Elite Vocal Performers Research Articles

Effect of vocal loading on voice parameters in trainee actors

Introduction: Prolonged use of voice or vocal load can be a risk factor for individuals and can end up in vocal fatigue and dysphonia. Vocal loading can alter tissue structure and affect the voice quality forever. An obvious factor to be considered is the vocal use by a professional voice user. Actors are a group of professionals who can be affected by the long-term use of voice. There is a higher prevalence of inflammatory lesion in acting students and they were found to have poor vocal hygiene habits; which shows that these future elite vocal performers are at risk for developing a voice disorder. Aim: To study the objective and subjective changes in voice characteristics post vocal loading task in trainee actors. Method: A total 37 trainee actors (14 females and 23 males) participated in the study. The age range of the participants were 20 – 39 years and the range of the training period was 6 – 12 months. The participants were instructed to read a passage for 30 – 45 minutes at a loudness level of 70 – 80 dB SPL. Individuals with perceptually normal voice in terms of pitch and intensity and with a score less than 1 in GRBASI (Grade, Roughness, Breathiness, Asthenia, Strain, Instability) rating scale were included in the study. Acoustic, and perceptual evaluation were measured immediately before and after vocal loading task. Acoustic analysis was done using MDVP, whereas The Auditory Perceptual Rating Scale and GRABASI rating scale were used for perceptual analysis. Self-rating of the voice after vocal loading task was measured after the vocal loading task using Vocal Fatigue Index.1 Results and conclusion: The results revealed a significant difference in perceptual parameters post vocal loading task. The f0, jitter and HNR (Harmonic to Noise Ratio) showed a significant increase in the values after the vocal loading task. However, shimmer and RAP (Relative Amplitude Perturbation) did not show significant difference in the values post vocal loading task. The self-rating of the voice after the vocal loading task revealed that 54% of the trainee actors did not perceive vocal fatigue. The study hence shows significant effects of vocal loading in perceptual and acoustic analysis whereas the self-rating shows less perception of vocal changes in training actors. The acoustic, perceptual and self-rating of the voice quality before and after vocal loading task can aid in effective training and management of the trainee actors. However, the actors themselves are not equipped to measure the voice changes acoustically or perceptually and would take much longer time to perceive changes in their voice quality. Therefore, it is important to give a vocal hygiene programme in the preventive stage, that is, in the training period.

전문 음성사용자와 직업적 음성사용자의 주관적 음성증상 비교

전문 음성사용자와 직업적 음성사용자의 주관적 음성증상 비교

Considerations and demands in the voice care of contemporary commercial singers in occupational health and safety aspects.

Singers, classified as "vocal performers" are at an increased risk of developing voice disorders. The area of contemporary commercial singing has not been studied as extensively as classical singing. Non-classical singing is generally considered detrimental to vocal health and thus the information on challenges contemporary commercial singers (CCS) pose to otolaryngologists and other healthcare professionals is scarce. The authors present an overview of contemporary commercial singing styles in comparison to classical singing, discuss the notion of non-classical style being harmful to vocal health, present major risk factors associated with developing voice disorders in contemporary commercial singers, and outline the diagnostic process of vocal health assessment in this group of occupational voice users. Given that contemporary commercial singers constitute a unique and vast group of elite vocal performers, the authors stress the importance of raising awareness among healthcare professionals of the fact that these patients require special considerations for voice evaluation and treatment in the occupational health and safety framework. Med Pr. 2022;73(1):33-41.

Vocal Quality, Symptoms, and Habits in Musical Theater Actors

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. 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. 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. 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.

Immediate Effects of a Semi-Occluded Water Resistance Ventilation Mask on Objective and Subjective Vocal Outcomes in Musical Theater Students.

