Vocal Hygiene Education Research Articles

Vocal Hygiene Education, Voice Production Therapy, and the Role of Patient Adherence: A Treatment Effectiveness Study in Women With Phonotrauma

To assess the effectiveness of vocal hygiene education (VHE) and voice production therapy (VP) in altering patient perception of vocal handicap in adult women with benign, bilateral phonotraumatic vocal fold lesions and the role of adherence in that perception. Sixty-two women were randomly assigned to 6 weeks of VP (n = 31) or VHE (n = 31), followed by 4 weeks of self-study. The primary outcome measure was the Voice Handicap Index (VHI) score, assessed at baseline, post-therapy, and post-self-study. Patient adherence was assessed as a cofactor. Both groups achieved a decrease in VHI scores from baseline to completion of the study, although the improvement was significantly greater for the VP group. The treatment effect size was large for the VP group and small for the VHE group. More participants adhered to VP than to VHE. Only adherent participants achieved significant improvement. Only adherent participants in the VP group improved with self-study. More than two thirds of the VP group achieved final VHI scores within normal limits, compared with approximately one third of those in the VHE group. VP therapy may be more effective than VHE in addressing patient perception of vocal handicap in adult women with phonotrauma, and self-study may be an important component of therapy. However, adherence is a critical mediator of outcome.

Vocal Hygiene Awareness Program for Professional Voice Users (Teachers): An Evaluative Study from Chennai

AbstractVocal hygiene awareness programs aim at educating vocal professionals regarding prevalent voice use, abuse, and misuse and address ways to prevent voice problems. This study investigated the efficacy of one such program on vocal hygiene education (lecture demonstration) designed for school teachers in Chennai. A questionnaire addressing various issues/aspects of vocal hygiene was developed. The teachers (65) had to complete the same twice (pre- and posteducation). These were compared for differences in scores, which indicated awareness of vocal hygiene related issues after the program. The post-test scores were found to be 9% higher than pretest scores which suggested that the teachers had better awareness after the program.

発声障害と音声治療

It has become recently well known that voice therapy is an effective method to treat voice disorders conservatively. We introduced voice therapy for various kinds of voice disorders. 224 cases (73 males and 151 females) with voice disorders were treated at Ehime University Hospital 1998 and 2008. The wide range of maladies consisted of vocal nodules, laryngeal granulomas, sulcus vocalis and atrophies, vocal fold paralyses, and functional voice disorders. Methods of treatment included vocal hygiene education, laryngeal relaxation maneuvering, abdominal breathing, pitch adjustment, resonant voice therapy and the accent method. In performing a structured therapeutic program, the needs of each patient should be considered. Close cooperation between otolaryngologists and speech therapists is mandatory. Surgical management should be considered in cases where insufficient improvement has resulted from voice therapy.

The effect of vocal hygiene education for patients with vocal polyp

The authors aimed to assess the effect of vocal hygiene education for patients suffering with vocal polyp and to discover the meaningful factors that can predict better outcomes with performing vocal hygiene. Voice evaluation and vocal hygiene education were provided to 340 consecutive patients with vocal polyp. Three months later, 175 of the 340 patients completed a follow-up evaluation. According to the change in polyp size, these patients were divided into two groups: the "improvement" and the "no improvement." The effect of vocal hygiene was assessed. Eight parameters were compared between these two groups. The "improvement" group was composed of 20% of the 340 patients and 38% of the 175 patients. Multivariate analyses demonstrated that nonsmokers with a small polyp had the greatest possibility of improvement with vocal hygiene and so avoid unnecessary surgery. Patients who do not smoke and who have a polyp that is small in size have a much better chance to improve their voice by performing vocal hygiene.

The Effectiveness of a Voice Treatment Approach for Teachers With Self-Reported Voice Problems

Teachers are considered the professional group most at risk of developing voice-problems, but limited treatment effectiveness evidence exists. We studied prospectively the effectiveness of a 6-week combined treatment approach using vocal function exercises (VFEs) and vocal hygiene (VH) education with 20 teachers with self-reported voice problems. Twenty subjects were randomly assigned to a no-treatment control (n = 11) and a treatment group (n = 9). Fibreoptic endoscopic evaluation was carried out on all subjects before randomization. Two self-report voice outcome measures were used: the Voice-Related Quality of Life (VRQOL) and the Voice Symptom Severity Scale (VoiSS). A Voice Care Knowledge Visual Analogue Scale (VAS), developed specifically for the study, was also used to evaluate change in selected voice knowledge areas. A Student unpaired t test revealed a statistically significant (P < 0.05) improvement in the treatment group as measured by the VoiSS. There was not a significant improvement in the treatment group as measured by the V-RQOL. The difference in voice care knowledge areas was also significant for the treatment group (P < 0.05). This study suggests that a voice treatment approach of VFEs and VH education improved self-reported voice symptoms and voice care knowledge in a group of teachers.

