Good vocal health is a vital concern for those people who use the voice in a professional capacity, such as teachers, singers, actors, clergymen, and lawyers. Research in the area of vocal health reveals the need to determine if specific exercises are beneficial to the voice and if exercises used to train the singing voice might be beneficial to alleviate pathological and/or dysfunctional voice disorders. The purpose of this study was to describe the response of a variety of pathological voices to a selected set of singing exercises. Subjects were selected from the private practice of cooperating physicians who felt that the vocal instruction and exercise program might be helpful to the teachers, students, professional "pop" singers, and housewife-singers who were diagnosed to have muscle tension dysphonia, nodules, recurrent laryngeal nerve paralysis, or iatrogenic dysphonia. Instrumentation for assessing conditions before, during, and after exercise included a brief case history, subject interviews, attending physicians' medical charts, flexible fiberoptic video nasolaryngoscopy, video cassette recorder and video tape segments, three physician/observers, and a specific diagnostic procedure which provided a method of assessing organic, functional, and perceptual variables. For the exercise program the researcher chose seven vocalises from the routine designed by Allan R. Lindquest, whose techniques combined those of the Italian school with those of Swedish studios which produced such singers as Flagstad and Bjoerling. The seven vocalises included a warm up "massage" and exercises for separation and blending of the registers, vowel clarity and modification, tone focus, vocal attack, and flexibility. Since all the subjects showed improvement after exercise in the vocal conditions observed in this study, these vocalises and technique may be helpful to alleviate pathological conditions and/or dysfunctional behavior in other subjects. The researcher further suggests that the voice profession investigate the efficiency of other techniques, exercises, and musical vocalises which might bring about positive changes in vocal conditions and behavior.

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No description available.

No description available.

This monograph is a review of the general state of vocology as it relates to the singing voice. It provides a working resource guide for singing voice professionals. Specifically, it presents the available technology, medical applications, and educational opportunities in the field of vocology. Having a central resource such as this allows voice professionals to more easily understand the interrelated portions of their parent field (vocology) and to access and navigate the resources available to them. Furthermore, the review raises awareness of the areas requiring further development in the field and brings to light many potential opportunities for collaborations among professionals. / Music Performance

