Voice Fatigue Research Articles

Acoustic Analysis of Mandarin-Speaking Transgender Women

ObjectiveThis study aims to investigate the speech characteristics and assess the potential risk of voice fatigue and voice disorders in Chinese transgender women. MethodsA case-control study was conducted involving transgender women recruited in Shanghai, China, from 2022 to 2024. The participants included 15 transgender women (TW), 20 cisgender men (CISM), and 20 cisgender women (CISW). Acoustic parameters, including formants (F1, F2, F3, F4), cepstral peak prominence (CPP), jitter, shimmer, harmonic-to-noise ratio (HNR), noise-to-harmonics (NHR), fundamental frequency (fo), and intensity, were analyzed across vowels, passages, and free speech. Additionally, the Voice Handicap Index-10 (VHI-10) and the Voice Fatigue Index (VFI) were administered to evaluate voice-related concerns. Results(1) The F1 of TW was significantly higher than that of CISW for the vowels /i/ and /u/, and significantly higher than that of CISM for the vowels /a/, /i/, and /u/; The F2 was significantly lower in TW compared to CISW for the vowels /i/ and /u/, and significantly higher than CISM for the vowels /a/ and /u/. F3 was significantly lower in TW than in CISW for the vowels /a/ and /i/. The F4 formant was significantly lower in TW than in CISW for the vowels /a/ and /i/, but significantly higher than in CISM for the vowel /u/. (2) The fo of TW was significantly lower than that of CISW for the vowels /a/, /i/, /u/, during passage reading, and in free speech, but was significantly higher than CISM during passage reading and free speech. Additionally, TW exhibited significantly higher intensity compared to CISW for the vowel /a/ and during passage reading. (3) Jitter in TW was significantly higher than in CISW for the vowels /i/ and /u/, and significantly lower than in CISM during passage reading and free speech. Shimmer was significantly higher in TW compared to both CISW and CISM across the vowels /a/, /i/, during passage reading, and in free speech. The harmonic-to-noise ratio (HNR) in TW was significantly lower than in both CISW and CISM across all vowels, during passage reading, and in free speech. The NHR was significantly higher in TW than in CISW across the vowels /a/, /i/, /u/, during passage reading, and in free speech, and significantly higher than in CISM for the vowels /a/, /i/, during passage reading, and in free speech. The CPP in TW was significantly lower than in CISW during passage reading and free speech, and significantly lower than in CISM across all vowels, during passage reading, and in free speech. (4) The VHI-10 scores were significantly higher in TW compared to both CISM and CISW. ConclusionsTransgender women exhibit certain acoustic parameters, such as fo and some of the formants, that fall between those of CISW and CISM without undergoing phonosurgery or voice training. The findings suggest a potential risk for voice fatigue and the development of voice disorders as transgender women try to modify their vocal characteristics to align with their gender identity.

Detecting Voice Fatigue With Artificial Intelligence

Voice fatigue (VF) has many symptoms and can occur after extended or brief voice use, depending on the presence or absence of voice pathology, and other factors. However, fatigue is difficult to detect and quantify through current approaches. This study explores the use of artificial intelligence (AI) in the automatic detection and analysis of voice fatigue, presenting a novel approach to detect and monitor the condition. ObjectiveThis study aims to create an AI-based system for detecting voice fatigue. The AI model’s performance is evaluated against traditional methods of assessment conducted by speech-language pathologists (SLPs). MethodsVoice samples were collected from individuals experiencing varying levels of voice fatigue. To validate these samples, we calculated fo, increases which have been shown to be correlated with voice fatigue, at the beginning and end of the recordings. The samples were processed using a machine learning model trained to recognize patterns associated with voice fatigue. To build the model, we extracted embeddings from an ECAPA-TDNN model that has been shown to capture changes in the voice characteristics of a speaker over time and used a convolutional neural network for classification. To validate the model, the model’s accuracy in detecting voice fatigue was compared to assessments from SLPs. ResultsWe achieved an accuracy score of 93% on our dataset of English academic lectures and podcasts. As further validation, we asked 3 experienced SLPs to classify audio segments from our dataset and compared their responses to the classifications from our model, and achieved an accuracy of 86% as compared to their ratings. ConclusionThe application of AI in the detection of voice fatigue shows a generalizable approach for the analysis of voice fatigue. Future research will incorporate patient data to validate further the models that we created.

