amadores relataram desvantagem vocal e transtornos mentais comuns possivelmente relacionados às restrições sociais provocadas pela pandemia de Covid-19. Os índices observados, todavia, parecem não estar associados à infecção pelo vírus em si, mas às limitações impostas pela restrição social do período pandêmico.
... Especialmente para os cantores sem queixa vocal, as dificuldades relacionadas à habilidade de cantar estavam relacionadas à restrição ocasionada pela fadiga vocal, como uma provável consequência da elevada demanda vocal do canto gospel (Tabela 2). Dado semelhante foi observado em um ensaio controlado realizado com 30 cantores de coral adultos, evidenciando que essa população, apesar de não apresentar queixas vocais, as queixas aumentam conforme aumenta a sensação de fadiga (26) . Nos sujeitos sem queixa vocal, apesar de não terem pontuado acima da nota de corte do IDV-10, as queixas evidenciadas neste protocolo pareciam estar relacionadas com a restrição ocasionada pelos sintomas de fadiga vocal. ...
... Isso pode ser explicado pela maior desvantagem vocal de mulheres em relação aos homens devido a características anatômicas e fisiológicas específicas do sexo feminino como o formato das cartilagens cricóidea e tireóidea que fazem com que muitas laringes femininas apresentem uma fenda fisiológica (29) . Já a fadiga vocal pode influenciar negativamente na habilidade de cantar (12,26) . ...
Purpose
To investigate the immediate impact on the voice of gospel singers with and without vocal complaints after a one-hour individual presentation.
Methods
Application of an online questionnaire that addressed the following aspects: 1 - Sociodemographic data; 2 – Self-assessment of the ability to sing using the Evaluation of the Ability to Sing Easily (EASE-BR) protocol; 3 - Self-assessment of vocal fatigue symptoms using the Vocal Fatigue Index (VFI) protocol; and 4 - Self-assessment of voice handicap using the Voice Handicap Index 10 (VHI-10) protocol. Participants were divided into two groups: Group with Vocal Complaint (WVC) and Group with no Vocal Complaint (WnVC) based on the total score of the IDV-10. Data underwent descriptive and inferential statistical analysis with a significance level of 5%.
Results
The study included 43 gospel singers with a median age of 34 years: 32 were in the WnVC group and 11 were in the WVC group. The WVC group reported hoarseness and experienced more difficulty while singing in the EASE, resulting in higher scores in both the VHI-10 and VFI protocols. A positive correlation was observed between singing difficulty and vocal handicap due to fatigue in amateur gospel singers, with this correlation being stronger within the WnVC group.
Conclusion
After one hour of performance, singers with vocal complaints exhibited higher rates of vocal fatigue, vocal disadvantage, and greater difficulty in singing. Singers without complaints may have their ability to sing impaired by vocal fatigue. Variations in singing ability and vocal handicaps in amateur gospel singers may be directly related to vocal fatigue.
Keywords:
Voice; Clinical Protocols; Speech Language and Hearing Sciences; Singing; Voice Disorders
... A similar result was noted in a controlled study involving 30 adult choir singers. Even though these singers did not initially report any vocal complaints, as fatigue levels increased, so did the number of vocal complaints (26) . Although the participants with no vocal complaints scored below the VHI-10 cutoff point, the complaints highlighted by this protocol seemed to be related to the restriction caused by vocal fatigue symptoms. ...
... This could be explained by women experiencing greater vocal disadvantage compared to men due to specific anatomical and physiological characteristics in females, such as the shape of the cricoid and thyroid cartilages, which often lead to a physiological gap (29) in female larynges. Also, vocal fatigue can negatively impact the singing ability (12,26) . ...
Purpose
To investigate the immediate impact on the voice of gospel singers with and without vocal complaints after a one-hour individual presentation.
Methods
Application of an online questionnaire that addressed the following aspects: 1 - Sociodemographic data; 2 – Self-assessment of the ability to sing using the Evaluation of the Ability to Sing Easily (EASE-BR) protocol; 3 - Self-assessment of vocal fatigue symptoms using the Vocal Fatigue Index (VFI) protocol; and 4 - Self-assessment of voice handicap using the Voice Handicap Index 10 (VHI-10) protocol. Participants were divided into two groups: Group with Vocal Complaint (WVC) and Group with no Vocal Complaint (WnVC) based on the total score of the IDV-10. Data underwent descriptive and inferential statistical analysis with a significance level of 5%.
Results
The study included 43 gospel singers with a median age of 34 years: 32 were in the WnVC group and 11 were in the WVC group. The WVC group reported hoarseness and experienced more difficulty while singing in the EASE, resulting in higher scores in both the VHI-10 and VFI protocols. A positive correlation was observed between singing difficulty and vocal handicap due to fatigue in amateur gospel singers, with this correlation being stronger within the WnVC group.
Conclusion
After one hour of performance, singers with vocal complaints exhibited higher rates of vocal fatigue, vocal disadvantage, and greater difficulty in singing. Singers without complaints may have their ability to sing impaired by vocal fatigue. Variations in singing ability and vocal handicaps in amateur gospel singers may be directly related to vocal fatigue.
Keywords:
Voice; Clinical Protocols; Speech Language and Hearing Sciences; Singing; Voice Disorders
... First of all, it needs to be absolutely neat, the pitch should be relatively stable, and the cooperation between each voice part should be dependent on each other. The horizontal melody in the choral weave refers to the respective melodic lines formed by each voice part in a single item, while the vertical weave refers to the harmonic structure formed by different voice parts in the upper and lower relationships [1][2]. ...
The development of traditional music is facing the change of digitalization and multimedia, and the application of research and acoustic theory in enhancing the effect of choral music with the help of computer technology is an important trend in the development of musicology at present. The article first proposes a method for choral training and then combines the LCQA algorithm and the FBE algorithm based on Mel filtering energy to propose a method for evaluating the quality of choral sound. The article finally takes a chorus as an empirical research object. It conducts specific experimental tests using the method proposed in this article, and the experimental results obtained are, in the analysis of choral sound effect, the total hoarseness and roughness of choral sound have decreased by about 0.8±0.31. In the evaluation of choral sound quality, the average score of the overall sound quality has risen by 23.25 points.
... This study found that only 42.6% of chanters received training before chanting. This is in agreement with study of Sharma et al., (16) revealing that no less than 60% of the chanters performed no vocal warm-up before singing while this result disagrees with Iris et al., (2022) (10) as vocal warm-up was clearly more represented, with half of the participants warming-up the voice prior to every singing performance and half of them warming-up sometimes. ...
... 38 which are indicators of better vocal abilities in trained singers. 39 However, it is unclear whether these differences are mainly due to the training, innate special abilities of trained singers, or a combination of these elements. 40 Furthermore, the DSI values of untrained Iranian traditional singers were below the cutoff point (< 1.6) and significantly lower than those of untrained Western classical male singers. ...
Summary: Objectives. This study aimed to compare trained and untrained Iranian traditional singers on the Dysphonia Severity Index (DSI) and the Singing Voice Handicap Index. The second objective was to examine the relationship between the DSI and Persian version of the Singing Voice Handicap Index (P-SVHI) scores in each group of trained and untrained Iranian traditional singers.
Study Design. This study is a comparative cross-sectional study.
Methods. This study included 17 trained male Iranian traditional singers who were compared with 17 untrained ones who were matched in terms of age. The P-SVHI was completed by trained and untrained Iranian traditional singers. Measures of jitter, lowest intensity, highest phonational frequency, and maximum phonation time (MPT) were obtained from each participant. The DSI scores were calculated using these values.
