Introdução: Na prática fonoaudiológica, o treinamento vocal refere-se à realização de exercícios selecionados para fixar os ajustes motores necessários à reorganização do padrão vocal e laríngeo que apresenta alteração; porém, os princípios da fisiologia do exercício não têm sido muito aplicados aos músculos laríngeos. Proposição: Verificar os efeitos do Treinamento Vocal Periodizado (TVP) com uso da técnica de vibração sonorizada de língua (TVSL) nos aspectos vocais de mulheres com queixas vocais e comparar com a execução da mesma técnica, de forma tradicional, na mesma população. Desenho do estudo: Ensaio clínico, randomizado e cego. Metodologia: Participaram do estudo 28 mulheres entre 18 e 44 anos, com queixas vocais e sem lesões na laringe, divididas de forma randomizada em dois grupos: experimental (GE) - 14 mulheres que receberam seis sessões da TVP; controle (GC) - 14 mulheres que receberam seis sessões de treinamento vocal de modo tradicional. Após assinar o termo de consentimento livre e esclarecido, as voluntárias passaram por avaliações antes e após treinamento, e após 30 dias do treinamento. Foram realizadas avaliações: sintomas vocais/laríngeos (índice de triagem para distúrbios da voz ITDV), fadiga vocal, qualidade de vida relacionada à voz, autoavaliação da qualidade vocal, gravação da voz (para análises perceptivo-auditiva e acústica). O treinamento vocal consistiu em 12 minutos de execução da técnica de vibração sonorizada de língua (TVSL), em pitch habitual, em ambos os grupos. O TVP com GE considerou os princípios da sobrecarga, intervalos controlados de execução da TVSL (30 segundos) e repouso (30 segundos). No treinamento vocal tradicional com o GC, as voluntárias realizaram a TVSL, com período de descanso a cada três minutos, sem controle de intensidade e tempo de repouso. Resultados: Houve redução significante na pontuação total do ITDV e intensidade dos sintomas (rouquidão, perda da voz, falha na voz, pigarro, tosse seca, tosse com secreção, dor ao falar, secreção na garganta, garganta seca e cansaço ao falar), índice de fadiga vocal, e aumento da qualidade de vida em voz, após treinamento em ambos os grupos. No GE a intensidade vocal habitual na execução da TVSL aumentou após o treinamento, enquanto que para o GC, diminuiu imediatamente após. A execução da TVLS na intensidade mais fraca diminuiu após o treinamento, independente do grupo de intervenção. Conclusão: O TVP, com o princípio da sobrecarga realizado com a técnica de vibração sonorizada de língua foi tão efetivo quanto o treinamento vocal tradicional, em mulheres com queixas vocais em relação à frequência e intensidade de sintomas vocais e laríngeos, fadiga vocal e qualidade de vida em Voz. Ambos os treinamentos não modificaram os aspectos acústicos, inclusive a intensidade vocal, bem como a autoavaliação vocal. E apesar de haver aumento do desvio do grau geral da qualidade vocal, clinicamente esse aumento não foi relevante. / Introduction: In speech-language practice, vocal training refers to the performance of selected exercises to fix the motor adjustments necessary for the reorganization of the vocal and laryngeal pattern that presents alteration; however, the principles of exercise physiology have not been much applied to laryngeal muscles. Proposition: Verify the effects of Periodic Vocal Training (PVT) with the sonorized tongue trills technique (STTT) in vocal aspects of women with vocal complaints and compare it with the traditional technique in the same population. Study design: clinical study, randomized and blind. Study design: clinical trial, randomized and blind. Methodology: Participated 28 women between 18 and 44 years old, with vocal complaints and no lesions in the larynx, divided in two groups: experimental (EG) - 14 women who received six sessions of PVT; control group (CG) - 14 women who received six traditional vocal training sessions. After signing the informed consent form, the volunteers underwent evaluations before and after training, and after 30 days of training. The following were evaluated: voice / laryngeal symptoms (screening index for voice disorders - SIVD), vocal fatigue, voice-related quality of life, self-evaluation of vocal quality, voice recording (for auditory-perceptual and acoustic analysis). The vocal training consisted of 12 minutes of vocal tongue trills technique (STTT) in usual pitch, in both groups. TVP with GE considered the principles of overload, controlled intervals of execution of the STTT (30 seconds) and rest (30 seconds). In the traditional vocal training with CG, the volunteers performed STTT, with rest period every three minutes, without intensity control and rest time. Results: There was a significant reduction in total SIVD score and intensity of symptoms (hoarseness, loss of voice, failure of voice, clearing of cough, dry cough, cough with discharge, pain in speech, throat discharge, dry throat and tiredness in speech), vocal fatigue index, and increased voice quality of life, after training in both groups. In EG, the usual vocal intensity in the STTT) performance increased after training, while for CG it decreased immediately after training. The performance of STTT at the lowest intensity decreased after the training, regardless of the intervention group. Conclusion: PVT with the overload principle performed with the sonorized tongue trills technique was as effective as traditional vocal training in women with vocal complaints regarding the frequency and intensity of vocal and laryngeal symptoms, vocal fatigue and quality of speech life in Voice. Both training did not modify acoustic aspects, including vocal intensity, as well as vocal self-assessment. And although there was an increase in the deviation of the general degree of vocal quality, clinically this increase was not relevant.