Ansa Cervicalis External Branch Anastomosis to Restore High Tone Voice in Thyroid Surgery.

Injury to the external branch of the superior laryngeal nerve (EBSLN) causes low-pitch voice and voice fatigue, particularly in female subjects, and available treatments are limited. Here, we assess a novel surgical procedure to restore a high-tone voice: ansa cervicalis to EBSLN anastomosis (A-E anastomosis). Between November 2012 and April 2022, 13 patients (12 female) underwent unilateral EBSLN resection and A-E anastomosis, while 20 (16 female) underwent EBSLN resection during thyroid surgery. Patients (4494 women and 1025 men) with normal laryngoscopy scheduled for thyroid surgery served as normal controls. Phonatory function was examined using a Phonation Analyzer PA-1000 preoperatively and intermittently postoperatively. In patients who underwent A-E anastomosis, high-tone voice pitch decreased significantly postoperatively (673.9-471.5 Hz, p = 0.047), with restoration achieved within 5 months. The mean voice pitch in female patients who underwent A-E anastomosis, EBSLN resection, and controls were 580.4, 522.8, and 682.0 Hz, respectively, indicating a significant decrease in EBSLN resection patients than controls (p = 0.002). The (mean - 1SD) of high-tone voice pitch in female controls was 497 Hz; exceeding this may indicate recovery to a high-tone voice. Overall, 73% (8/11) of A-E anastomosis patients exceeded this value, which was marginally larger than the 43% (6/14) who underwent EBSLN resection. Data on male subjects are limited. There were no cases of adverse functional or cosmetic events. A-E anastomosis, a novel simple procedure, restored high-tone voice to some extent without any adverse events and thus warrants further investigation. 3 Laryngoscope, 134:3868-3873, 2024.

CPAP Treatment Improves Quality of Life and Self-perception of Voice Impairment in Patients with OSA

The purpose of this study is to examine vocal fatigue and impairment, gastroesophageal symptoms, dysphagia risk, and sleep-related quality of life in individuals with obstructive sleep apnea (OSA) who have been treated with continuous positive airway pressure (CPAP) compared to those who have not received treatment. Fifty-four participants diagnosed with OSA completed an online research form. Of these, 29 were receiving CPAP treatment, while 25 were not undergoing treatment. The following instruments were used: Vocal Fatigue Index, Voice Handicap Index, Gastroesophageal symptoms, Eating Assessment Tool, and Quebec Sleep Questionnaire. The group that received CPAP treatment had significantly lower scores in the functional domain and total Voice Handicap Index. They also experienced fewer symptoms of regurgitation, reduced daytime sleepiness, fewer nocturnal symptoms, and better emotional and social interactions in their quality of life compared to the untreated group. There were no significant differences in voice fatigue and dysphagia risk between the groups. Individuals treated with CPAP experience reduced vocal impairment, fewer regurgitation symptoms, and improvement in the emotional and social interactions domains of their quality of life compared to individuals without treatment.

Special Education Teachers’ Self-Assessed Voice Health Regarding Voice Use Habits