Results. Trained male traditional singers had an average age of 33.76 ± 7.45 years, 3.24 ± 1.85 hours of daily practice, 5.24 ± 3.78 years of training, 3.06 ± 2.65 no. of professional performances, and untrained singers had an average age of 32.76 ± 12.92 years, 1.53 ± 1.17 hours of daily practice, and 0.88 ± 1.65 no. of professional performances. Trained singers had lower P-SVHI scores and sub-scores, longer MPT, higher F0 high, lower jitter, and lower I low, resulting in higher DSI values (P < 0.05). There was no significant correlation between P-SVHI scores and DSI values in each group of trained and untrained Iranian traditional singers (P > 0.05).
Conclusions. The results of this study show that the vocal abilities of professional vocalists are enhanced through voice training (higher DSI scores in trained singers vs untrained ones). Voice training can also help to lessen the perception of a handicap related to the singing voice. Hence, it may be necessary to consider alter- native norms for the DSI and P-SVHI when administering them to patients who have undergone guided vocal training, such as voice/singing lessons. The current research indicates that the perception of singing voice handicap and DSI values are two distinct characteristics that do not have a significant correlation.
Key Words: Dysphonia severity index–Singers–Voice training–Maximum phonation time–Jitter–Singing Voice Handicap Index.
... Given the mismatch of high vocal requirements vs. poor vocal education, and hence greater risk for voice issues, choir singers' voice usage remains understudied. With mean scores on the Dysphonia Severity Index and AVQI, choir members demonstrated exceptional voice quality and capabilities [49]. The mean grade score corresponded to a normal to somewhat aberrant voice quality in terms of auditory perception. ...
Multiparametric indices offer a more comprehensive approach to voice quality assessment by taking into account multiple acoustic parameters. Artificial intelligence technology can be utilized in healthcare to evaluate data and optimize decision-making processes. Mobile devices provide new opportunities for remote speech monitoring, allowing the use of basic mobile devices as screening tools for the early identification and treatment of voice disorders. However, it is necessary to demonstrate equivalence between mobile device signals and gold standard microphone preamplifiers. Despite the increased use and availability of technology, there is still a lack of understanding of the impact of physiological, speech/language, and cultural factors on voice assessment. Challenges to research include accounting for organic speech-related covariables, such as differences in conversing voice sound pressure level (SPL) and fundamental frequency (f0), recognizing the link between sensory and experimental acoustic outcomes, and obtaining a large dataset to understand regular variation between and within voice-disordered individuals. Our study investigated the use of cellphones to estimate the Acoustic Voice Quality Index (AVQI) in a typical clinical setting using a Pareto-optimized approach in the signal processing path. We found that there was a strong correlation between AVQI results obtained from different smartphones and a studio microphone, with no significant differences in mean AVQI scores between different smartphones. The diagnostic accuracy of different smartphones was comparable to that of a professional microphone, with optimal AVQI cut-off values that can effectively distinguish between normal and pathological voice for each smartphone used in the study. All devices met the proposed 0.8 AUC threshold and demonstrated an acceptable Youden index value.
... According to Cohen et al. [14] SVHI is a reliable and valid tool to measuring the impact of vocal problems on the singer [15]. As in other studies in the literature, we found unknow laryngeal pathologies in singers [16]. ...
The finding of minimal laryngeal dysfunctions in professional voice users is essential to prevent the onset of organic vocal pathologies. The purpose of this study is to identify an objective parameter that supports the phoniatric evaluation in detecting minimal laryngeal dysfunctions in singers. 54 professional and non-professional singers have been evaluated with laryngostroboscopy, Multi-Dimensional Voice Program (MDVP), Dysphonia Severity Index (DSI), maximum phonation time (TMF), minimum intensity of sound emission (I-min), maximum frequency (F-max), voice handicap index (VHI), singing voice handicap index (SVHI), manual phonogram and audiometric examination. The SVHI of all the “healthy” singers was on average 23.7 ± 22.5, while that of the “dysfunctional” 20.9 ± 18. No statistically significant difference was found between the SVHI scores of the total of healthy singers compared to the scores of the dysfunctional ones on the VSL ( p = 0.6). The between-group comparison of the means of individual parameter values of DSI, TMF, F-max, Jitter, Shimmer, NHR, and SPI was not statistically significant (respectively p = 0.315, 0.2, 0.18, 0.09, 0.2, 0.08, 0.3). The only parameter analyzed that was statistically significant was the I-min ( p < 0.05). SVHI is a valid instrument for the evaluation after a therapy but in our experience, it is not useful in distinguishing healthy from dysfunctional patients. The minimum intensity of sound emission measured with the sound level meter (I-low2) resulted a reliable parameter to identify minimal laryngeal dysfunctions and a useful tool in supporting the phoniatric diagnostic-therapeutic process in singers.
"The relevance of the studied issue is the need to identify the main trends in choral performance, and determine the principles of the work of conductors and choral artists in the context of renewal of the components in this field. The aim of the research is to study the problem of current global trends in the development of choral performance as a complex multifaceted and integral phenomenon. Its practical methods (audio search; audio selection; audio analysis) were used in the research. The aspects of modern choral performance (interdisciplinary; socio-cultural; as well as artistic management; professional training; modern engineering technologies; information and communication space; technologies aimed at preserving human and professional resources) were identified. The current components of activity in the field of modern choral art were established. The directions of modern choral practice were identified (activation of the musical group in the life of society; expansion of traditional executive functions; growth of the genre stylistic palette of the choral repertoire). The system of key modernized methods of interpreting choral works of the 20th and 21st centuries was studied (principles of intonation; the principle of expanding the range; the principle of enriching the technical means of interpretation; the principles of forming the performance texture; the principle of interpreting the verbal text in the context of the choral score; the principle of creating different types of sound). The general features of modern choral performance in Ukraine and in the world were studied. The results can be applied in the process of researching future choral performing practice and preparing the relevant studies. The prospects of research in this field of musical culture are to enrich the theoretical and practical sectors of choral art as a complex system which is open for updates. Keywords: choral art, choir, choral work, performance interpretation, choral genre, choral style, timbre dramaturgy, performance analysis."
Purpose
Choir singing is an important tradition of Christian worship across India. However, vocal health issues related to the church choir singers are less addressed in the literature. Hence, this study aimed to investigate the prevalence of vocal symptoms, identify the variables associated with increased risk of voice problems and knowledge of factors influencing vocal health in church choir singers.
Method
One hundred and forty-eight church choir singers (61 males and 85 females) between the age range of 18 and 70 years participated in the study. They completed a self-reported questionnaire addressing demographic and singing-related details, vocal symptoms, variables associated with increased risk reporting voice problems and knowledge about factors influencing vocal health.
Result
Eighty-four percent of the choir singers reported two or more vocal symptoms sometimes or more frequently while or after singing. More than half of the church choir singers had experienced vocal symptoms such as accessing notes in the upper range, loss of vocal endurance, pitch breaks, hoarseness, dryness in the throat, and discomfort in the throat. Among the different variables, systemic hydration found to have a significant association with reporting of voice problems in church choir singers. The overall knowledge regarding the factors influencing vocal health was found to be limited among the choir singers.
Conclusion
Choir singers like other professional singers experienced a higher prevalence of vocal symptoms during or after singing and exhibited limited knowledge about factors that negatively influence vocal health. Hence, there is a need to look into these singer’s vocal requirements, who usually go unnoticed.