O treinamento físico é um processo repetitivo e sistemático composto de exercícios físicos progressivos que tem por objetivo aperfeiçoar o desempenho. Um dos princípios da fisiologia do exercício é a sobrecarga que se baseia em desenvolver o treinamento com treinos intervalados, aumento de intensidade e de volume. O objetivo deste estudo foi avaliar o efeito da Proposta de Periodização do Treinamento Vocal (PPTV) com técnica de vibração sonorizada de língua na qualidade vocal de mulheres sem queixas vocais e com vozes saudáveis. Estudo prospectivo, controlado e randomizado, desenvolvido após aprovação do Comitê de Ética em Pesquisa com Seres Humanos da FOB/USP (parecer 1.198.625). Participaram do estudo 30 mulheres entre 18 e 39 anos, vocalmente saudáveis (evidenciadas por protocolo de sintomas vocais/laríngeos, avaliação vocal e laringológica inicial), divididas em dois grupos de forma randomizada: grupo experimental (GE) com 15 mulheres que receberam seis sessões da PPTV; grupo controle (GC) com 15 mulheres que receberam seis sessões de treinamento vocal tradicional. Após assinatura do termo de consentimento livre e esclarecido, as voluntárias passaram pelas avaliações antes e após treinamento e, após 30 dias do treinamento. As avaliações realizadas foram: investigação das sensações na voz, laringe, respiração e articulação (sessão a sessão); mensuração da intensidade vocal habitual; mensuração das medidas fonatórias; gravação vocal para posterior análise perceptivo-auditiva e acústica da voz. Para ambos os grupos o treinamento consistiu de 12 minutos de execução da técnica de vibração sonorizada de língua (TVSL), em pitch habitual. O treinamento vocal do GE (PPTV) considerou o princípio da sobrecarga, com administração da intensidade vocal e com intervalos controlados de execução da TVSL (30 segundos) e repouso (30 segundos). As voluntárias do GC executaram a TVSL de forma tradicional, com período de descanso a cada três minutos, mas sem controle do tempo de repouso. Os testes estatísticos (nível de significância de 0,05) revelaram que as sensações após o treino, controladas sessão a sessão, foram positivas para ambos os grupos (Teste de Sinais). As sensações positivas na voz e na articulação foram as mais relatadas por ambos os grupos. O teste ANOVA, seguido de Tukey revelou que o GE apresentou aumento significante da intensidade vocal habitual após a PPTV e 30 dias após na emissão da vogal /a/, o que não ocorreu com o GC; não houve diferença significante nas medidas fonatórias após o treino vocal em ambos os grupos. A análise perceptivo-auditiva (teste de Sinais) revelou que o parâmetro de instabilidade melhorou significantemente no GE após a PPTV e 30 dias após, o que não ocorreu com o GC. Por outro lado, o GC apresentou piora significante 30 dias após o treinamento vocal tradicional do parâmetro tensão. Por meio do teste ANOVA e Tukey, a análise acústica revelou melhora significante nos valores de jitter e variação da frequência (Vf0) no GE, 30 dias após, o que não ocorreu com o GC. Entretanto, o GC apresentou melhora significante do índice de fonação suave após o treino vocal tradicional, mas que não se sustentou 30 dias após. Este estudo permitiu concluir que a PPTV, com uso da TVSL foi capaz de produzir efeitos na qualidade vocal, com melhora da instabilidade vocal, intensidade vocal habitual e medidas acústicas (Vf0 e jitter) quando comparados ao treinamento vocal tradicional, em mulheres vocalmente saudáveis. O treinamento vocal proposto não influenciou negativamente nos relatos de sensações na voz, laringe, respiração e articulação. Conclui-se que o treino com o princípio da sobrecarga, com intensidade e intervalo controlados, levou à adaptação do sistema vocal, em relação à instabilidade. Portanto, os achados deste estudo tornam necessária a reflexão sobre a prática e execução das técnicas e treinamentos vocais tradicionais, ressaltando a importância dos princípios da fisiologia do exercício nas práticas fonoaudiológicas na clínica vocal. / Physical training is a repetitive and systematic process composed of physical progressive exercises which aims to improve the performance. One of the principles of exercise physiology is the overload that is based on develop the training with interval training. The aim of this study was to evaluate the effect of Proposal of Periodization of the Vocal Training (PPVT) with sonorous tongue vibration technique in the vocal quality of women without vocal complaints and healthy voices. Prospective, controlled and randomized study, developed after approval by Human Research Ethics Committees (HRECs) from FOB/USP (purport 1.198.625).The study included 30 women aged 18 to 39, vocally healthy (evidenced through protocol of symptoms vocal/laryngeal, vocal assessment and initial laryngological), divided into two groups randomly: experimental group (EG) with 15 women who received six sessions of PPVT; control group (CG) with 15 women who received six sessions of traditional vocal training. After signing of the informed consent, the volunteers through the evaluations before and after training and, after 30 days of training. The assessments performed were: research of the sensations in the voice, larynx, breathing and articulation (session to session); measurement of the usual vocal intensity; measurement of phonatory measures; vocal recording for later analysis-perceptive-auditory and acoustics of the voice. For both groups the training consisted of 12 minutes of execution of sonorous tongue vibration technique (STVT) in usual pitch. Vocal training from EG (PPVT) considered the principle of overload, with administration of vocal intensity and controlled execution intervals STVT (30 seconds) and rest (30 