ObjectivesSpecial education teachers (SETs) work with students with disabilities. To get and keep these students' attention during the lesson, they may use their voices with high loudness and frequent pitch changes. These situations can be tiring for their voices and affect their vocal health. This study aimed to compare SETs' voice fatigue, reflux symptoms, and self-assessments according to their voice use habits in their work and social lives. MethodsA total of 208 SETs were included. A Teacher Voice Use Habits Questionnaire was developed by considering the literature, taking expert opinion, and conducting a pilot study. In addition, the Vocal Fatigue Index (VFI), Voice Handicap Index-30 (VHI-30), and Reflux Symptom Index (RSI) were used. One-way ANOVA, Mann-Whitney U, Kruskal Wallis-H, and Pearson correlation analyses were performed. ResultsOf SETs, 37.5% reported frequent hoarseness, and 65.4% reported voice fatigue during/at the end of the day. Those who answered "yes" to the questions about talking loudly at home, having the television on at home, feeling stressed in the work environment, eating and drinking before going to bed at night, smoking, having frequent colds, talking loudly during the day, and voice fatigue during/at the end of the day had significantly higher scores in all scales. Those who used their voice for more than six hours were found to have significantly higher scores on the VFI and RSI. In all scales, the scores of those who made very frequent long phone calls were significantly higher. ConclusionAccording to the SETs' reports, it was concluded that they did not comply with the rules of vocal hygiene, although they used their voices for a long time. This situation should be considered an occupational health problem in schools, and it may be helpful to screen this group's voice disorders and design preventive programs.

Early Assessment of Voice Problems in Post-Thyroidectomy Syndrome Using Cepstral Analysis.

Post-thyroidectomy syndrome (PTS), characterized by voice issues after thyroidectomy without recurrent laryngeal nerve injury, was investigated in this study. The Voice Fatigue Index (VFI) and cepstral analysis were employed for subjective and objective voice evaluation. Retrospective analysis involved 96 patients (37 males, 59 females) who underwent thyroidectomy without nerve injury from April 2018 to June 2022. Assessments pre- and post-thyroidectomy included the Voice Handicap Index (VHI) and VFI, along with auditory perceptual, acoustic (including cepstral), aerodynamic, and glottal vibration analyses. In females, although the GRBAS scale showed no significant change, both VHI and VFI increased post-thyroidectomy. Significant correlations were observed between the VHI and VFI in females. Acoustic analysis indicated a decrease in the cepstral peak prominence (CPP) of vowels (/a/) and sentences in females, with significant correlations between changes in the CPP/a/ and VHI/VFI. The maximum fundamental frequency (F0max) exhibited a significant decrease, correlating with the VHI and VFI changes. The VFI demonstrated effectiveness in subjective PTS voice evaluation, comparable to the VHI. The present study highlights the potential of cepstral analysis as an index reflecting subjective voice discomfort, suggesting its promise for a comprehensive PTS voice evaluation.

Vocal Self-Perception of Singers During COVID-19 Pandemic.

to compare the self-perception of vocal fatigue and use of singing voice during the COVID-19 pandemic between professional and amateur singers and to relate this self-perception with vocal use characteristics during this period. Participants were 121 singers divided into professional singers group (PSG) (12 men and 20 women) comprising singers who depended exclusively on singing as a profession and an amateur singers group (ASG) (37 men and 52 women) of singers who did not depend exclusively on singing for their livelihood. All answered online questionnaires through Google Forms ®. Sociodemographic and vocal characteristics were investigated before and during the pandemic; symptoms of vocal fatigue were assessed through the vocal fatigue index (VFI); and self-perception of use of singing voice through the evaluation of the ability to sing easily protocol for Brazil (EASE-Br). In the comparison between groups, the PSG presented higher scores of vocal fatigue in fatigue and vocal limitation (P=0.045), vocal restriction (P=0.002), and recovery with vocal rest (P=0.008) domains than did the ASG. There was no difference between the groups regarding the use of singing voice. Based on the relationship between self-perception and vocal use characteristics during the pandemic, it was observed that the presence of vocal complaint was the only factor associated with self-perception of fatigue symptomatology in both groups. Regarding the self-perception of the current status of the singing voice, singing time, the presence of vocal complaints, the need to increase visual concentration, and the perception of vocal worsening during the pandemic were considered predictive for amateur singers. For professional singers, vocal complaints and vocal training were predictors for self-perception of the current status of the singing voice. Professional singers presented with higher scores of vocal fatigue than did amateur singers. The symptomatology of vocal fatigue was associated with the presence of vocal complaints in both groups. However, self-perception of the current status of the singing voice was different between the groups and was associated with vocal training for professional singers and characteristics of vocal demand of singing voice during the pandemic period for amateur singers.