PurposeThe purpose of the present study was to compare the voice of choir singers before and after 60 min of singing and after an absolute rest.Methods
Twenty-one female choir singers aged on average 26.59 years, with experience in choir singing of at least one year were instructed to emit the vowel /a/ before and after singing and after a vocal rest of 30 min for an analysis of acoustic measures, and for the evaluation of their tactile–kinesthetic self-perception. Vocal warm-up was performed for 10 min. The participants were instructed to sing the “Ave Verum” music continuously for 60 min.
Resultsf0 (p = 0.0001) and Flo (p = 0.0002) increased after the singing test and were reduced after the vocal rest, in contrast to Fhi (p = 0.001), which continued to be increased compared to the pre-test measure even after the vocal rest. The vAm parameter (p = 0.05) was reduced after continuous singing and rest. All self-evaluation symptoms increased after the continuous singing task and were reduced after the 30 min rest, except for complaints of low voice, pain when swallowing and cough/throat clearing.Conclusion60 min of continuous use of the singing voice induced signs of vocal fatigue with an increase in f0, with improvement of symptoms and a reduction of f0 occurring after 30 min of vocal rest.
Purpose
The purpose of this document is threefold: (a) review the uses of the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a “linguistically modeled” definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts.
Method
A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms (“vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading”), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions.
Results
The occurrence and frequency of “vocal load,” “vocal loading,” “vocal effort,” and “vocal fatigue” in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, “vocal demand” and “vocal demand response,” in place of the terms “vocal load” and “vocal loading.” We also propose standardized definitions for all four concepts.
Conclusion
Through a comprehensive literature search, the terms “vocal fatigue,” “vocal effort,” “vocal load,” and “vocal loading” were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.
Introduction
There are no official diagnostic protocols for singing voice assessment. In this publication, on the basis of a literature review, standards for the singing voice handicap index exclusively dedicated to voice disorders in singing have been given.
Objective
The study aims to determine the normative values for the singing voice handicap index.
Methods
The study is a systematic review and a meta-analysis. A systematic literature search was performed using PubMed to access relevant databases and to locate outcome studies. The “inclusion” criteria were as follows: English language, original papers and human studies retrospective and prospective papers, cross-sectional and case-control studies.
Results
Eight articles were included for the final analysis. The normative value for the singing voice handicap index was 20.35 with a confidential range of 10.6–30.1 for a group of 729 healthy subjects whose voices were judged as normal, with an age range of 16–64 years.
Conclusion
The mean normative value of the singing voice handicap index was 20.35 with the confidence levels between 10.6 and 30.1.
Objectives:
The study aimed to investigate and compare the acoustic and aerodynamic characteristics of choral singers and nonsingers.
Method:
Twenty choral singers and 20 nonsingers in the age range of 20-30 years with no vocal pathology participated in the study. For acoustic analysis, the voice sample was recorded and analyzed using Praat software (Phonetic Sciences, University of Amsterdam, Amsterdam, Netherlands) version 6.0.33 and for aerodynamic evaluation, Helios 401 PC based spirometer (Recorders & Medicare System Pvt. Ltd., Panchkula, Haryana, India) was used.
Results:
The results from acoustic analysis of female groups revealed higher F0 in singers than nonsingers; higher jitter, shimmer, and noise-to-harmonics ratio (NHR) values were obtained for nonsingers compared to singers. Results from acoustic analysis of male groups revealed significantly higher F0 in singers than nonsingers and significantly higher shimmer and NHR values for nonsingers compared to singers. Results from aerodynamic analysis for both male and female groups revealed higher vital capacity, forced vital capacity, and slow vital capacity in singers than nonsingers.
Conclusion:
The results revealed better control over phonatory and respiratory subsystems among singers compared to nonsingers, although the singers were untrained. This could be possible due to the fact that long-term singing practices involving vocal modulation and changes in the breathing pattern, better respiratory control during the expiratory phase among singers. However, as the participants of the singing group are untrained, further studies are required to compare the acoustic and the aerodynamic characteristics with trained singers.
Objectives:
The study aimed to investigate and map the existence of vocal risk in amateur singers, analyzing the contribution of general voice signs and symptoms, specific singing handicap, and generalized anxiety.
Study design:
This is a cross-sectional study.
Methods:
The sample comprised 526 volunteer amateur choristers-186 male and 340 female-(mean age of 42.07 years) from different choirs in the region of São Paulo. Three questionnaires were used: the Voice Symptom Scale (VoiSS), the Modern Singing Handicap Index (MSHI), and the Generalized Anxiety Disorder 7-item (GAD-7) scale.
Results:
The mean total score obtained on the VoiSS was 17.57, which is almost two points higher than the protocol's passing score (16). The choristers who scored higher or equal to 16 points (51.5%, n = 271)-considered at vocal risk-and the group who scored less than 16 points (48.5%, n = 255)-healthy group-were analyzed separately. The risk group presented a mean total score of 26.34 on the VoiSS and 20.97 on the MSHI, with higher deviation on the impairment subscale, followed by the disability and handicap subscales, along with mild anxiety. The healthy group presented a mean total score of 8.27 on the VoiSS and 6.11 on the MSHI, also with higher deviation in the impairment subscale, followed by disability and handicap, and a minimum level of anxiety.
Conclusion:
Even in leisure activities, vocal care is necessary for the correct use of the singing voice, which demands individual adaptations. The use of protocols for voice symptoms and singing handicap has revealed the possibility of amateur choristers to present vocal risk.
Objectives:
The aim of this study was to evaluate the acoustic measurements of the vowel /a/ in modal recording before and after a singing voice resistance test and after 30 minutes of absolute rest in female choir singers.
Study design:
This is a prospective cohort study.
Methods:
A total of 13 soprano choir singers with experience in choir singing were evaluated through analysis of acoustic voice parameters at three points in time: before continuous use of the voice, after vocal warm-up and a singing test 60 minutes in duration respecting the pauses for breathing, and after vocal cooldown and an absolute voice rest for 30 minutes.
Results:
The fundamental frequency increased after the voice resistance test (P = 0.012) and remained elevated after the 30 minutes of voice rest (P = 0.01). The jitter decreased after the voice resistance test (P = 0.02) and after the 30 minutes of voice rest. A significant difference was detected for the acoustic voice parameters relative average perturbation (RAP), (P = 0.05), and pitch perturbation quotient (PPQ), (P = 0.04), compared with the initial time point.
Conclusions:
The fundamental frequency increased after 60 minutes of singing and remained elevated after vocal cooldown and absolute rest for 30 minutes, proving an efficient parameter for identifying the changes inherent to voice demand during singing.
Objectives:
The popularity of choir singing among Indonesian university students as an extracurricular activity has increased in the last few years. Choir singers use physiology principles especially respiration roles in the voice production process. This research aims to determine the lung vital capacity difference between singers and nonsingers.
Methods:
This is a cross-sectional study which uses primary data collected from spirograms of 20 university students. Half of the students were Airlangga University choir singers, and the other half were students who are not members of the choir. The spirometry tests were performed to obtain inspiratory capacity, vital capacity, and forced vital capacity of both groups.
Results:
The average lung vital capacity of choir singers was higher (3.12 L) than that of the nonsingers (2.73 L). The average inspiratory capacity of the singer group was 1.79 L, and the average inspiratory capacity of the nonsinger group was 1.71 L. The lung vital capacity difference between singers and nonsingers group was statistically significant (P = 0.02). There was no significant inspiratory capacity difference between singers and nonsingers group in this study (P = 0.611). The forced vital capacity measurement showed a significant difference (P = 0.01) between singers (75.28%) and nonsingers (68.14%).