Analysis and Evaluation of a Voice-Training Program in Future Professional Voice Users

The goal of this study is to analyze and evaluate the effectiveness of a voice-training program. Twenty-three professional voice users received voice training for 2 years and vocal hygiene education for 1 year. The voice-training program consisted of lectures, technical workshops, and vocal coaching. The European Laryngological Society (ELS) protocol, including the Dysphonia Severity Index (DSI) and the Voice Handicap Index (VHI), was applied before and after, respectively, 9 and 18 months of voice training. A questionnaire on daily habits was presented at study onset and after 18 months. The DSI improvement is more significant after 9 months (P=0.005) than it is after 18 months (P=0.2). On the other hand, the perceptual evaluation remained unchanged after 9 months, whereas it improved significantly after 18 months. The results of the daily habit questionnaire are disturbing: the prevalence of smoking, vocal abuse, stress, and late meals were not influenced by the lectures and remained high. This study emphasizes the need for a well-organized voice-training program that is most effective after 9 months. Regarding the low effectiveness of the vocal hygiene program, the concept needs revision.

Training Outcome in Future Professional Voice Users after 18 Months of Voice Training

The goal of this study is to define the long-term influence of vocal hygiene education and the effectiveness of voice training in 46 students. Half of the subjects, called the trained group (n = 23), received vocal hygiene education during 1 school year and voice training during 2 school years (18 months). The other half, also 23 subjects, received neither vocal hygiene education nor voice training as such (called the untrained group). The voice training is made up of technical workshops (30 h a year in groups of 5–8 subjects) and vocal coaching in the radio and drama projects (30 h whole class). In the lectures (30 h) a theoretical background on breathing, articulation, voicing and vocal hygiene was discussed. 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) was applied before and after 18 months to evaluate the effect of voice training over time. A questionnaire on daily habits was presented before the lectures, and after 18 months to detect the long-term effect of the lectures. The objectively measured voice quality (DSI) of the trained group improved significantly over time (p < 0.001) due to training (p = 0.008), which was not the case in the untrained group. The self-assessed VHI, on the other hand, changed over time (p < 0.001) in both groups. For the trained group the VHI changed from 18.4 to 14.4 and in the untrained group from 20.1 to 15.3. It is important to note that the VHI scores of both groups remained high. The interpretation of the results of the daily habit questionnaire is disturbing: the initial high degree of smoking, vocal abuse, stress and late meals was not influenced by the lectures or training and remained high. This study proves the positive outcome and emphasizes the need for a well-organized voice training program in future professional voice users. However, the lectures and training on vocal hygiene failed to improve voice-conserving habits.

Vocal hygiene in radio students and in radio professionals

In this study 27 future professional voice users (i.e., radio students) and 53 professional voice users (i.e., radio professionals) were questioned on their vocal hygiene. Both groups differed clearly in age and in radio experience. The mean age of the radio students was 22 years, whereas the mean age of the radio professionals was 41 years; radio students had no radio experience and radio professionals' experience ranged from 2 to 32 years. This study shows that the vocal hygiene of radio professionals is not superior to the vocal hygiene of radio students. On the contrary, every group has a distinctive vocal hygiene profile. The intake of coffee was significantly higher in radio professionals ( p <0.001) and they indicated significantly more vocal fatigue ( p =0.028). The radio students, on the other hand, experienced more acid reflux problems ( p <0.001) and signalled significantly more hoarseness ( p =0.012). Next to this, both groups smoked more than one could expect from (future) professional voice users (radio students: 33%; radio professionals: 28%). This study demonstrates the necessity of an adapted vocal hygiene education programme for both future and professional voice users, as they seem to underestimate the negative implications of bad vocal hygiene.

The effects of preventive vocal hygiene education on the vocal hygiene habits and perceptual vocal characteristics of training singers

The purpose of the present study was to determine the effects of vocal hygiene education on the vocal hygiene behaviors and perceptual vocal characteristics of untrained singers. Eleven adult untrained singers served as subjects. They attended four 1-hour class sessions on vocal hygiene, including anatomy and physiology of the phonatory mechanism, vocally abusive behaviors, voice disorders commonly seen in singers, and measures to prevent voice disorders. Pre- and postinstruction surveys were used to record subjects' vocal abuses and their perceptions of their speaking and singing voice. They also rated their perceived value of vocal hygiene education. Results revealed minimal changes in vocal hygiene behaviors and perceptual voice characteristics. The subjects did report a high degree of benefit and learning, however.

Does the voice improve with vocal hygiene education? A study of some instrumental voice measures in a group of kindergarten teachers

This study investigated the efficacy of a program of vocal hygiene education designed for an occupational group at risk for dysphonia, namely, kindergarten teachers. Twelve female teachers explored concepts and knowledge of vocal abuse and vocal hygiene in a workshop session and attempted to practice vocal hygiene for 2 months. They showed significant voice improvement as assessed instrumentally in terms of three acoustic and electroglottographic parameters. There was no significant change of voice in a control group of 13 teachers. The results suggest that teachers were able to improve their voices if they significantly reduced vocal abuses in daily life and practiced specific strategies to maintain classroom order and reduce the use of voice in teaching.