seconds). The volunteers of the CG performed the STVT in a traditional way, with rest period every three minutes, but without the rest time control. The statistical tests (significance level of 0.05) showed that the sensations after training, controlled session to session were positive for both groups (signal Test). The positive sensations in the voice and articulation were the most reported by both groups. The test ANOVA, followed by Tukey revealed that the EG presented significant increase of usual vocal intensity after PPVT 30 days after the issuance of the vowel /a/, which did not occur with the CG; There was no significant difference in the phonatory measures after the vocal training in both groups. Perceptive-auditory analysis (Signal test) revealed that the instability parameter has improved significantly in the EG after the PPVT and 30 days after, which did not occur with the GC. On the other hand, the GC presented significant worsening 30 days after the traditional vocal training of tension parameter. Through ANOVA and Tukey test, acoustic analysis revealed significant improvement in jitter values and frequency variation (Vf0) in EG, 30 days after, what did not happened with the CG. Though, the CG presented significant improvement of the soft phonation index after the traditional vocal training, but it did not hold 30 days after.This study made it possible to conclude that the PPVT, with the use of the STVT was able to produce effects on vocal quality, with improved vocal instability, usual vocal intensity and acoustic measures (Vf0 and jitter) when compared to the traditional vocal training, women healthy vocally. The proposed vocal training did not influence negatively in the accounts of sensations in the voice, larynx, breathing and articulation. It is concluded that the training with the principle of overload, with intensity and controlled interval, led to the adaptation of the vocal system in relation to the instability. Therefore, the findings of this study make it necessary the reflection on the practice and implementation of techniques and traditional vocal training, emphasizing the importance of the principles of exercise physiology in the speech therapy practices at the clinic.

Disfonia é a principal sequela cirúrgica do paciente submetido à laringectomia parcial vertical (LPV) com presença de ruído glótico intenso o que dificulta a análise acústica convencional. Por esse motivo a análise não linear (ANL), teoria dinâmica de sistemas não lineares aplicada a séries temporais não lineares, tem sido recentemente adotada como uma nova abordagem para avaliação acústica vocal. Objetivo: aplicar a ANL por meio da escala L-IE na análise acústica da voz de pacientes submetidos à LPV. Método: foram analisadas 31 vozes de pacientes submetidos à LPV, denominado de grupo de pacientes (GP) e 31 vozes de indivíduos sem alteração vocal ou laríngea, denominado grupo controle (GC). Os gráficos bidimensionais gerados a partir dos sinais de voz foram avaliados com base na técnica dos padrões visuais da dinâmica vocal (PVDV), por meio da escala de classificação L-IE para os três parâmetros: número de laços (L), irregularidade (I) e espaçamento (E). Para a correlação dos dados da ANL com a avaliação perceptivo-auditiva da voz, as vozes do GP foram avaliadas por meio da escala GRBAS. Resultados: houve correlação significativa (p<0,05) entre os três parâmetros da escala L-IE para a análise total da amostra GP e GC. Os resultados da escala L-IE para a maioria do pacientes do GP se caracterizaram por: número de laços zero; irregularidade e espaçamento dos traçados, ambos com grau 6. O GP teve a maioria de suas vozes avaliadas com grau 3 de disfonia na escala GRBAS. Houve correlação estatisticamente significante (p<0,05) entre a escala L-IE e a GRBAS nos seguintes parâmetros: o \"L\" com o grau global da disfonia (G) e com soprosidade (B) e o \"I\" com a soprosidade (B). Conclusão: o método da ANL por meio da escala L-IE, se mostrou eficiente na avaliação das vozes de pacientes submetidos a LPV. / Dysphonia is the main surgical sequel in patients who underwent vertical partial laryngectomy (VPL) with the presence of intense glottal noise which makes more difficult conventional acoustic analysis. Therefore the nonlinear analysis, dynamic theory of nonlinear systems applied to nonlinear time series, has recently been adopted as a new approach to acoustic analysis of voice. Objective: apply to ANL by L- IS scale on acoustic voice analysis of patients underwent VPL. Method: 31 voices of patients underwent VPL called patient group (PG) and 31 voices of individuals without vocal or laryngeal disorder were analyzed called control group (CG). Two-dimensional graphs generated from the voice signals the both groups were evaluated based on the technique of VDVP through the rating scale L-IS for the three parameters: number of loops (L), irregularity (I) and spacing (S). For the correlation of data from nonlinear analysis with the perceptual evaluation, the voices of the PG were evaluated by GRBAS scale. Results: significant correlation (p <0.05) between the three parameters of the L-IS scale for the total sample analysis PG and CG. The results of the L-IS scale for the majority of PG patients were characterized by: zero for number of loops; 6 degree for both irregularity and spacing of the traces. The PG had most of their voices evaluated with 3 degree of dysphonia in GRBAS. There was a statistically significant correlation (p<0.05) between L-IS and GRBAS parameters: \"L\" with the overall grade of dysphonia (G) and breathiness (B) and \"I\" with breathiness (B). Conclusion: the method of ANL by L-IS scale, is efficient for evaluating the voices of patients underwent VPL.