Conclusion:
It can be understood that the increasing vital capacity in choir singers is most likely from the expiration phase of the respiration. Further studies need to be conducted to confirm the causes of the increasing vital capacity in singers.
Objectives:
To evaluate the behavior of the phonatory function and the perceived strain in Brazilian young women, before and after a test of prolonged voice use test, for a period of one continuous hour.
Methods:
Twenty young women without laryngeal disorders participated in the study and were submitted to vocal acoustic analysis (MDVP-Advanced, CSL-Kay Pentax(r)), perceptual voice assessment, carried out by five judges, and the measurement of speech-strain level using a visual analog scale before and after a prolonged use of the voice, from the reading of a standardized text for one hour in usual vocal intensity and frequency, without breaks for hydration or vocal rest. The description and comparison between the variables and the appropriate statistical analysis were carried out.
Results:
The acoustic parameters of fundamental (f0) and low frequency (Flo) of the emission increased after 1 hour of voice use, while the values for the amplitude tremor intensity index (Atri), amplitude variation (vAm), noise-to-harmonic ratio (NHR), and soft phonation index (SPI) were reduced after the prolonged voice use test. The judges agreed with the decrease in the overall level of dysphonia (kappa=0.66), roughness (kappa=0.59), and vocal breathiness (kappa=0.73); increased phonatory stability (kappa=0.64); vocal projection (kappa=0.48); pitch (kappa=0.74); and loudness (kappa=0.65). The phonatory strain increased significantly after the test (p=0.003).
Conclusion:
One hour of prolonged voice use seems to favor laryngeal adaptation and increased adductor muscle activity to maintain vocal efficiency. However, the self-perception of vocal strain is evident and can be understood as a sign of muscle fatigue caused by continuous use.
To develop a psychometrically sound self-report questionnaire, the Vocal Fatigue Index (VFI), to help identify individuals with vocal fatigue (VF) and characterize their complaints.
Descriptive research-scale development.
Four laryngologists and six speech-language pathologists specialized in voice created a beta version of the VFI (version 1), an index of 21 statements they considered to reflect VF. Two hundred patients presenting to two different clinics completed the VFI-1. Two items from VFI-1 were excluded because of poor item-to-total correlations. The final VFI of 19 items (version 2), completed by 105 patients with voice complaints and 70 vocally healthy individuals, was assessed for its psychometric properties.
Test-retest reliability for the final VFI was generally strong, as was sensitivity and specificity using the classification table under logistic regression for correctly distinguishing individuals with and without VF. Moreover, factor analysis indicated that VF may be characterized by three factors: (1) factor 1, related to tiredness of voice and voice avoidance, (2) factor 2, related to physical discomfort associated with voicing, and (3) factor 3, related to improvement of symptoms with rest.
The VFI is a standardized tool that can identify individuals with probable VF with good reliability, validity, sensitivity, and specificity.
Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
In professional choirs one would like to identify the incidence and severity of vocal problems due to ageing, and know how to influence them. The aim of the current study was to investigate to what extent easily obtainable voice parameters were age-related. From 47 singers of the Netherlands Radio Choir the Voice Range Profile parameters and the vibrato characteristics were measured. Dysphonia Severity Index (DSI) was calculated. We found that the age of male and female singers correlated negatively to the highest fundamental frequency and the Dysphonia Severity Index. No signs of slower and wider vibrato were found. These findings can lead to identifying adequate parameters e.g. for the ageing voice, useful in larger groups of professional singers.
In the context of the development of prototypic assessment instruments in the areas of cognition, personality, and adaptive functioning, the issues of standardization, norming procedures, and the important psychometrics of test reliability and validity are evaluated critically. Criteria, guidelines, and simple rules of thumb are provided to assist the clinician faced with the challenge of choosing an appropriate test instrument for a given psychological assessment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This prospective cross-sectional study examines the effects of voice training on vocal capabilities in vocally healthy age and gender differentiated groups measured by voice range profile (VRP) and speech range profile (SRP).
Frequency and intensity measurements of the VRP and SRP using standard singing and speaking voice protocols were derived from 161 trained choir singers (21 males, 59 females, and 81 prepubescent children) and from 188 nonsingers (38 males, 89 females, and 61 children).
When compared with nonsingers, both genders of trained adult and child singers exhibited increased mean pitch range, highest frequency, and VRP area in high frequencies (P<0.05). Female singers and child singers also showed significantly increased mean maximum voice intensity, intensity range, and total VRP area. The logistic regression analysis showed that VRP pitch range, highest frequency, maximum voice intensity, and maximum-minimum intensity range, and SRP slope of speaking curve were the key predictors of voice training. Age, gender, and voice training differentiated norms of VRP and SRP parameters are presented.
Significant positive effect of voice training on vocal capabilities, mostly singing voice, was confirmed. The presented norms for trained singers, with key parameters differentiated by gender and age, are suggested for clinical practice of otolaryngologists and speech-language pathologists.
The purpose of this study was to determine the impact of a specific vocal warm-up (WU) program-focused on the improvement of the dynamics of the extrinsic and intrinsic laryngeal muscles-on the objective vocal quality in Dutch female students who are getting trained to be speech language pathologists (SLPs). Hypothetically, one can assume that the objective vocal quality will increase after vocal WU exercises in SLPs in comparison with the matched control group that receives no WU program.
This was a pretest-posttest control group design study, in which 45 female future SLPs were randomly assigned into two groups. The experimental group received a well-defined vocal WU program, whereas the control group took 30 minutes of vocal rest. Objective assessment techniques (aerodynamic, vocal range, acoustic measurements, and Dysphonia Severity Index [DSI]) were used.
After vocal WU, a significant increased DSI value, increased vocal performance (with lower intensity and higher frequency), and increased fundamental frequency (F₀) were measured.
Clinically, there is clear evidence that warming up the vocal mechanism is beneficial to the objective vocal quality and the vocal performance in future SLPs. To what extent the repetition of these vocal WU exercises has the possibility to maintain increased objective vocal quality in these future professional voice users is subject to further research.
To develop a shortened version of the validated health status instrument for singers, the Singing Voice Handicap Index (SVHI).
Prospective item analysis of the SVHI in patients with singing voice problems and creation and validation of an abbreviated SVHI, the SVHI-10.
Patients presenting to two tertiary care voice clinics prospectively completed the SVHI. Principal component analysis was performed. Individual item to total correlations were calculated, and individual items were also evaluated for bipolar response patterns. A clinical consensus conference prioritized each individual item. Items were then eliminated, and the internal consistency was evaluated. A second cohort of patients with singing voice problems completed the Voice Handicap Index-10 (VHI-10) and SVHI-10 at two time points. Singers without voice problems also completed the SVHI-10. SVHI-10 scores were compared between the groups, correlations between the SVHI-10 and VHI-10 were performed, and test-retest reliability of the SVHI-10 assessed.
Singers with voice problems had worse SVHI-10 scores than normal singers (P < .0001, t test). Test-retest reliability was high (Spearman correlation = 0.86, P < .001). Internal consistency of the SVHI-10 demonstrated a Cronbach alpha of .94, and the correlation between the SVHI-10 and VHI-10 was 0.7 (P < .001, Spearman correlation).
The SVHI-10 is a valuable instrument to assess self-perceived handicap associated with singing voice problems with reduced patient burden.
Purpose
This article presents the development of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) following a consensus conference on perceptual voice quality measurement sponsored by the American Speech-Language-Hearing Association’s Special Interest Division 3, Voice and Voice Disorders. The CAPE-V protocol and recording form were designed to promote a standardized approach to evaluating and documenting auditory-perceptual judgments of vocal quality.