Adaptation and Validation of the Mandarin (Simplified) Chinese Version of the Voice Fatigue Handicap Questionnaire.

The aim of this study was to assess the reliability and validity of the Mandarin (simplified) Chinese version of the Voice Fatigue Handicap Questionnaire (MC-VFHQ). A total of 358 participants were included from June 2020 to April 2021: 243 patients with voice disorders (patient group) and 115 vocally healthy individuals (control group). The internal consistency, test-retest reliability, content validity, clinical, sensitivity and specificity were analyzed, and the cutoff point was determined. The internal consistency of the MC-VFHQ was high, and the internal consistency assessed with Cronbach α coefficients for the subscale scores ranged from 0.821 to 0.983; the values for the total score were 0.952 and 0.943 in the patient and control group, respectively. Test-retest reliability was high for the total score (intraclass correlation coefficient (ICC)=0.924) and the subscales (ICCs=0.969, 0.939, 0.922). The patient group had significantly higher total score, subscale scores, and item scores than the control group (P < 0.001). The cutoff point for screening between the two groups was 63.5, with a sensitivity of 84.8% and a specificity of 84.30%. The MC-VFHQ is a valid and reliable tool for identifying individuals with probable vocal fatigue. It has good reliability, validity, sensitivity, and specificity in the Mandarin Chinese-speaking population.

Investigation of the Relationship Between Vocal Fatigue, Quality of Life, and Compliance With Vocal Hygiene in Professional Voice Users.

Intensive voice use may lead to the development of voice disorders or voice complaints, such as vocal fatigue, for professional voice users (teachers, academics, call center workers, actors, singers, speech and language therapists, voice trainers, and religious officials). Vocal fatigue has a detrimental effect on occupational, emotional, and social performance, besides the quality of life of the individual. The effect of voice hygiene interventions on voice fatigue is not fully known. The results of studies conducted with different occupational groups are inconsistent. The present study aims to analyze the relationship between vocal fatigue and voice-related quality of life (V-RQOL) in professional voice users, and the impact of vocal hygiene on vocal fatigue. Participants (24 male, 90 female), who were professional voice users without any diagnosis of voice disorders or voice complaints were divided into two groups low vocal hygiene compliance (LVH; n=66) and high vocal hygiene compliance (HVH; n=48). In this study, vocal fatigue was measured by the vocal fatigue index (VFI), and V-RQOL was measured by the voice handicap index (VHI-10) and V-RQOL. VFI subscales (tiredness, avoidance, physical discomfort) have a moderate positive correlation with VHI-10 and V-RQOL, which indicates that there is a significant relationship between vocal fatigue and quality of life amongst professional voice users. While there was no significant difference between the LVH and HVH groups in terms of quality of life, it was found that the vocal fatigue level of the LVH group was higher. This study of professional voice users with healthy voices reveals a relationship between vocal fatigue and V-RQOL. Vocal hygiene compliance may affect professional voice users' vocal fatigue symptoms; the low-compliant group has higher levels of tiredness, avoidance, and physical discomfort. The findings highlight the importance of raising awareness ofthe problems of professional voice users, even though they have healthy voices and the need for vocal hygiene education programs that target them.

Cross-cultural adaptation and validation of vocal fatigue index (VFI) to Chinese language

Objectives: This study aimed to translate the Vocal Fatigue Index (VFI) into Simplified Chinese and test its reliability and validity in mainland China. Methods: The original English version of the VFI was translated and adapted to a Simplified Chinese version (VFI -SC). Fifty-four participants with voice disorders and 21 healthy controls completed the VFI-SC. Sixteen participants with voice disorders completed it again two weeks later. Reliability, validity, and receiver operating characteristic (ROC) of the VFI-SC were analyzed. Results: The Cronbach’s alpha values for the VFI factor scores were found to be 0.930 for tiredness and avoidance of voice use (factor 1), 0.878 for physical discomfort with voice use (factor 2), and 0.915 for improvement of symptoms with voice rest (factor 3). The test–retest reliability was 0.967 for all three factors. There was a significant difference between the total scores of the patient group and the control group (p < 0.01). Factor 1 and factor 2 were positively correlated with the Voice Handicap Index (VHI-30). The ROC curves showed acceptable intrinsic accuracies for factor 1 (AUC = 0.883), factor 2 (AUC = 0.901), and factor 3 (AUC = 0.800), with cutoff scores of 22, 7, and 9, respectively. Conclusions: This study provides preliminary evidence that the VFI-SC has good reliability and validity. It can be used to screen for clinical symptoms of voice fatigue in mainland China.