Introdução: A terapia vocal após tireoidectomia tem como objetivo reduzir características de rugosidade, soprosidade, tensão e incoordenação pneumofonoarticulatória. A nasofibroscopia é um exame que permite analisar alterações orgânicas, neurogênicas e funcionais de laringe, assim como observar o comportamento laríngeo durante a execução de técnicas vocais. Objetivo: analisar a configuração laríngea em pacientes com queixa vocal após tireoidectomia durante a execução das técnicas terapêuticas. Método: Trata-se de um estudo transversal observacional comparativo no qual foram avaliados indivíduos adultos atendidos pelo Serviço de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina da USP. A amostra foi composta por 31 indivíduos do gênero feminino, entre 20 e 50 anos, dos quais 21 com queixa vocal após tireoidectomia total ou parcial e dez sem cirurgia ou tratamento prévio de doença de tireoide. A amostra foi dividida em três grupos: com mobilidade laríngea (GEmob, n=16), sem mobilidade laríngea (GEimob, n=5) e o grupo-controle (GC, n=10), todos sem terapia fonoaudiológica prévia. Foram submetidos à nasofibroscopia e instruídos a repetir duas vezes, por cinco segundos, cada uma das seguintes técnicas: vogal /a/ prolongada com mãos em gancho (AMEG), vibratório de língua (VL) e fonação com canudo (FC). As imagens do exame foram analisadas por dois juízes concomitantemente, que preencheram parte do Protocolo de Cooperação Fonoaudiológica para a Avaliação Nasofibrolaringoscópica da Mobilidade Laríngea em Doenças da Tireoide - PAN para observação da configuração laríngea. Resultados: Não houve diferença significante no grupo GEimob. Quando comparados a vogal /a/ com AMEG e FC, houve mudança no movimento ântero-posterior nos grupos GEmob e controle. Conclusão: As técnicas FC e AMEG alteraram a configuração laríngea supraglótica em pacientes com mobilidade laríngea. A técnica AMEG promoveu maior adução de pregas vocais em pacientes com imobilidade / Vocal therapy after thyroidectomy aims to reduce roughness, breathiness, strain and pneumophonoarticulatory incoordination. Nasofibroscopy is a test that permits the analysis of organic, neurogenic and functional larynx alterations, as well as the observation of laryngeal behavior during the execution of vocal techniques. The aim of this study was to analyze laryngeal configuration in patients with vocal complaint after thyroidectomy during the performance of therapeutic techniques. A transversal observational comparative study in which adults were seen by the Hospital das Clínicas Head and Neck Service, São Paulo University Medical School. The sample was composed of 31 people of the female gender, aged between 20 and 50 years old, 21 with vocal complaint after total or partial thyroidectomy, and 10 with no surgery or previous treatment for a thyroid disease. The sample was divided into three groups: with laryngeal mobility (mobSG, n=16), with no laryngeal mobility (immobSG, n=5) and the control group (CG, n=10), all with no previous phonoaudiological therapy. Groups were submitted to nasofibroscopy and instructed to repeat twice, for 5 seconds, each of the following techniques: prolonged /a/ vowel with hooked hands (AMEG), tongue trill (TT) and straw phonation (SP). The images of the test were analyzed by two judges simultaneously, who filled in part of the Phonoaudiological Cooperation Protocol for Nasofibrolaryngoscopic Assessment of laryngeal mobility in Thyroid Diseases - PAN for the observation of laryngeal configuration. There was no significant difference in the immob SG group. When the /a/ vowel was compared with AMEG and SP, there was some change in anteroposterior movement in groups SGmob and control. Conclusion: SP and AMEG techniques alter supraglottic laryngeal configuration in patients with laryngeal mobility. The AMEG technique allows for more adduction of the vocal folds in patients with immobility

Differences may exist between the voice qualities of those who professionally use and train their voices and those who do not. The examination of fundamental frequency and frequency range m actresses and non-actresses is integral to determining voice quality differences in these populations. These differences, whether the result of frequent use or training of the voice, may exist relative to fatiguing conditions such as may be experienced by actresses in the course of their work. Fatigue has been shown to produce greater effects in normals than in performers, particularly in singers (Gelfer, Andrews, and Schmidt, 1991). Little research has been found comparing actresses to non-actresses in such an interaction effect. In order to determine whether a separate set of normative values should be sought for actresses, it is first necessary to determine whether significant differences exist between these populations in voice quality parameters. The purpose of the present study was to determine whether or not significant changes in fundamental frequency and frequency range occurred in non-actresses relative to actresses as a result of fatigue. The subjects for the study included ten actresses between the ages of 20 and 30 who had a minimum of one quarter of voice training and three years of acting experience and ten women of the same age group who had no voice training or experience in acting. Each subject passed a puretone audiometric screening, had a negative history of voice disorders, and had not smoked within the last year. These two groups were evaluated for: 1) fundamental frequency in prolonged productions of the vowel lal; 2) speaking fundamental frequency in connected speech; 3) frequency range in sung scales; and 4) frequency range in connected speech. Data was statistically analyzed using one way ANOV A tests with repeated measures. No significant interactions occurred between group and time, suggesting that non-actresses did not produce a greater shift than did actresses in fundamental frequency or frequency range as a result of fatigue. These results contradicted some findings and supported other findings of previous research based on similar samples.