Method
A summary of the consensus conference proceedings and the factors considered by the authors in developing this instrument are included.
Conclusion
The CAPE-V form and instructions, included as appendices to this article, enable clinicians to document perceived voice quality deviations following a standard (i.e., consistent and specified) protocol.
Most singers prefer to warm up their voices before performing. Although the subjective effect is often considerable, the underlying physiological effects are largely unknown. Because warm-up tends to increase blood flow in muscles, it seems likely that vocal warm-up might induce decreased viscosity in the vocal folds. According to the theory of vocal-fold vibration, such a decrease should lead to a lower phonation threshold pressure. In this investigation the effect of vocal warm-up on the phonation threshold pressure was examined in a group of male and female singers. The effect varied considerably between subjects, presumably because the vocal-fold viscosity was not a dominating factor for the phonation-threshold pressure.
The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F(0)-High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI = 0.13 x MPT + 0.0053 x F(0)-High - 0.26 x I-Low - 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices -5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.
The present study investigates the effects of choir music on secretory immunoglobulin A (S-IgA), cortisol, and emotional states in members of a mixed amateur choir. Subjects participated in two conditions during two rehearsals 1 week apart, namely singing versus listening to choral music. Saliva samples and subjective measures of affect were taken both before each session and 60 min later. Repeated measure analyses of variance were conducted for positive and negative affect scores, S-IgA, and cortisol. Results indicate several significant effects. In particular, singing leads to increases in positive affect and S-IgA, while negative affect is reduced. Listening to choral music leads to an increase in negative affect, and decreases in levels of cortisol. These results suggest that choir singing positively influences both emotional affect and immune competence. The observation that subjective and physiological responses differed between listening and singing conditions invites further investigation of task factors.
Objectives
We developed and validated a disorder-specific health status instrument (Singing Voice Handicap Index; SVHI) for use in patients with singing problems.
Methods
Prospective instrument validation was performed. Of 81 original items, those with poor statistical validity were eliminated, resulting in 36 items. The ability to discriminate dysphonic from normal singers, test-retest reliability, internal consistency, and construct validity were assessed.
Results
We included 112 dysphonic and 129 normal singers, professional and nonprofessional, of classical, country, rock, choral, and gospel repertoire. Dysphonic singers had worse SVHI scores than normal singers (p ≤ .001, rank sum test). Test-retest reliability was high (Spearman correlation, 0.92; p ≤ .001). Internal consistency demonstrated a Cronbach's α of 97, and the correlation between the SVHI and self-rated singing voice impairment was .63 (p ≤ .001, Spearman correlation).
Conclusions
The SVHI is a reliable and valid tool for assessing self-perceived handicap associated with singing problems.
Introduction
Vocal tract discomfort (VTD), dysphonia, and laryngopharyngeal reflux (LPR) symptoms are complaints frequently reported by amateur singers. There are two aims of this study. The first is to evaluate the prevalence of these symptoms using validated questionnaires. The second is to correlate singing-related variables with the questionnaire responses.
Methods
A total of 392 amateur choir singers (ACS) and 514 control subjects completed an online survey divided into four parts: (1) clinical and demographic characteristics, (2) training in singing and singing experience, (3) history of gastroesophageal reflux disease and LPR symptoms, (4) validated questionnaires. Specifically, the reflux symptom index (RSI), the vocal tract discomfort scale (VTDS), and the voice symptom scale (VoiSS) were included to analyze the actual burden related to LPR symptoms, VTD, and dysphonia.
Results
ACS demonstrated a healthier lifestyle and a lower prevalence of gastroesophageal reflux disease symptoms in comparison with control subjects. ACS scored significantly higher in VTDS and VoiSS than control subjects, while no differences in the RSI results were found. Significant correlations among the questionnaires’ results were demonstrated. Occasional professional singing was the variable influencing VTDS and VoiSS results the most.
Conclusion
ACS do not evidently manifest a higher impairment connected to LPR (RSI score), while they do report higher levels of voice (VoiSS score) and vocal tract (VTDS score) impairments, in comparison with control subjects. The relevant correlations among the PRO measures suggest that LPR symptoms, VTD, and dysphonia are related to each other. Given the relevant repercussion on the severity of VTD and dysphonia, providers should specifically ask about occasional professional singing when treating amateur singers.
Background:
Performing vocal warm-ups prior to singing repertoire has been shown to change the perceived quality and acoustic parameters of the voice. To date, there are no studies that specifically compare singers' and listeners' perceptions of vocal quality after various warm-up durations.
Objective:
To determine if specific warm-up durations (0, 5, 10, or 15 minutes) change subjective and objective measures of voice.
Study design:
Prospective cohort study.
Methods:
Information related to demographics, singing practice, medical history, and vocal hygiene were collected. First- and second-year collegiate classical voice majors completed a series of four warm-up times, 1 week apart, prior to singing Caro mio ben in a standard key for their voice type. A modified Voice Range Profile (mVRP), and the Evaluation of the Ability to Sing Easily (EASE) scale were completed. Participants blindly rated 30-second recorded audio clips using the Auditory-Perceptual Rating Instrument for Operatic Singing. Four independent expert blinded listeners rated all audio clips for each participant in random order.
Results:
Six first-year and three second-year classical vocal performance majors completed all measures. Results of the EASE scale showed decreased scores with 5- and 10-minute warm-up duration, compared to 0 and 15 minutes of warm-up (P = 0.029 for the total EASE score and P = 0.044 for Rasch score). Delayed perceptual analysis of voice yielded nearly equal medians between warm-up durations for both self and expert-listener ratings. The mVRP showed that both 5 and 10 minutes of warm-up duration led to increased highest fundamental frequency for females (P = 0.017).
Conclusion:
This pilot study demonstrates the immediate self-perceived benefit for all participants and increased frequency range for females after performing 5 and 10 minutes of vocal warm-up. No significant differences were found in delayed perceptual analyses completed by the participants or the expert raters after the different warm-up durations. Future investigations should include a larger population and different levels of education and genres of singing.
Purpose
The purpose of this study was to measure and compare the voice characteristics and vocal complaints and habits of musical theater actors and musical theater students.
Method
Thirty participants were included in the study, 18 musical theater students and 12 professional musical theater actors. Vocal quality was measured by the multiparameter indices Dysphonia Severity Index (DSI) and Acoustic Voice Quality Index (AVQI). A perceptual evaluation of the speaking voice was performed using the GRBASI scale. All participants completed the Voice Handicap Index (VHI), the VHI adapted to the singing voice, the Vocal Tract Discomfort (VTD) Scale and the Corporal Pain Scale.
Results
Excellent scores for DSI (resp. 7.3, 7.1) and AVQI (resp. 2.6, 2.5) were found in the musical theater actors and students. All participants reported at least two symptoms of VTD and the mean scores for the VHI adapted to the singing voice were located in the clinical zone. Musical theater students reported significantly more VTD and pain symptoms compared to the professionals. No significant differences in perceptual and objective voice characteristics were found between musical theater actors and students. A higher presence of vocal misuse and stress in the students was observed.
Conclusion
Musical theater students and actors are elite vocal performers with comparable excellent objective vocal measures (DSI, AVQI). In both groups, an increased number of VTD and complaints of the singing voice were reported. Especially students were vulnerable for stress, vocal misuse, VTD, and pain symptoms. The findings suggest that musical theater actors are a risk group for developing voice disorders requiring multidimensional voice assessment and voice care.