Acoustic Characteristics and Voice Fatigue in Hearing Impared Adult Males according to the Degree of Hearing Loss

This study was conducted to use it as basic information to suggest the necessity and program for self-regulation that can properly maintain voice according to the degree of hearing loss. For this purpose, twenty-six men in their fifties were classified according to the degree of hearing loss, and multidimensional voice program (MDVP) (F&lt;sub&gt;0&lt;/sub&gt;, jitter, shimmer, noise to harmonics ratio [NHR]), cepstrum (cepstral peak prominence [CPP], low/high spectral ratio [L/H ratio], mean CPP F&lt;sub&gt;0&lt;/sub&gt;, cepstral/spectral index of dysphonia [CSID]) and vocal fatigue index (fatigue, physical, rest, total) were performed and analyzed. The more severe the degree of hearing loss, the higher the F&lt;sub&gt;0&lt;/sub&gt; and CSID, and the lower the L/H ratio, the overall quality of the voice deteriorated. Normal-mild hearing loss group indicated a positive correlation between mean CPP F&lt;sub&gt;0&lt;/sub&gt; and fatigue, rest and total, and negative correlation between CPP and rest. In severe-profound group, F&lt;sub&gt;0&lt;/sub&gt; and rest showed a negative correlation, and shimmer and rest showed a positive correlation. Through the analysis of vowel and connected speech, it was found that the more severe the degree of hearing loss, the higher the F&lt;sub&gt;0&lt;/sub&gt; in vowel phonation, the lower the L/H ratio and the higher the CSID, and the lower the overall sound quality. In addition, it was observed that that the more severe the hearing loss, the higher the fatigue level of the hearing-loss person who speaks due to severe voice misuse and abuse. Therefore, auditory rehabilitation patients with hearing loss optimal voice production, and voice rehabilitation programs that use proper voices should be supported.

A Case Study: Management of Hypothyroidism through Ayurveda Medication

One of the most common endocrine disorders seen in daily practise is hypothyroidism. Hypothyroidism is caused by a lack of thyroid hormone or resistance of body tissue to thyroid hormone in relation to metabolic demand. Although diagnosis and treatment of hypothyroidism are frequently thought to be simple, a large number of people with this condition receive suboptimal care. Thyroid disorders are common in India, with hypothyroidism being a condition that is currently not adequately controlled. Because of the disease's broad scope and high prevalence in society, the current issue was chosen for study and management using Ayurveda principles. 60 years old male patient on 10/03/2023 came to OPD of Shalakya Tantra, Parul Ayurved Hospital, Parul University, Vadodara with general body weakness, breathlessness, voice fatigue, dryness, difficulty in swallowing big tablet since a year. Primarily he had steroid therapy for 10 days in November, 2022 but he wanted to be on Ayurveda medication completely. In an interval of 30 days, complete Ayurveda treatment was given, patient was symptomless and TSH level reduced from 15.96 micro IU/ml to 7.77 micro IU/ml.

Thyroarytenoid Muscle Avulsion

Thyroarytenoid muscle avulsion is a rare condition in which laryngeal trauma causes a separation of the thyroarytenoid muscle from the arytenoid cartilage. Typically, symptoms are nonspecific but include severe dysphonia and voice fatigue. They are similar to symptoms of vocal process avulsion. Strobovideolaryngoscopy, laryngeal electromyography, and laryngeal computed tomography may be helpful in diagnosis. However, intraoperative palpation under general anesthesia is the most definitive way to establish its diagnosis. We present two cases of thyroarytenoid muscle avulsion, a condition that has not been described previously. Surgical techniques for repair are detailed.