Bakgrund Kraven på evidensbaserad vård ökar ständigt. Att jämföra patienters självskattade besvär före och efter behandling är ett sätt att utvärdera behandlingseffekten.  Rösthandikappindex (RHI) och VA-skala för röstbesvär är två verktyg för utvärdering av röstbehandling. Tidigare studier har visat att röstbehandling ger minskade självskattade röstbesvär. Syfte Syftet med denna studie var att med självskattningsformulär utvärdera effekten av logopedisk röstbehandling i Västerbottens läns landsting (VLL) och undersöka om behandlingseffekten påverkas av kön, diagnos, antal behandlingstillfällen och hur mycket tid patienten är beredd att lägga på behandling, samt att undersöka om det finns ett samband mellan självskattningsformuläret RHI och VA-skala för röstbesvär. Metod 102 patienter, 28 män och 74 kvinnor, som under perioden januari 2009 till september 2012 genomgått logopedisk röstbehandling inom VLL, deltog i studien. Deltagarna rekryterades retrospektivt. Genom dataanalys undersöktes huruvida det fanns någon signifikant skillnad i poäng på RHI efter behandling, om det fanns några signifikanta skillnader i självskattning beroende på kön, diagnos eller antal behandlingstillfällen samt om det fanns en korrelation mellan RHI-poäng och skattning på VA-skala. Resultat En signifikant minskning av RHI-poäng kunde ses för hela gruppen efter röstbehandling jämfört med före. Inga signifikanta skillnader sågs mellan könen eller mellan grupper indelade utifrån antal behandlingstillfällen. Det fanns inte heller någon skillnad mellan olika diagnoser. Däremot sågs signifikanta korrelationer mellan RHI och VA-skala för röstbesvär. Slutsats Studien visade att de självskattade besvären minskade efter behandling. Resultaten var inte beroende av kön, diagnos eller antal behandlingstillfällen. Utifrån detta dras slutsatsen att den logopediska röstbehandlingen i Västerbottens läns landsting ger effekt. Vad gäller de självskattningsverktyg som används i verksamheten sågs en korrelation mellan RHI och VA-skala för röstbesvär. Det är möjligt att dessa verktyg mäter olika aspekter av samma problem. Det är då av vikt att kombinera dessa för att få en helhetsbild av patienters upplevda röstbesvär / Background The demand for evidence based health care is increasing. One way to evaluate the effect of treatment is to compare patients’ self-assessed malaise before and after treatment. Two useful tools for evaluating voice therapy administered by a speech-language pathologist  is Voice Handicap Index (VHI) and a Visual Analogue Scale, VA-scale, for voice problems. Previous studies has found that voice therapy results in a decreased level of voice problems                                                                                        Aim The aim of this study was to evaluate the effect of voice treatment administered by speech-language pathologists in Västerbottens läns landsting (VLL) with help of the self-assessment tools VHI and VA-scale for voice problems and to investigate if there were any differences in the self-assessment due to gender, diagnosis, number of treatment sessions or the amount of time the patient was willing to spend on voice therapy. The aim was also to investigate if there was a correlation between the VHI and the VA-scale for voice problems.                                                                                                                      Method This retrospective study has analyzed self-assessment forms from 102 patients, 28 men and 74 women, who have been seeing a speech-language pathologist for voice therapy sometime between January 2009 and September 2012 in VLL. Data analysis was used to investigate if there was any significant difference in VHI points before and after voice therapy, if there was any significant differences in the self-assessment due to gender, diagnosis or number of therapy sessions and if there was a correlation between the points on VHI and self-assessed malaise on the VA-scale for voice problems.                                                                                                                      Results There was a significant decrease of VHI points for the whole group after voice therapy. No significant differences were found regarding gender, diagnosis or number of treatment sessions. There was no correlation between the VHI score and the amount of time the patient was willing to spend on voice therapy. A significant correlation was found between VHI and the VA-scale for voice problems.           Conclusion This study found that self-assessed voice problems decreased after voice treatment. The efficacy of voice therapy does not seem to be affected by gender, diagnosis, number of treatment sessions or the amount of time the patient was willing to spend on voice therapy. The conclusion is that the voice therapy administered by speech-language pathologists in VLL has an effect. There was a correlation between VHI and the VA-scale for voice disorders. It is possible that these tools are measuring different aspects of the same problem. Therefore, it is important to combine these tools to get an overall picture of the patients’ self-perceived voice problems.