The primary aim of this research was to quantify the degree to which the upper airway temperature changes with singing warm-up. Based on prior upper airway thermoregulation research it was hypothesized that upper airway temperature would not significantly increase during singing warm up when compared to prewarm up and recovery phases. Ten participants completed a short singing warm-up of their choice until they felt sufficiently warmed up while upper airway temperature was measured at 1 second intervals via a transnasal thermistor placed against the posterior pharyngeal wall, just above the larynx. Descriptive statistics and statistical modeling were used for comparison of pre-warm-up, warm-up, and recovery phases of a short singing warm-up. Results indicated a physiologically-significant increase (≥0.5°C) of upper airway temperature during the singing warm-up when compared to the prewarm up average. Significant differences (P < 0.0001) were identified between all pairwise comparisons analyzed for the three phases of data collected (baseline, warm-up, and recovery). These findings support an upper airway tissue temperature increase in response to the singing warm-up. The extent to which these findings can be generalized to the intrinsic laryngeal muscles is still unknown given the technical difficulty of obtaining intramuscular laryngeal temperature measures.
Abstract
Background/Aims: Although water resistance therapy (WRT) has been widely used in voice training, no data are supporting the effectiveness of WRT as vocal warm-up for singers. The present study aimed to determine the effects of WRT as a vocal warm-up method in contemporary commercial music (CCM) singers. Methods: Twenty-two CCM singers were randomly assigned to one of two types of 15-min vocal warm-up: open vocal tract (OVT) warm-up and WRT. Self- perceived resonant voice quality and aerodynamic, electroglottographic, and acoustic measures were assessed before, immediately after vocal warm-up, and after 40 min of vocal loading. Results: Significant results were found immediately after vocal warm-up. Subglottic pressure and inspiratory airflow duration decreased in both groups. SPL decreased for the OVT group. No changes in SPL were found for the WRT group. Significant results were observed after vocal loading. Subglottic pressure and inspiratory airflow duration decreased for both groups after vocal loading. Expiratory airflow duration and electroglottographic contact quotient decreased for the OVT group. Conclusion: Some objective data suggest that the WRT method is more effective as vocal warm-up than OVT exercises. Since outcomes in self-perceived resonant voice quality for both methods were similar but physiological effects were different, vocal warm-up strategies might produce a placebo effect.
Objectives:
Singers have reported higher prevalence of vocally harmful behaviors, vocal symptoms, and voice disorders than nonsingers have. The purpose of this study was to investigate the prevalence of voice disorders among choir singers and to discover the risk factors associated with voice disorders. Another purpose was to explore the choir singers' knowledge about the anatomy and physiology of the voice, and voice ergonomics.
Methods:
Three hundred and fifteen adult choir singers, 65% women, and 35% men, completed a web-questionnaire. The questionnaire included demographic questions and questions about vocal symptoms, risk factors for voice disorders, and voice knowledge.
Results:
Twenty one percent of the participants experienced two or more frequently occurring vocal symptoms, which was defined as having a functional voice disorder. Choir singers with a vocally demanding profession were almost twice as likely to report several frequently occurring vocal symptoms. Health-related risk factors, such as inhalant allergy and asthma, had a significant relation with the number of vocal symptoms. The overall voice knowledge among the choir singers seemed limited.
Conclusions:
The prevalence of voice disorders among choir singers seems to be similar to the prevalence rate among professional voice users. Choir singers with a vocally demanding profession are at a higher risk of developing a functional voice disorder. The results of this study raise the importance of educating choir singers about the voice, in order to prevent development of voice disorders.
Background:
Recent scholarship has suggested that semi-occluded vocal tract (SOVT) exercises may increase vocal economy of individuals by reducing vocal effort while maintaining or increasing acoustic output. Choral singers, however, may use different resonance techniques or change voicing behaviors in an effort to hear their own sound in relation to others. One investigation revealed significant increases in a choir's mean spectral energy after participating in a straw phonation protocol. However, that study reported only acoustic measures and did not include choristers' perceptions of the choral sound and their own voicing efficiency.
Objective:
The purpose of this study was to measure the effect of a straw phonation protocol on acoustic (long-term average spectrum) and perceptual (self-report) measures of the choral sound of an intact soprano, alto, tenor, and bass (SATB) choir.
Study design:
This is a quasi-experimental, one-group, pretest-posttest design.
Methods:
An SATB choir (N = 48 singers) performed a Renaissance motet, participated in a 4-minute voicing protocol with a small straw, and then sang the motet a second time. They completed the same procedure later in the rehearsal.
Results:
Long-term average spectrum results indicated no statistically significant mean changes in spectral energy after the SOVT protocols. Most participants, however, perceived that the choir sounded better (78.26%) and that their own vocal production was more efficient or comfortable (73.91%) following the protocol.
Conclusion:
Choristers perceived less vocal effort while maintaining vocal output after straw phonation, which may feasibly align with extant solo research. More research may determine whether this result is due specifically to SOVTs.
Objective:
The purpose of this investigation was to assess the effects of three warm-up procedures (vocal-only, physical-only, physical/vocal combination) on acoustic and perceptual measures of choir sound.
Methods:
The researchers tested three videotaped, 5-minute, choral warm-up procedures on three university choirs. After participating in a warm-up procedure, each choir was recorded singing a folk song for long-term average spectra and pitch analysis. Singer participants responded to a questionnaire about preferences after each warm-up procedure. Warm-up procedures and recording sessions occurred during each choir's regular rehearsal time and in each choir's regular rehearsal space during three consecutive rehearsals.
Results:
Long-term average spectra results demonstrated more resonant singing after the physical/vocal warm-up for two of the three choirs. Pitch analysis results indicate that all three choirs sang "in-tune" or with the least pitch deviation after participating in the physical/vocal warm-up. Singer questionnaire responses showed general preference for the physical/vocal combination warm-up, and singer ranking of the three procedures indicated the physical/vocal warm-up as the most favored for readiness to sing.
Conclusions:
In the context of this study with these three university choir participants, it seems that a combination choral warm-up that includes physical and vocal aspects is preferred by singers, enables more resonant singing, and more in-tune singing. Findings from this study could provide teachers and choral directors with important information as they structure and experiment with their choral warm-up procedures.
Objective:
The purpose of this study was to determine the effect of two isolated vocal facilitating techniques, glottal fry and yawn-sigh, on the phonation of vocally healthy female speech-language pathology (SLP) students.
Study design:
A multigroup pretest-posttest design was used.
Methods:
A group of thirty-six healthy female SLP students with a mean age of 18.1 years were assigned into three groups: a glottal fry group (practicing the facilitating technique glottal fry across 18 weeks, n=12), a yawn-sigh group (practicing the facilitating technique yawn-sigh across 18 weeks, n=12) and a control group (receiving no facilitating techniques, n=12). To compare vocal measures before and after this training period, an identical objective voice assessment protocol (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was performed in the three groups. Groups were compared over time using linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons.
Results:
Glottal fry resulted in a significant decrease in lowest and highest intensity. Yawn-sigh resulted in a significant increase in fundamental frequency, a significant decrease in shimmer and noise-to-harmonic ratio, and a significant increase in highest intensity.
Conclusions:
Yawn-sigh may have a positive effect on the phonation of female vocally healthy future SLPs, whereas results are less supportive for using glottal fry in training this population's voice.
Background
Researchers have found that semi-occluded vocal tract (SOVT) exercises may increase vocal economy by reducing phonation threshold pressure and effort while increasing or maintaining consistent acoustic output. This research has focused solely on individual singers. Much singing instruction, however, takes place in choral settings. Choral singers may use different resonance strategies or unconsciously adjust their singing based on the ability to hear their own sound in relation to others. Results of studies with individual singers, then, may not be directly applicable to choral settings.