Background Traditional semi-occluded vocal tract exercises (SOVTEs) are restricted to single-phoneme tasks due to the semi-occlusion at the mouth, which hinders full articulation, continuous speech, and singing. Innovative SOVTEs should overcome this limitation by creating the semi-occlusion outside the oral cavity. Purpose The purpose of this study was to investigate the immediate effects of a semi-occluded water resistance ventilation mask, which allows for continuous speech and singing, on objective (voice range, multiparametric voice quality indices) and subjective (auditory-perceptual, self-report) vocal outcomes in musical theater students. Method A pre-/posttest randomized controlled trial was used. Twenty-four musical theater students (16 women and eight men, with a mean age of 21 years) were randomly assigned into a study group and a control group. The study group received a vocal warm-up session with the innovative water resistance ventilation mask (tube attached to the mask "outside" the mouth), whereas the control group received the traditional water resistance approach (tube "inside" the mouth). Both sessions lasted 30 min and were similar with respect to vocal demand tasks. A multidimensional voice assessment including objective and subjective outcomes was performed pre- and posttraining by an assessor blinded to group allocation. Results The Dysphonia Severity Index significantly and similarly increased (improved) in both the study and control groups, whereas the Acoustic Voice Quality Index solely decreased (improved) in the control group. The intensity range significantly decreased (worsened) and the semitone range significantly increased (improved) in the study group, whereas no differences in voice range profile were found in the control group. Auditory-perceptually, a more strenuous speaking voice was noticed after the use of the traditional water resistance approach. The subjects perceived both SOVTEs as comfortable vocal warm-up exercises that decrease the amount of effort during speaking and singing, with a slight preference for the water resistance ventilation mask. Conclusions Both the innovative water resistance ventilation mask and the traditional water resistance exercise seem effective vocal warm-up exercises for musical theater students. The additional articulatory freedom of the mask might increase the phonatory comfort and the practical implementation of SOVTEs in the daily vocal warm-up of (future) elite vocal performers. The hypothesis of a higher transfer to continuous speech or singing in the mask condition has not been supported by the current study. Larger scale investigation and longer term follow-up studies are needed to confirm these preliminary results. Supplemental Material https://doi.org/10.23641/asha.11991549.

Side effects of medications in professional opera singers’ voice: survey findings

<p class="abstract"><strong>Background:</strong> Opera singers are classified under level I, as the elite vocal performers, being the quintessential representatives of this group. As the professional voice users, they meticulously observe any changes relevant to their health, therefore self-reported side effects should be taken under serious consideration. The aim of this study was to initiate the process of gathering general information about the most common side effects of medications taken by the opera singers.</p><p class="abstract"><strong>Methods:</strong> The study group consisted of 264 professional opera singers, treated in Clarós Clinic in a 35 years period, who were asked to complete a questionnaire. The response rate was 62.1% (n=164) with a male-to-female ratio being 1.27:1 (72 men and 92 women). 46 cases of adverse effects of medicines were updated and analysed. All the responses were collected between February and April 2018. </p><p class="abstract"><strong>Results:</strong> The mean age of our study group was 38.3 for females and 49.95 for males, with the range between 18-83 years. The vocal categories were as follows: 39 tenors, 17 baritones, 14 basses, 64 sopranos, 23 mezzo-sopranos and 5 contraltos. Patients with chronic diseases and comorbidities represented the 39.1% of the study group. The most common adverse effect reported was dryness (15.2%). The most frequent voice side effects raised by singers were clearing the throat frequently (14.63%), hoarseness and coarse or scratchy sound (10.37%), and vocal fatigue (7.32%).</p><p><strong>Conclusions:</strong> We believe that exploring the subject of vocal side effects of medications in professional opera singers is extremely important.</p>

Acoustical and perceptual vocal profile of beatboxers

Background: Beatboxers are elite vocal performers who modify their voice to mimic drum and other instrumental sounds. It requires a lot of modification and manipulation at the level of vocal folds in terms of laryngeal muscles and/or cartilages which may have adverse effect on their vocal profile. As per current literature, there is not much research on the vocal profile of beatboxers. Aim: This study aims to explore the acoustical and perceptual characteristics of beatboxers. Methodology: Ten beatboxers participated in the study. Acoustical and perceptual analyses were done using Praat and Buffalo III voice profile. VRQOL was also performed to assess the voice-related quality of life. Results: The results of the present study revealed significant difference in jitter, shimmer, and harmonic-to-noise ratio values. Rigorous and prolonged practices of beatboxing adversely affect voice. Conclusion: Beatboxing is a vocal phenomenon and may have an adverse effect on vocal musculature due to overloading and manipulation of vocal fold to produce different sounds. This is a preliminary study and further it can be done at larger level with bigger sample size.

Indications and Effects of Microlaryngoscopic Surgery for Micro Lesions on Vocal Folds of Elite Vocal Performers with Normal Findings on Voice Examination and Normal Speech

Indications and Effects of Microlaryngoscopic Surgery for Micro Lesions on Vocal Folds of Elite Vocal Performers with Normal Findings on Voice Examination and Normal Speech

Vocal Characteristics and Laryngoscopic Findings in Future Musical Theater Performers

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. Observational study. 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. 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. Despite the overall good voice quality, videolaryngostroboscopy showed a high presence of vocal fold lesions and supraglottic constriction during phonation.