The purpose of this study was to identify the perceptions of voice teachers regarding the degree to which they believe they teach and monitor healthy vocal behaviors among their students as they sing and speak. Participants for the study were college/university voice professors who were members of the College Music Society and listed in its Directory of Music Faculties in Colleges and Universities, U.S. and Canada, 2012-2013 Edition. Online, survey research procedures and a researcher-generated questionnaire were utilized for data collection purposes. Results indicated that an overwhelming majority of participants believed there to be a relationship between the health of one’s singing voice and the health of one’s speaking voice. Participants’ perception scores were the most positive for variable MBSi, or the degree to which they believe they monitor the vocal behaviors of students when singing. Participants’ perception scores for variable TVB, the degree to which they believe they teach healthy vocal behaviors to students, and variable MBSp, the degree to which they believe they monitor the vocal behaviors of students when speaking, ranked second and third respectively. Perception scores for variable TVB were primarily associated with participants’ familiarity with vocal rehabilitation techniques, gender, and participants’ familiarity with the McClosky Technique. Perception scores for variable MBSi were primarily associated with participants’ familiarity with vocal rehabilitation techniques, gender, type of student taught, and whether participants had instructed a student with a vocal disorder. Perception scores for variable MBSp were correlated with the greatest number of characteristics, including participants’ familiarity with vocal rehabilitation techniques, participants’ familiarity with the McClosky Technique, type of student taught, years of teaching experience, and whether participants had instructed a student with a vocal disorder. The researcher concluded that, while many voice teachers understand the relationship between the health of the speaking voice and the health of the singing voice and use various methods within their private studios to work with injured voices, voice teachers and students may not understand, nor be adequately prepared to prevent and intervene when it comes to issues of the speaking voice. In fact, the researcher concluded that there seems to be a disconnect among teachers and students alike when it comes to teaching and understanding healthy vocal behaviors and applying them to the speaking voice. Multiple resources exist, however, in the form of various certifications, symposiums, and workshops, through which voice teachers may avail themselves of the knowledge necessary to care for the overall health of their students’ speaking and singing voices. Indeed, the voice teacher is obligated to teach well-rounded, healthy vocal behaviors, applying them to both the singing voice and the speaking voice. As medical professionals more frequently reach out to voice teachers, voice teachers will have increased opportunity to assume a more active role on a voice care team. Because so many teachers already implement methods found within the McClosky Technique, if used with understanding and commitment, the Technique could be a means for habilitation, prevention, and intervention on behalf of students suffering from speaking voice disorders within the voice studio. / Access to thesis permanently restricted to Ball State community only. / School of Music

Made available in DSpace on 2014-06-11T19:31:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-06Bitstream added on 2014-06-13T19:02:15Z : No. of bitstreams: 1 masson_mlv_dr_mar.pdf: 892378 bytes, checksum: ab195f0a93b5bb84375fb6b2ea0e5a25 (MD5) / Justificativa: professores compõem uma categoria profissional que tem a voz como um dos cruciais instrumentos de trabalho. Fatores de risco os expõem a alterações vocais que podem prejudicar o exercício profissional. Dentre os aspectos considerados no cuidado com a voz, o aquecimento e o desaquecimento vocal possibilitam a preparação da voz para o uso em sala de aula. Objetivo: analisar os efeitos da aula, do repouso e de um procedimento de aquecimento e desaquecimento vocal na qualidade da voz e no grau de desconforto auto-referido. Métodos: Dezoito professores de uma escola pública estadual do município de Salvador-BA, selecionada por conveniência, compuseram a amostra deste estudo. Dividiram-se as amostras entre grupos experimental (n=8) e controle (n=10) e analisaram-se os efeitos da aula e repouso (grupo controle), aquecimento e desaquecimento vocal (grupo experimental), considerando-se a avaliação de juízes por meio da escala GRBASI e ressonância, análise acústica e grau de desconforto auto-referido. O material analisado foi submetido a tratamento estatístico, sendo considerado nível de significância de 5%. Resultados: A aula provocou elevação estatisticamente significante da freqüência fundamental e aumento do grau de desconforto auto-referido. Não houve diferença significante nas variáveis analisadas para o repouso vocal. O aquecimento vocal proporcionou redução do grau geral de alteração vocal e diminuição do desconforto, especialmente nos aspectos relacionados ao corpo. O desaquecimento vocal proporcionou diminuição da freqüência fundamental e redução do grau de desconforto, especialmente relacionado à voz. A comparação entre os grupos experimental e controle não demonstrou diferença estatisticamente significante em nenhuma variável analisada. Tanto o desaquecimento quanto o repouso vocal proporcionaram o retorno da voz ao ajuste coloquial... / Justification: Voice is a main work tool for teachers and they are exposed to risk factors able to cause voice disorders. Vocal warm-up and cool-down procedures are used as preparation for the use of voice in classrooms. Goal: to analyze the effects of vocal warm-up and cool-down procedure, rest and lecture on voice quality, as well as on the degree of self-reported discomfort. Methods: the subjects of this research were 18 teachers of a state school in Salvador/BA, which were selected by convenience. They were divided in two groups, one experimental (n=8) and the control (n=10). Then they were subject to an analysis of the effects of lecture and rest (control group), vocal warmup and cool-down procedures (experimental group). The criteria for comparison between the voices were evaluation by judges, considering the GRBASI scale and resonance, analysis of acoustic parameters and the degree