Objective
The purpose of this investigation was to measure the effect of an SOVT protocol (ie, straw phonation) on acoustic changes of conglomerate, choral sound.
Study Design
This is a quasi-experimental, one-group, pretest-posttest design.
Methods
Participants in this study constituted an intact SATB choir (soprano, alto, tenor, and bass) (N = 15 singers) who performed from memory two unaccompanied pieces of varied tempos from memory, participated in a 4-minute straw phonation protocol with a small stirring straw, and then sang each piece a second time.
Results
The long-term average spectrum results indicated small, statistically significant increases in spectral energy for both pieces in the 0–10 kHz (.32 and .20 dB Sound Pressure Level) and 2–4 kHz regions (.46 and .25 dB SPL).
Conclusion
These results, although not likely audible to average hearing humans, seem consistent with the assertion that singers enjoy vocal benefits with consistent or increased vocal output. SOVT exercises, therefore, may be useful as a time-efficient way to evoke more efficient and economical singing during choral warm-up and voice building procedures.
Objective:
Musical theater performers are a special group of elite vocal performers with a high vocal load as they combine singing, acting, and physical performance. As they are absolutely depending on their voice quality and vocal capacities for their studies and their future profession, an optimal voice production is very important. The purpose of this study was to determine the voice quality of musical theater students. The voice quality of seven students was then reevaluated 1 year after the first assessment.
Study design:
Observational study.
Methods:
Thirty-one musical students (7 men and 24 women) with a mean age of 20 years participated in the study. To determine the voice quality, objective (aerodynamic measurements, voice range profile, acoustic analysis, and Dysphonia Severity Index) and subjective (videolaryngostroboscopy, Voice Handicap Indexes, and questionnaires regarding voice symptoms and risk factors) voice measurements were performed.
Results:
The median Dysphonia Severity Index in male and female musical students was respectively 5.3 and 5.7, both corresponding with an overall good voice quality. The questionnaires revealed the presence of vocal fatigue, dryness of the throat, vocal tract discomfort, and harmful vocal habits in the majority of students. In 45% of the subjects, videolaryngostroboscopic evaluation of the vocal folds showed an organic lesion. The majority of these lesions are inflammatory lesions (26%). In 68% of the subjects, a certain degree of supraglottic constriction was observed.
Conclusion:
Despite the overall good voice quality, videolaryngostroboscopy showed a high presence of vocal fold lesions and supraglottic constriction during phonation.
Objective:
The purpose of this study was to determine the effect of the isolated vocal-facilitating techniques Chant Talk and Pitch Inflections on the phonation of healthy female speech-language pathology (SLP) students.
Study design:
A multigroup pretest-posttest design was used.
Methods:
A homogenous group of 40 healthy female SLP students with a mean age of 18.7 years were randomly assigned into 3 groups: a Chant Talk group (practicing Chant Talk across 18 weeks), a Pitch Inflections group (practicing Pitch Inflections across 18 weeks), and a control group (practicing no facilitating techniques). To compare vocal measures before and after this time span, an identical objective voice assessment protocol (aerodynamic measurement, acoustic analysis, voice range profile, and Dysphonia Severity Index) was performed in the 3 groups.
Results:
Both Chant Talk and Pitch Inflections groups resulted in a significant decrease of the acoustic measure noise-to-harmonics ratio compared with the control group. The Chant Talk group resulted in a significant increase in the acoustic measure fundamental frequency compared with the control group.
Conclusions:
The results of this pilot study suggest that the facilitating techniques Chant Talk and Pitch Inflections may improve the objective measure of breathiness (noise-to-harmonics ratio) in healthy female SLP students.
The purpose of this study was to determine how use of the vocal facilitating technique, chewing, affected the phonation of speech-language pathology (SLP) students.
A pretest-posttest randomized control group design was used.
Twenty-seven healthy female SLP students were randomly assigned into either an experimental group or a control group. The experimental group practiced chewing exercises across 18 weeks, whereas the control group received no vocal facilitating techniques. Both groups completed pre- and post- objective voice assessment measures (aerodynamic measurement, acoustic analysis, voice range profile, and Dysphonia Severity Index). Differences between pre- and post-data were compared between the experimental and control group using an independent sample t test.
Compared to the control group, chewing resulted in a significant decrease in jitter and noise-to-harmonic ratio (NHR), a significant increase in fundamental frequency (fo), a significant expansion of the voice range profile, and a significant increase in Dysphonia Severity Index (DSI). Shimmer and maximum phonation time (MPT) were not significantly different between groups.
The results of this pilot study suggest that the vocal facilitating technique, chewing, may improve objective vocal measures in healthy female SLP students.
Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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.
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Objective:
The present study aimed to investigate the vocal tract and glottal function during and after phonation into a tube and a stirring straw.
Methods:
A male classically trained singer was assessed. Computerized tomography (CT) was performed when the subject produced [a:] at comfortable speaking pitch, phonated into the resonance tube and when repeating [a:] after the exercise. Similar procedure was performed with a narrow straw after 15 minutes silence. Anatomic distances and area measures were obtained from CT midsagittal and transversal images. Acoustic, perceptual, electroglottographic (EGG), and subglottic pressure measures were also obtained.
Results:
During and after phonation into the tube or straw, the velum closed the nasal passage better, the larynx position lowered, and hypopharynx area widened. Moreover, the ratio between the inlet of the lower pharynx and the outlet of the epilaryngeal tube became larger during and after tube/straw phonation. Acoustic results revealed a stronger spectral prominence in the singer/speaker's formant cluster region after exercising. Listening test demonstrated better voice quality after straw/tube than before. Contact quotient derived from EGG decreased during both tube and straw and remained lower after exercising. Subglottic pressure increased during straw and remained somewhat higher after it.
Conclusion:
CT and acoustic results indicated that vocal exercises with increased vocal tract impedance lead to increased vocal efficiency and economy. One of the major changes was the more prominent singer's/speaker's formant cluster. Vocal tract and glottal modifications were more prominent during and after straw exercising compared with tube phonation.
Investigated in a pilot study the type, duration, and frequency of vocal warm-up regimens in the singing community using a survey.
One hundred seventeen participants completed an online survey. Participants included voice students from undergraduate, masters, and doctoral music programs and professional singers.
Fifty-four percent of participants reported always using vocal warm-up before singing. Twenty-two percent of the participants used vocal cool down. The most preferred warm-up duration was of 5-10 minutes in duration. Despite using vocal warm-up, 26% of the participants reported experiencing voice problems. Females tended to use vocal warm-up more frequently than males. Females also tended to use longer warm-up sessions than males. Education of the participants did not appear to have any noticeable effect on the vocal warm-up practices. The most commonly used singing warm-up exercises were ascending/descending five-note scales, ascending/descending octave scales, legato arpeggios, and glissandi.
Exposing healthy adults to extended periods of wakefulness is known to induce changes in psychomotor functioning [Maruff et al. (2005). J. Sleep Res. 14, 21-27]. The effect of fatigue on speech is less well understood. To date, no studies have examined the pitch and timing of neurologically healthy individuals over 24 h of sustained wakefulness. Therefore, speech samples were systematically acquired (e.g., every 4 h) from 18 healthy adults over 24 h. Stimuli included automated and extemporaneous speech tasks, sustained vowel, and a read passage. Measures of timing, frequency and spectral energy were derived acoustically using PRAAT and significant changes were observed on all tasks. The effect of fatigue on speech was found to be strongest just before dawn (after 22 h). Specifically, total speech time, mean pause length, and total signal time all increased as a function of increasing levels of fatigue on the reading tasks; percentage pause and mean pause length decreased on the counting task; F4 variation decreased on the sustained vowel tasks /a:/; and alpha ratio increased on the extemporaneous speech tasks. These findings suggest that acoustic methodologies provide objective data on central nervous system functioning and that changes in speech production occur in healthy adults after just 24 h of sustained wakefulness.