Laryngeal sensory neuropathy caused by COVID-19: findings using laryngeal electromyography

PurposeLaryngeal sensory neuropathy (LSN) is caused by a disorder of the superior laryngeal nerve or the recurrent laryngeal nerve. A diagnosis of LSN should include laryngeal electromyography (LEMG) and laryngovideostroboscopy (LVS). The aim of this study was to characterize the physical and subjective symptoms of neuropathy in patients diagnosed with LSN following COVID-19.Material and methodsSince the beginning of the COVID-19 pandemic, 6 patients who had recovered from the disease presented to us with LSN symptoms. All patients underwent laryngological and phoniatric examination, objective and subjective voice assessment, and LEMG.ResultsThe most common LSN symptom reported by patients was periodic hoarseness of varying severity. Other common symptoms were the sensation of a foreign body in the throat and voice fatigue. Endoscopy often showed functional abnormalities. The LSN patients could be characterized by LEMG recordings, and all showed abnormal activity of the cricothyroid (CT) muscle. The degree of EMG changes in the CT correlated moderately with the severity of dysphonia.ConclusionsSensory neuropathy of the larynx may be a long-lasting complication of SARS-COV-2 infection. The severity of EMG neuropathic changes in the CT muscle broadly corresponds to the severity of dysphonia.

The effect of wearing face masks on voice and intelligibility of speech during the COVID-19 pandemic

BackgroundThe study aims at evaluating the effect of wearing face masks on voice and intelligibility of speech in Egyptian working individuals during the COVID-19 pandemic to identify if there are any adverse effects of wearing face masks in the working environment.Materials and methodsA cross-section analytical study was conducted on 153 participants. Personal data and data about the nature of their workplaces were collected. The evaluation included a subjective assessment of voice and intelligibility of speech using a specifically designed questionnaire addressing self-perception of voice fatigue, speech unintelligibility, received auditory feedback and breathing difficulty, and objective voice assessment by Computerized Speech Lab, while objective speech unintelligibility assessment by the Arabic Speech Intelligibility Test.ResultsThe study revealed poor workplace acoustics and increased their self-perception of voice fatigue, speech unintelligibility, auditory feedback, and breathing difficulty while wearing masks. Medical professionals showed increased self-perception of speech unintelligibility and the received auditory feedback. No significant difference was found in absolute jitter with and without a face mask. Increasing shimmer and mean fundamental frequency and decreasing noise to harmonic ratio and maximum phonation time were found. The study revealed decreased speech intelligibility especially with the N95 mask.ConclusionWearing face masks negatively affects communication in the workplace, with poor room acoustics. It affects both speech intelligibility and voice subjectively and objectively. It caused increased self-perception of voice fatigue and changes in objective voice parameters.

The Adaption to Online Synchronous Teaching and Voice Fatigue: Acoustic and Clinical Data.

At the onset of the COVID-19 pandemic in 2020, educators around the world suddenly shifted to online teaching., In 2021, we presented research on the impact of this new professional reality on the vocal load of Saint Petersburg State University professors. The online synchronous teaching caused the significant increase in the vocal fatigue in university professors in comparison with the prepandemic studies. We continued our study during the postpandemic semester (winter-spring 2022). The goal of this study was to find out whether adaptation mechanisms during the pandemic period were developed to adjust to the different types of teaching modes. The acoustic and clinical data from the pre/post comparative study are now presented.