of self-related discomfort. The significance level for the statistical treatment was 5%. Results: lecture resulted in statistically relevant increase of the fundamental frequency and rising of self-related discomfort. Rest did not result on statistically significant difference on the variables. Vocal warm-up resulted on decreasing in degree of vocal alteration and discomfort, especially on body related aspects. Vocal cool-down resulted on decreasing the fundamental frequency and the degree of discomfort, especially on voice related aspects. Comparison between experimental and control groups did not show any statistical difference on the analyzed variables. Cool-down and rest showed equally positive on adjusting back to the colloquial voice. Conclusion: lecture has raised the vocal attrition, indicating the vocal loading to which teachers are exposed. The proposed procedure showed to be positive and able to be applied preventively. New studies, with a larger number of subjects, should take place, ...(Complete abstract click electronic address below)

Orientador: Maria de Lourdes Morales Horiguela / Banca: Léslie Piccolotto Ferreira / Banca: Maria Suzana Behlau / Banca: Eliana Maria Gradim Fabron / Banca: Simone Aparecida Capellini / Resumo: Justificativa: professores compõem uma categoria profissional que tem a voz como um dos cruciais instrumentos de trabalho. Fatores de risco os expõem a alterações vocais que podem prejudicar o exercício profissional. Dentre os aspectos considerados no cuidado com a voz, o aquecimento e o desaquecimento vocal possibilitam a preparação da voz para o uso em sala de aula. Objetivo: analisar os efeitos da aula, do repouso e de um procedimento de aquecimento e desaquecimento vocal na qualidade da voz e no grau de desconforto auto-referido. Métodos: Dezoito professores de uma escola pública estadual do município de Salvador-BA, selecionada por conveniência, compuseram a amostra deste estudo. Dividiram-se as amostras entre grupos experimental (n=8) e controle (n=10) e analisaram-se os efeitos da aula e repouso (grupo controle), aquecimento e desaquecimento vocal (grupo experimental), considerando-se a avaliação de juízes por meio da escala GRBASI e ressonância, análise acústica e grau de desconforto auto-referido. O material analisado foi submetido a tratamento estatístico, sendo considerado nível de significância de 5%. Resultados: A aula provocou elevação estatisticamente significante da freqüência fundamental e aumento do grau de desconforto auto-referido. Não houve diferença significante nas variáveis analisadas para o repouso vocal. O aquecimento vocal proporcionou redução do grau geral de alteração vocal e diminuição do desconforto, especialmente nos aspectos relacionados ao corpo. O desaquecimento vocal proporcionou diminuição da freqüência fundamental e redução do grau de desconforto, especialmente relacionado à voz. A comparação entre os grupos experimental e controle não demonstrou diferença estatisticamente significante em nenhuma variável analisada. Tanto o desaquecimento quanto o repouso vocal proporcionaram o retorno da voz ao ajuste coloquial ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract:Justification: Voice is a main work tool for teachers and they are exposed to risk factors able to cause voice disorders. Vocal warm-up and cool-down procedures are used as preparation for the use of voice in classrooms. Goal: to analyze the effects of vocal warm-up and cool-down procedure, rest and lecture on voice quality, as well as on the degree of self-reported discomfort. Methods: the subjects of this research were 18 teachers of a state school in Salvador/BA, which were selected by convenience. They were divided in two groups, one experimental (n=8) and the control (n=10). Then they were subject to an analysis of the effects of lecture and rest (control group), vocal warmup and cool-down procedures (experimental group). The criteria for comparison between the voices were evaluation by judges, considering the GRBASI scale and resonance, analysis of acoustic parameters and the degree of self-related discomfort. The significance level for the statistical treatment was 5%. Results: lecture resulted in statistically relevant increase of the fundamental frequency and rising of self-related discomfort. Rest did not result on statistically significant difference on the variables. Vocal warm-up resulted on decreasing in degree of vocal alteration and discomfort, especially on body related aspects. Vocal cool-down resulted on decreasing the fundamental frequency and the degree of discomfort, especially on voice related aspects. Comparison between experimental and control groups did not show any statistical difference on the analyzed variables. Cool-down and rest showed equally positive on adjusting back to the colloquial voice. Conclusion: lecture has raised the vocal attrition, indicating the vocal loading to which teachers are exposed. The proposed procedure showed to be positive and able to be applied preventively. New studies, with a larger number of subjects, should take place, ...(Complete abstract click electronic address below) / Doutor

O treinamento físico é um processo repetitivo e sistemático composto de exercícios físicos progressivos que tem por objetivo aperfeiçoar o desempenho. Um dos princípios da fisiologia do exercício é a sobrecarga que se baseia em desenvolver o treinamento com treinos intervalados, aumento de intensidade e de volume. O objetivo deste estudo foi avaliar o efeito da Proposta de Periodização do Treinamento Vocal (PPTV) com técnica de vibração sonorizada de língua na qualidade vocal de mulheres sem queixas vocais e com vozes saudáveis. Estudo prospectivo, controlado e randomizado, desenvolvido após aprovação do Comitê de Ética em Pesquisa com Seres Humanos da FOB/USP (parecer 1.198.625). Participaram do estudo 30 mulheres entre 18 e 39 anos, vocalmente saudáveis (evidenciadas por protocolo de sintomas vocais/laríngeos, avaliação vocal e laringológica inicial), divididas em dois grupos de forma randomizada: grupo experimental (GE) com 15 mulheres que receberam seis sessões da PPTV; grupo controle (GC) com 15 mulheres que receberam seis sessões de treinamento vocal tradicional. Após assinatura do termo de consentimento livre e esclarecido, as voluntárias passaram pelas avaliações antes e após treinamento e, após 30 dias do treinamento. As avaliações realizadas foram: investigação das sensações na voz, laringe, respiração e articulação (sessão a sessão); mensuração da intensidade vocal