Background: To date, research has primarily focused on the subjective and objective measurement of vocal fatigue in professional voice users such as teachers and singers. However, these studies have not examined the effects of psychosocial factors (e.g., lack of sleep, emotional distress) leading to vocal fatigue in depth. Much like the professional voice users, students seeking to be professional voice users may face several psychosocial difficulties, may also experience similar vocal demands, and may develop vocal fatigue. Goal: The purpose of this study is to identify the relationship between psychosocial factors and vocal fatigue in students majoring in Communication Sciences and Disorders. Methods: During this study, graduate and undergraduate students completed a survey consisting of questions on employment, general health, vocal demands, and several standardized measures, (e.g., Beck’s Depression Inventory, Perceived Stress Scale, and the Vocal Fatigue Index). Vocal fatigue was induced using an adapted LingWAVES vocal loading task (~30-min duration) where participants had to meet a specific intensity goal as well as modify their pitch and voice quality. Recordings of phonation and passage reading were also made pre- and post-loading to evaluate the effects of vocal exertion. The VFI score and two objective measures (fundamental frequency and sound pressure level) were acquired and analyzed in addition to the scores from the surveys. Results: Results revealed that all students were moderately stressed, while graduate students reported more depression. All students demonstrated vocal fatigue in both subjective and objective outcome measures. Moderate-high correlation between total psychosocial scores and VFI as well as phonation Sound Pressure Level (SPL) were observed.

Straw phonation is a semi-occluded vocal tract exercise (SOVTE) that has long been used as a therapeutic device for the voice. The purpose of this study was to compare outcomes following voice lessons that included a straw phonation protocol to those that did not include a protocol. The primary outcome measures were the shortened version of the Singing Voice Handicap Index (SVHI-10), which is a validated health status instrument for singers, and Perceived Vocal Efficiency (PVE). Ten student singers in a large college of music consented into the study and participated in both lesson conditions, serving as their own control. They completed six voice lessons over a six week period with lessons alternating between the straw phonation protocol and no straw phonation protocol conditions. Outcome measures were collected following all six lessons. Repeated measures one-way analysis of variance (RM-ANOVA) revealed no statistically significant effect of the straw phonation protocol on either dependent variable. However, a small effect was found for PVE, indicating that straw phonation led to a perceived improvement in vocal efficiency. There was significant variation in individual responses to straw phonation and participants who had more prior experience with the SOVT experienced less perceptual change across lesson conditions. Most singers reported finding straw phonation a useful addition to their voice lesson and felt it improved their vocal efficiency. These results indicate that straw phonation could be regularly integrated into voice lessons and may be most helpful to students who find the SOVTE worthwhile. Future studies should examine the effects of a similar protocol using multiple SOVTEs, tailored to what is most efficacious for individuals, and should use a separate control group.

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Purpose Vocal fatigue (VF) is a primary vocal symptom experienced by professional voice users, such as teachers, whose voice is an occupational tool. The study determines the utilization of the Vocal Fatigue Index (VFI), a 19-item scale in identifying symptoms of VF and its severity in teachers. Methods Using responses of 695 teachers who completed the VFI, Mokken scaling was conducted on the items to identify the experiences of VF and its associated hierarchical nature of VF symptoms in teachers. Mokken scaling was completed on a total of four groups: (a) Total teachers group, (b) No VF group, (c) Low VF group, and (d) High VF group. Results Results revealed differences in item hierarchies between total teachers and across the separate groups of VF severity. Item hierarchy for teachers highlighted items from physical discomfort at the mild end of the hierarchy to items from symptom improvement with rest at the severe end of the hierarchy. Items related to avoidance presented as a separate scale for teachers presenting with high VF. Discussion Mokken scaling in teachers provides insight into the underlying complexity of the experience of VF symptoms and reliance on differential behavioral strategies in its management, suggesting the heterogenous nature of latent trait for VF in this specific population.

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 The aim of the present study was the cross-cultural adaptation and validation of the Vocal Fatigue Index (VFI) in Persian. Methods The English version of the VFI was translated to Persian using the guidelines of International Quality of Life Assessment. Eighty participants with voice disorders and 50 healthy controls without any voice disorders completed the Persian version of the VFI. The 80 participants with voice disorders completed the VFI a second time a week from the initial completion to evaluate test-retest reliability. Results The VFI measure demonstrated a strong internal consistency. Cronbach alpha coefficient was 0.95 for tiredness and avoidance of voice use, 0.86 for physical discomfort and 0.83 for improvement or lack thereof of symptoms with voice rest. VFI also showed a high test-retest reliability (r = 0.75–0.89). Conclusions The Persian version of the VFI is considered to be a valid and reliable questionnaire for identifying individuals with probable vocal fatigue. The VFI can be utilized in clinics across Iran in the assessment and treatment of individuals with vocal fatigue.