Elite Vocal Performersを対象とした音声障害の診療に対する意識調査

Elite Vocal Performersを対象とした音声障害の診療に対する意識調査

Acoustic Analysis and Electroglottography in Elite Vocal Performers

Acoustic analysis of voice (AAV) and electroglottography (EGG) have been used for assessing vocal quality in patients with voice disorders. The effectiveness of these procedures for detecting mild disturbances in vocal quality in elite vocal performers has been controversial. To compare acoustic parameters obtained by AAV and EGG before and after vocal training to determine the effectiveness of these procedures for detecting vocal improvements in elite vocal performers. Thirty-three elite vocal performers were studied. The study group included 14 males and 19 females, ages 18-40 years, without a history of voice disorders. Acoustic parameters were obtained through AAV and EGG before and after vocal training using the Linklater method. Nonsignificant differences (P > 0.05) were found between values of fundamental frequency (F0), shimmer, and jitter obtained by both procedures before vocal training. Mean F0 was similar after vocal training. Jitter percentage as measured by AAV showed nonsignificant differences (P > 0.05) before and after vocal training. Shimmer percentage as measured by AAV demonstrated a significant reduction (P < 0.05) after vocal training. As measured by EGG after vocal training, shimmer and jitter were significantly reduced (P < 0.05); open quotient was significantly increased (P < 0.05); and irregularity was significantly reduced (P < 0.05). AAV and EGG were effective for detecting improvements in vocal function after vocal training in male and female elite vocal performers undergoing vocal training. EGG demonstrated better efficacy for detecting improvements and provided additional parameters as compared to AAV.

Impact of Vagal Nerve Stimulation on Objective Vocal Quality, a Pilot Study

The purpose of this study was to determine the impact of vagal nerve stimulation (VNS) on the vocal quality using the dysphonia severity index (DSI). It was hypothesized that the objective vocal quality and other vocal characteristics are disordered in comparison with an age- and gender-matched control group. In addition, the acoustic vocal parameters were compared during three conditions: at rest, during normal stimulation, and raised stimulation. A significant relation between the amount of stimulation and the presence of disturbed acoustic parameters was hypothesized. Subjective (auditory-perceptual evaluation and voice handicap index) and objective (aerodynamic, vocal range, acoustic measurements and determination of the DSI) measurements were used to determine the vocal quality in 13 subjects with VNS in three different conditions (at rest and during normal and raised stimulation) and the age- and gender-matched control group. The subjects with VNS had a disordered perceptual vocal quality mainly characterized by the presence of a moderate roughness and slight breathiness, and the objective vocal quality by means of the DSI value is -2.4. During stimulation and especially during raised stimulation, the fundamental frequency is significantly increased. However, the subjects experienced no psychosocial handicapping effect of the vocal quality on the quality of life. Subjects with VNS have typical vocal characteristics. Ear, nose, and throat specialists and voice therapist must be aware of the presence of this vocal pattern at rest and during normal and raised stimulation. Especially, professional voice users and elite vocal performers must be informed before implantation.

Value of the Portuguese VHI and SVHI Instruments to Discriminate Voice Pathologies in Voice Professionals

Objectives: 1) Determine the sociodemographic characteristics of a group of elite vocal performers (singers and actors). 2) Investigate the discriminating power of the Portuguese validated versions of the instruments VHI and SVHI in addressing different voice pathologies. Methods: The study had the participation of 324 individuals (217 singers and 107 actors). All the participants were evaluated by telescopic or transnasal laryngoscopy and completed: 1) a questionnaire addressing sociodemographic characteristics and vocal use; and 2) the Portuguese version of the VHI. All the singers completed also the Portuguese version of the SVHI. Descriptive statistics used mean, median, standard deviation, minimum, maximum values for quantitative variables, and absolute (n) and relative (%) values for qualitative variables. Receiver operating characteristic (ROC) curves were used to investigate the discriminating power of the VHI and SVHI instruments to address different voice pathologies. Results: Of the 324 subjects, 51.2% were female and 48.8% were male with a mean age of 40.8 years (range: 15-82 years). 52.3% were single, followed by married (32.1%) and divorced/widowed (15.6%). Approximately 34% of subjects smoked on average and worked with the voice for nearly 21 years. Receiver-operating characteristic curve analysis showed a weak discriminating power between diagnoses and VHI or SVHI scores, except for vocal cord nodules that are associated with a higher (worse) VHI score. Conclusions: The Portuguese versions of the VHI and SVHI instruments are useful to measure the voice handicap among Portuguese actors and singers but have a limited value to discriminate between vocal pathologies.