Unlabelled:
Voice practitioners require an objective index of dysphonia severity as a means to reliably track treatment outcomes. To ensure ecological validity however, such a measure should survey both sustained vowels and continuous speech. In an earlier study, a multivariate acoustic model referred to as the Acoustic Voice Quality Index (AVQI), consisting of a weighted combination of 6 time-, frequency- and quefrency-domain metrics, was developed to measure dysphonia severity in both speaking tasks. In the current investigation, the generalizability and clinical utility of the AVQI are evaluated by first assessing its external cross-validity and then determining its sensitivity to change in dysphonia severity following surgical and/or behavioral voice treatment. The results, based upon a new set of normal and disordered voices compared favorably with outcomes reported earlier, indicating acceptable external validity. Furthermore, the AVQI was sensitive to treatment-related changes, validating its role as a potentially robust and objective voice treatment outcomes measure.
Learning outcomes:
Readers will be able to: (1) explain methodological issues surrounding the development of voice treatment outcomes measures (such as external cross-validity and responsiveness to change), (2) appreciate the relevance of measuring dysphonia severity in both sustained vowels and connected speech, (3) describe the method of obtaining the Acoustic Voice Quality Index (AVQI), (4) appreciate differences among a variety of estimates of diagnostic accuracy, and (5) discuss the AVQI as a clinically valid treatment outcomes measure.
To improve ecological validity, perceptual and instrumental assessment of disordered voice, including overall voice quality, should ideally sample both sustained vowels and continuous speech. This investigation assessed the utility of combining both voice contexts for the purpose of auditory-perceptual ratings as well as acoustic measurement of overall voice quality. Sustained vowel and continuous speech samples from 251 subjects with (n=229) or without (n=22) various voice disorders were concatenated and perceptually rated on overall voice quality by five experienced voice clinicians. After removing the nonvoiced segments within the continuous speech samples, the concatenated samples were analyzed using 13 acoustic measures based on fundamental frequency perturbation, amplitude perturbation, spectral and cepstral analyses. Stepwise multiple regression analysis yielded a six-variable acoustic model for the multiparametric measurement of overall voice quality of the concatenated samples (with a cepstral measure as the main contributor to the prediction of overall voice quality). The correlation of this model with mean ratings of overall voice quality resulted in r(s)=0.78. A cross-validation approach involving the iterated internal cross-correlations with 30 subgroups of 100, 50, and 10 samples confirmed a comparable degree of association. Furthermore, the ability of the model to distinguish voice-disordered from vocally normal participants was assessed using estimates of diagnostic precision including receiver operating characteristic (ROC) curve analysis, sensitivity, and specificity, as well as likelihood ratios (LRs), which adjust for base-rate differences between the groups. Depending on the cutoff criteria employed, the analyses revealed an impressive area under ROC=0.895 as well as respectable sensitivity, specificity, and LR. The results support the diagnostic utility of combining voice samples from both continuous speech and sustained vowels in acoustic and perceptual analysis of disordered voice. The findings are discussed in relation to the extant literature and the need for further refinement of the acoustic algorithm.
Trained choral tenors performed a series of vocal tasks before and after a "live" performance. Acoustic (perturbation, harmonic-to-noise ratio, pitch and amplitude ranges) and perceptual analyses (auditory and proprioceptive/kinesthetic) were undertaken to detect changes from pre- to postperformance. Individuality of response to the performance was revealed, with the majority of subjects showing vocal deterioration after performance. The most sensitive vocal tasks were the comfortably pitched notes, high soft notes, and the bottom notes in scale singing. The most sensitive acoustic measure in detecting change from pre- to postperformance was harmonic-to-noise ratio. In contrast to the demonstrated acoustic changes, no significant differences in perceptual ratings were evident after the performance. Perceptual ratings did not reflect the acoustic analysis results. The present study highlights the need to establish further normative data for the singing voice and to consider individual differences in vocal characteristics in future studies of the singing voice.
The perceptual GRBAS scale for deviant voice quality (completed with a "I" parameter: Instability = fluctuation of voice quality over time) was tested in 5 different institutes on 943 voice patients. Each voice was evaluated separately by 2 professionals. The interrater correlation reaches 0.87 for G (grade), 0.70 for R (roughness), 0.69 for B (breathiness) and 0.65 for A/S (asthenicity/strain). Experience with the scale significantly improves the interrater agreement. The intrarater correlation (80 voices; time interval 2-6 months) is systematically slightly stronger than the interrater correlation. Further, GIRBAS/acoustical correlations were investigated on 80 pathological voices, by using the Multidimensional Voice Program (MDVP) of Kay. Principal component analysis allows reduction of 21 MDVP parameters to 5 clinically relevant aspects, with a typical acoustical measurement for each of them. The strongest correlations are found between G and Shimmer/Noise to harmonics ratio, R and Jitter, and B and Shimmer. As tremor and diplophonia are easily identified perceptually and acoustically, it seems useful to add this information respectively to AS and R. The GIRBAS scale seems to be a valuable instrument for clinical practice.
The purpose of this investigation was to study voice changes during a working day. The subjects consisted of 33 female primary and secondary schoolteachers who recorded their first and last lessons during one school day. The subjects were studied both as one group and two subgroups (those with many and those with few voice complaints). Estimates of fundamental frequency (F0), sound pressure level (SPL), the standard deviations of these values (F0 SD; SPL SD) and F0 time (vibration time of vocal folds) were made. The most obvious change due to loading was the rise of F0 that was 9.7 Hz between the first and last lesson (P = 0.00). F0 increased more (12.8. Hz, P = 0.006) in the subgroup with few complaints.
Voiced obstruents and phonation into tubes are widely used as vocal exercises. They increase the inertive reactance of the vocal tract in the 200-1000 Hz range and thereby reinforce vocal fold vibration. But the effect is strong only when the epilarynx tube is also narrowed. The present study focused on the effects of a 'resonance tube' (27 cm in length, 0.5 cm2 cross-sectional area, hard walls) on vocal tract reactance and the accompanying economy of voice production (defined as maximum flow declination rate (MFDR), divided by maximum area declination rate (MADR)). The vowel /u/ and phonation into the tube were simulated with a computer model. Three values were given to the cross-sectional area of the epilarynx tube (0.2 cm2, 0.5 cm2, and 1.6 cm2), which is at the opposite end of the vocal tract from the artificial 'resonance tube'. The degree of glottal adduction was varied in order to find the economy maximum for each epilarynx tube setting. Results showed that the 'resonance tube' lowered F1 from 300 Hz to 150 Hz and doubled the vocal tract inertive reactance at F0=100 Hz. The largest economy with the 'resonance tube' was obtained when the epilarynx tube was narrowed (relative to the rest of the vocal tract) and sufficiently tight adduction was used. Most importantly, the intraoral acoustic pressure (calculated at 0.8 cm behind the lips) was tripled with the tube. The results suggest that by optimizing the vibratory sensations in the face that are attributed to increased intraoral acoustic pressure, phonation into a tube may assist a trainee in finding an optimal glottal and epilaryngeal setting for the greatest vocal economy.