Voice Outcomes of Straw Phonation Exercises for Telephone Customer Service Staff

This study aimed to investigate the effectiveness of a straw phonation exercise program in preventing voice problems in telephone customer service staff. Prospective study. Twenty-eight participants with no obvious voice problems were placed into two groups: the experimental (n=13) and control (n=15) groups. The experimental group received voice hygiene instructions and participated in a 3-week straw phonation exercise program, while the control group only received voice hygiene instructions. The acoustic parameters and Mandarin Chinese version of the Vocal Fatigue Index (CVFI) scores were statistically analyzed before training, immediately after training, followed up one and 3 months after training. The results showed that speaking fundamental frequency (SF0), shimmer, and cepstral peak prominence (CPP) of the experimental group improved immediately after the straw phonation exercise program, and shimmer of the experimental group after training was also significantly lower than that of the control group. A higher SF0 and lower shimmer were noted in the experimental group during the follow-up phase, whereas factors 1 (voice load and fatigue) and 2 (physiological symptoms) of the CVFI did not differ significantly until the third month after training. The study results suggest that the straw phonation exercise program can help telephone service staff to establish an appropriate speaking pitch and prevent voice fatigue.

Testing a model of noise-related stress in school teachers

In a cross-sectional study, we examined whether teacher stress and voice fatigue resulting from student noise mediated the relationship between noise sensitivity and noise-related burnout. Based on the simplified model of teacher stress, we collected online data from 159 German elementary and middle school teachers. Results indicated that teacher stress mediated the relationship between noise sensitivity and vocal fatigue; voice fatigue mediated the relationship between stress and noise-related burnout; stress and voice fatigue serially mediated the relationship between noise sensitivity and noise-related burnout. Implications of the findings for teachers are discussed and suggestions for future research are offered.

The Study of Vocal Fatigue Symptoms in Speech Therapy Students by Focusing on In-Turned and Ex-Turned Students

Introduction: The voice is a professional tool for speech-language pathologists (SLPs). Due to the daily professional use of voice, SLPs, especially novices in this profession are exposed to voice injuries and disorders. Identifying high-risk vocal behaviors in this group can prevent the spread of more serious laryngeal injuries. This study aimed to investigate voice fatigue symptoms in speech therapy students.&#x0D; Materials and Methods: In this study, 129 speech therapy students were divided into two main groups of in-turns and ex-turns. In three sections of the semester (beginning, middle, and end), the vocal fatigue index (VFI) questionnaire and two auditory-perceptual voice scales were completed for both groups. The within-between comparisons were made by considering other side factors, such as gender and students’ professional knowledge status in SPSS software v. 19.0.&#x0D; Results: In the in-turns group, the mean score of VFI at the middle (P=0.025) and the end (P=0.010) of the semester were significantly higher than at the beginning of the semester. Also, the mean score VFI of the in-turns at the middle and end of the semester were higher than of the ex-turned speech therapy students (P=0.011). The effects of students’ gender and their knowledge status on the findings were not statistically significant (P&gt;0.05).&#x0D; Conclusion: This study showed that new vocal-speech behaviors related to clinical activities in the clinic environment of speech therapy can increase laryngeal tensions and vocal fatigue in in-turned speech therapy students.

Vocal fatigue perceived in remote working by teachers of different school grades during COVID-19 pandemic

ObjectiveTeachers have an increased prevalence of voice disorders. The present study aimed to investigate the impact of remote teaching on perceived voice fatigue among Italian teachers of all grades during the lockdown due to the COVID-19 pandemic. Methods The participants were 195 female teachers (Mage=48.77; SDage=9.61) in primary, secondary, and high schools. They completed the Vocal Fatigue Index (VFI) through an online survey. The tool includes 19 items grouped into three dimensions: tiredness of voice and avoidance of voice use (TA); physical discomfort (PD); and improvement of symptoms with rest (IS). The participants reported their perceived voice fatigue during remote teaching. They were also asked to provide data about voice fatigue as perceived in previous classroom teaching. The data were analyzed through two sets of independent one-way ANOVAs, with voice fatigue subscales as criterion variables and school grade as a between-subjects factor. ResultsThe teachers involved in the study reported higher voice fatigue scores than vocally healthy adults from the general population. Primary school teachers showed higher voice fatigue during remote teaching than both secondary and high school teachers, specifically for the TA and PD dimensions, whereas no difference emerged for IS. The VFI scores of primary school teachers were similar to those of dysphonic individuals. ConclusionThe results of the study confirm that primary school teachers are more vulnerable to developing voice disorders and suggest the need for specific vocal health interventions in case of prolonged remote work.