The effectiveness of manual circumlaryngeal therapy in future elite vocal performers

The purpose of this study was to investigate the impact of a single session of manual circumlaryngeal therapy on the vocal characteristics of future elite vocal performers (music students). A pretest/post-test control group design was used. Sixteen music students were randomly divided in an experimental and control group. The experimental group received manual circumlaryngeal therapy for 20 minutes, whereas the control group was instructed to have complete vocal rest for 20 minutes. Immediately before and after the therapy or vocal rest, an identical objective voice assessment protocol (aerodynamic measurement, acoustic analysis, voice range profile, and Dysphonia Severity Index [DSI]) was performed. Vocal parameters were compared before and after manual circumlaryngeal therapy in the experimental group, and before and after vocal rest in the control group using the Wilcoxon signed rank test. In the experimental group a significant difference in DSI was found between the measurement before and after manual circumlaryngeal therapy. The median DSI increased from 6.3 before to 7.2 after manual circumlaryngeal therapy. No differences in DSI were found in the control group between the two measurements. The results of this pilot study prudently suggest that manual circumlaryngeal therapy can also improve vocal capacities in the healthy trained voices of future elite vocal performers.

Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approach

The main purpose of this study was to determine the impact of thyroidectomy on the subjective and objective vocal quality using the Dysphonia Severity Index. It was hypothesized that objective measures of vocal function and other vocal characteristics would change (temporarily or permanently) from the presurgical to the postsurgical conditions, even with the entire preservation of the laryngeal nerve, due to the surgical approach and other influencing factors. Prospective study in which 44 subjects were studied before (1 week) and three times post-thyroidectomy. Subjective (auditory perceptual evaluation and videolaryngostroboscopy) and objective (aerodynamic, vocal range, acoustic, and Dysphonia Severity Index measurements) assessment techniques were used. Paired samples t test indicated a significant decrease of the highest frequency, the highest intensity, the fundamental frequency, and the Dysphonia Severity Index in the first postoperative condition. When a repeated measures analysis of variance was performed with the pre- and all the postoperative moments of evaluation taken into account, no significant difference was noted for any of the objective voice characteristics. After thyroidectomy subjects had a normal perceptual and objective vocal quality corresponding with a Dysphonia Severity Index of 66%, and there is no permanent change of the vocal performance. Moreover, there is no psychosocial handicapping effect of the vocal quality, but immediately post-thyroidectomy there are more vocal complaints. To what extent thyroidectomy causes (temporary or permanent) alterations of the singing voice in elite vocal performers is subject to further research.

Results of videostroboscopic examinations of vocally healthy candidates for voice intensive professions

Questions regarding the vocal aptitude for voice professions are common in the daily phoniatrical and otorhinolaryngological practice. According to the classification by Koufman, Isaccson and Stemple professions can be classified into four groups. While it is common to perform laryngeal investigations and analyses of the vocal efficacy for candidates of elite vocal performers (level 1), i. e. singers and actors, those examinations are usually not executed for voice and speaking intensive professions (level 2) like teachers, as there is no legal base. This group is, however, predisposed with regard to professional voice disorders. Aim of the study was therefore to determine the frequency of laryngeal findings in a group of previously asymptomatic subjects using videostroboscopic examinations and to assess the risk concerning the emergence of professional voice disorders. 545 candidates for voice intensive professions have been examined with regard to the existence of any organic or secondary organic alterations on the vocal folds. One third of the subjects showed benign laryngeal alterations, which were not consequentially associated with auditive alterations of the voice sound and/or a consciousness of a voice disorder. Apart from 33 organic laryngeal alterations 129 phonation associated alterations of the vocal fold were determined. These subjects should especially in cases of excessive vocal demand and additional the efficacy reducing factors be regarded as a high risk group with regard to the emergence of professional voice disorders. The results underline the necessity to require vocal examinations and vocal assessment analyses for candidates of voice intensive professions in order to avoid professional voice disorders.

Poor Voice Quality in Future Elite Vocal Performers and Professional Voice Users

The voice quality of 86 occupational voice users, i.e., students of a high school for audiovisual communication, was assessed by means of a multidimensional test battery containing: the GRBAS scale, videolaryngostroboscopy, maximum phonation time, jitter, lowest intensity, highest frequency, dysphonia severity index (DSI), and voice handicap index (VHI). In a questionnaire on daily habits the prevalence of smoking, eating habits, and vocal abuse were recorded. A comparison of the voice characteristics of the future occupational voice users with a control group revealed significant differences. The results of the VHI and the DSI of these students revealed significantly worse scores than the score of a control group characterized by no vocal complaints. Moreover, the questionnaire on daily habits showed that the future elite vocal performers and professional voice users take less precautions for the care of their voices. These findings support the importance of a good balanced vocal coaching.