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Professores possuem predisposição a desenvolver alterações vocais em relação aos demais trabalhadores que utilizam a voz como instrumento de trabalho. Em geral, eles não apresentam preparo para utilizar a voz, o que pode acarretar o aparecimento de patologias associadas ao uso vocal prolongado e excessivo. O uso prolongado da voz, de modo inadequado, pode acarretar distúrbios da voz relacionados ao trabalho. O objetivo do presente estudo foi analisar o uso prolongado da voz em professoras universitárias em situações de repouso, 30 minutos, 60 minutos e 90 minutos e comparar a intensidade vocal, a análise acústica e a análise perceptivo-auditiva da voz. Trata-se de uma pesquisa quantitativa, com análise comparativa dos dados de delineamento transversal, descritivo. Participaram do estudo 17 docentes, do sexo feminino com idade mínima de 31 anos e máxima de 47 anos pertencentes a uma Instituição de Ensino Superior. Todos os participantes foram submetidos a captura da intensidade vocal habitual, mínima e máxima e gravação da emissão da vogal /a/ prolongada; também, realizaram a leitura de um texto padronizado de higiene vocal para posterior extração dos parâmetros perceptivo-auditivos e acústicos. Os registros foram capturados nas situações de repouso, 30, 60 e 90 minutos da prova de uso prolongado da voz, que foi realizada no tempo máximo de uma hora e meia. A análise acústica revelou elevação nas medidas de frequência fundamental (p= 0,01) e proporção harmônico ruído (p= 0,05). A análise perceptivo-auditiva da GIRBAS entre os experts fonoaudiólogos revelou concordância e disconcordância estatística durante as situações de uso prolongado da voz. Foram concordantes nas situações de repouso (instabilidade, rugosidade, soprosidade, astenia e tensão) e o parâmetro vocal loudness; 30 minutos (todos os parâmetros foram concordantes) 60 minutos (rugosidade, soprosidade, astenia e tensão); 90 minutos (soprosidade, astênia e tensão) e nos parâmetros vocais loudness e pitch. E os discordantes nas situações de repouso (Grau Geral) e o parâmetro vocal loudness, 60 minutos (Grau Geral e instabilidade), 90 minutos (Grau Geral, instabilidade e rugosidade). As medidas de extensão vocal e intensidade vocal habitual, mínima e máxima também não revelaram alterações significativas após o uso prolongado da voz. Deste modo, concluiu-se que o uso prolongado da voz em professoras universitárias não promoveu alterações significativas quanto a intensidade vocal e extensão dinâmica, havendo redução dos parâmetros perceptivo-auditivos ao longo do uso da voz. Entretanto, a análise acústica apresentou elevação dos parâmetros frequência fundamental e proporção harmônico ruído. / Teachers have a propensity to develop vocal changes when compared to other professionals who use their voice as a work tool. In general, they tend to exhibit no skills to use their voice professionally, which may trigger pathologies related to prolonged or excessive use. Prolonged, inadequate use may give rise to job-related disorders. The objective of the present study was to analyze prolonged use of voice among university professors under resting conditions at 30, 60, and 90 minutes and then compare voice pitch, acoustic analysis, and auditory-perceptive analysis of voice. It is a quantitative study that involved cross-sectional, descriptive analysis of comparative data. Seventeen female faculties aged 31 at least and 47 at most participated in the study. All subjects underwent habitual speech intensity- minimum and maximum- capture test and a test involving uttering the long vowel /ä/. They also read a standard text on vocal hygiene so that acoustic and auditory-perceptive parameters could be elicited later. Registers were captured under resting conditions at 30, 60, and 90 minutes of the test of prolonged use of voice, which was carried out within a maximum time frame of one and a half hours. Acoustic analysis revealed increased measures in fundamental frequency (p=o,o1) and harmoniousness/loudness ratio (p= 0,05). GIRBAS auditory-perceptive analysis among speech pathologists revealed statistical agreement and disagreement. Under resting conditions, instability, breathiness, vocal weakness, and strain, and the parameter loudness; at 30 minutes all parameters were concurrent; at 60 minutes roughness, breathiness, vocal weakness, and strain; at 90 minutes breathiness, vocal weakness, and strain and the parameters loudness and pitch were concurrent; however, under resting conditions, general level and the parameter loudness; at 60 minutes, general level and instability; at 90 minutes, general level, instability, and roughness were not concurrent. Vocal range and habitual vocal intensity measures, minimum and maximum, did not reveal significant changes after prolonged use of voice. Therefore, one may conclude that the prolonged use of voice among professors did not promote significant changes to their vocal range and vocal dynamics, with a decrease in auditory-perceptive parameters as the voice was being used. Nevertheless, acoustic analysis did reveal increased fundamental frequency and increased harmoniousness/loudness ratio.