habitual; mensuração das medidas fonatórias; gravação vocal para posterior análise perceptivo-auditiva e acústica da voz. Para ambos os grupos o treinamento consistiu de 12 minutos de execução da técnica de vibração sonorizada de língua (TVSL), em pitch habitual. O treinamento vocal do GE (PPTV) considerou o princípio da sobrecarga, com administração da intensidade vocal e com intervalos controlados de execução da TVSL (30 segundos) e repouso (30 segundos). As voluntárias do GC executaram a TVSL de forma tradicional, com período de descanso a cada três minutos, mas sem controle do tempo de repouso. Os testes estatísticos (nível de significância de 0,05) revelaram que as sensações após o treino, controladas sessão a sessão, foram positivas para ambos os grupos (Teste de Sinais). As sensações positivas na voz e na articulação foram as mais relatadas por ambos os grupos. O teste ANOVA, seguido de Tukey revelou que o GE apresentou aumento significante da intensidade vocal habitual após a PPTV e 30 dias após na emissão da vogal /a/, o que não ocorreu com o GC; não houve diferença significante nas medidas fonatórias após o treino vocal em ambos os grupos. A análise perceptivo-auditiva (teste de Sinais) revelou que o parâmetro de instabilidade melhorou significantemente no GE após a PPTV e 30 dias após, o que não ocorreu com o GC. Por outro lado, o GC apresentou piora significante 30 dias após o treinamento vocal tradicional do parâmetro tensão. Por meio do teste ANOVA e Tukey, a análise acústica revelou melhora significante nos valores de jitter e variação da frequência (Vf0) no GE, 30 dias após, o que não ocorreu com o GC. Entretanto, o GC apresentou melhora significante do índice de fonação suave após o treino vocal tradicional, mas que não se sustentou 30 dias após. Este estudo permitiu concluir que a PPTV, com uso da TVSL foi capaz de produzir efeitos na qualidade vocal, com melhora da instabilidade vocal, intensidade vocal habitual e medidas acústicas (Vf0 e jitter) quando comparados ao treinamento vocal tradicional, em mulheres vocalmente saudáveis. O treinamento vocal proposto não influenciou negativamente nos relatos de sensações na voz, laringe, respiração e articulação. Conclui-se que o treino com o princípio da sobrecarga, com intensidade e intervalo controlados, levou à adaptação do sistema vocal, em relação à instabilidade. Portanto, os achados deste estudo tornam necessária a reflexão sobre a prática e execução das técnicas e treinamentos vocais tradicionais, ressaltando a importância dos princípios da fisiologia do exercício nas práticas fonoaudiológicas na clínica vocal. / Physical training is a repetitive and systematic process composed of physical progressive exercises which aims to improve the performance. One of the principles of exercise physiology is the overload that is based on develop the training with interval training. The aim of this study was to evaluate the effect of Proposal of Periodization of the Vocal Training (PPVT) with sonorous tongue vibration technique in the vocal quality of women without vocal complaints and healthy voices. Prospective, controlled and randomized study, developed after approval by Human Research Ethics Committees (HRECs) from FOB/USP (purport 1.198.625).The study included 30 women aged 18 to 39, vocally healthy (evidenced through protocol of symptoms vocal/laryngeal, vocal assessment and initial laryngological), divided into two groups randomly: experimental group (EG) with 15 women who received six sessions of PPVT; control group (CG) with 15 women who received six sessions of traditional vocal training. After signing of the informed consent, the volunteers through the evaluations before and after training and, after 30 days of training. The assessments performed were: research of the sensations in the voice, larynx, breathing and articulation (session to session); measurement of the usual vocal intensity; measurement of phonatory measures; vocal recording for later analysis-perceptive-auditory and acoustics of the voice. For both groups the training consisted of 12 minutes of execution of sonorous tongue vibration technique (STVT) in usual pitch. Vocal training from EG (PPVT) considered the principle of overload, with administration of vocal intensity and controlled execution intervals STVT (30 seconds) and rest (30 seconds). The volunteers of the CG performed the STVT in a traditional way, with rest period every three minutes, but without the rest time control. The statistical tests (significance level of 0.05) showed that the sensations after training, controlled session to session were positive for both groups (signal Test). The positive sensations in the voice and articulation were the most reported by both groups. The test ANOVA, followed by Tukey revealed that the EG presented significant increase of usual vocal intensity after PPVT 30 days after the issuance of the vowel /a/, which did not occur with the CG; There was no significant difference in the phonatory measures after the vocal training in both groups. Perceptive-auditory analysis (Signal test) revealed that the instability parameter has improved significantly in the EG after the PPVT and 30 days after, which did not occur with the GC. On the other hand, the GC presented significant worsening 30 days after the traditional vocal training of tension parameter. Through ANOVA and Tukey test, acoustic analysis revealed significant improvement in jitter values and frequency variation (Vf0) in EG, 30 days after, what did not happened with the CG. Though, the CG presented significant improvement of the soft phonation index after the traditional vocal training, but it did not hold 30 days after.This study made it possible to conclude that the PPVT, with the use of the STVT was able to produce effects on vocal quality, with improved vocal instability, usual vocal intensity and acoustic measures (Vf0 and jitter) when compared to the traditional vocal training, women healthy vocally. The proposed vocal training did not influence negatively in the accounts of sensations in the voice, larynx, breathing and articulation. It is concluded that the training with the principle of overload, with intensity and controlled interval, led to the adaptation of the vocal system in relation to the instability. Therefore, the findings of this study make it necessary the reflection on the practice and implementation of techniques and traditional vocal training, emphasizing the importance of the principles of exercise physiology in the speech therapy practices at the clinic.