Relating ambulatory voice measures with self-ratings of vocal fatigue in individuals with phonotraumatic vocal hyperfunction

Abstract

Advancements in mobile and wearable technologies continue to enhance ambulatory voice monitoring for the improved assessment and treatment of behaviorally based voice disorders. Phonotraumatic vocal hyperfunction is one common behaviorally based voice disorder associated with faulty patterns of chronic vocal behavior that result in vocal fold tissue trauma, such as nodules or polyps. As a result, individuals often exhibit dysphonia and elevated levels of vocal fatigue. This study investigated the relationships between self-ratings of vocal fatigue and ambulatory voice measures in 44 patients with vocal fold nodules or polyps and a control group of individuals with normal voices matched for sex, age, and occupation. Using a smartphone-based ambulatory voice monitor, self-ratings were provided on a visual analog scale at five-hour intervals during the day, and data were continuously recorded from a subglottal neck-surface accelerometer. Voice dosimetry metrics and summary statistics of ambulatory voice measures were derived from accelerometer-based estimates of sound pressure level, fundamental frequency, and spectral and cepstral properties. Given the variance inherent in perceptual judgments, the analyses focused on comparisons between time periods that exhibited differences in self-ratings that were determined to be significant (>19.7 points on a 100-point scale).