A presente pesquisa teve como objetivo verificar se o tempo de execução do exercício de vibração sonorizada de língua interfere nas respostas perceptivoauditivas e acústicas da voz em mulheres com nódulos vocais. Além disso, se propôs identificar em qual momento há predomínio de respostas vocais positivas e negativas ao longo de sete minutos de execução deste exercício. Para tanto, participaram da pesquisa 27 mulheres, com idade entre 18 e 45 anos, disfônicas, com nódulos de pregas vocais. Todos os sujeitos da pesquisa foram incluídos no Grupo Experimental (GE), o qual realizou o Exercício de Vibração Sonorizada de Língua (EVSL) e apenas dez deles participaram também do Grupo-Controle (GC), onde foi feito o exercício placebo. Ambos foram realizados por sete minutos. As vozes foram registradas antes e após o primeiro, terceiro, quinto e sétimo minutos de execução dos exercícios e analisadas perceptivo- auditiva e acusticamente. Na análise perceptivo-auditiva, elas foram estudadas individualmente por meio do Protocolo CAPEV e aos pares, de forma comparativa, com a identificação da melhor voz para cada par examinado. Na análise acústica, utilizou-se o software VoxMetria versão 2.7h da CTS Informática na função Qualidade Vocal. Foram considerados os valores de frequência fundamental, jitter, shimmer, Glottal to Noise Excitation (GNE), irregularidade e ruído. De acordo com os resultados do CAPEV, o Exercício de Vibração Sonorizada de Língua (EVSL) provocou mudanças estatisticamente significantes em sete dos nove parâmetros investigados. A aplicação do teste estatístico ANOVA mostrou que no momento 5 (após o quinto minuto de execução do EVSL), a voz apresentou-se com melhor grau geral (p = 0,0004), menor rugosidade (p = 0,007), menor soprosidade (p < 0,001) e pitch agudo (p < 0,001). Porém, no momento 7 (após o sétimo minuto), a tensão apresentou-se significativamente mais alta (p = 0,016) em comparação a todos os outros momentos. Na análise pareada, houve prevalência de melhora vocal no pós-exercício em todos os momentos, com exceção do 7°. Não houve diferença estatisticamente significante entre os momentos 1 e 3. As vozes no momento 5 foram consideradas melhores do que nos momentos 3 (p = 0,013) e 7 (p = 0,013) no Grupo Experimental. Na análise acústica do grupo experimental houve aumento gradativo da frequência fundamental (p = 0,0030) e do GNE (p = 0,0011) após o terceiro minuto e diminuição do ruído (p = 0,0013) a partir do primeiro. Tanto na análise perceptivo-auditiva quanto na acústica, os resultados do Grupo Experimental foram superiores aos encontrados no Grupo-Controle no que diz respeito às melhoras vocais. Os resultados da presente pesquisa demonstram que o tempo de realização do EVSL interfere nas respostas vocais em mulheres disfônicas, sendo que no momento 5 há predomínio de respostas positivas em comparação aos momentos 1, 3 e 7. No 7, há aumento de tensão vocal e queda no desempenho do exercício. / The aim of this study was to assess whether tongue trills trill performance time interferes in the auditory perception and acoustic in women with vocal nodules. Furthermore, it was intended to identify at which moment during the 7-minute performance time the positive and negative responses predominate. This study comprised twenty-seven dysphonic women, who have vocal nodules, ranging from 18 to 45 years old. All subjects of this study were included in the experiment group which underwent tongue trills; only ten of these were also in the control group which underwent the placebo exercise. Both groups carried out the 7- minute performance time. The voices were recorded pre and post experimental and placebo exercises at the first, third, fifth and seventh minute of performance and auditory perception and acoustic were analyzed. In the auditory perception analysis the voices were analyzed individually according to the CAPEV protocol and in pairs, by comparison, to identify the better voice of the pair. The Voxmetria® program, version 2.7h by CTS Informática, was used to assess the vocal quality function. Fundamental frequency, jitter, shimmer, GNE, irregularity and noise were considered. According to the CAPEV results, the tongue trills caused statistically significant changes in seven out of the nine parameters analyzed. The use of the ANOVA analysis of variance showed that at moment 5 (after the fifth minute of experiment exercise) the voice presented the best overall rating, the least roughness, the least breathiness and high pitch. However, at moment 7 (after the seventh minute) the tension was significantly higher than at any other moment. In the paired comparison analysis, there was predominance of improved vocal in the post tongue trills at all moments, except the 7th. There was no statistically significant difference between moments 1 and 3. The voices at moment 5 were considered better that those at moment 3 and at moment 7 in the experiment group. In acoustic analysis of the experiment group there was gradual increase in the fundamental frequency and in the GNE after the 3rd minute and a decrease in noise as of the 1st minute. In the auditory perception analysis as well as in the acoustic analysis, the ratings for the experiment group were higher than those of the control group in relation to vocal improvement. The results of this study show the tongue trill performance time interferes in the vocal response of dysphonic women with positive response predominance at moment 5 compared to moments 1, 3 and 7. At moment 7 there is an increase of vocal tension and a drop in performance during tongue trills.

Enligt Hälso- och sjukvårdslagens ska behandling systematiskt utvecklas och säkras (HSL, SFS 1982:763). Logopedisk röstbehandling är inte ett undantag. I ett samverkansprojekt mellan Linköpings Universitet och sydöstra sjukvårdsregionen deltog sex logopedmottagningar genom att låta patienter som erhöll röstbehandling att fylla i självskattningsformuläret Rösthandikappindex, RHI, vid behandlingsstart och behandlingsslut. Projektets mål var att fungera som en utgångspunkt för framtida, systematiska förbättringsarbeten beträffande röstbehandling. Denna studie har ett tvådelat syfte. Den ämnar undersöka om summan av deltagarnas RHI-skattningar förändrades efter genomgången röstbehandling och huruvida ålder, röstkrav inom yrket samt antalet behandlingstillfällen påverkade resultatet av skattningarna. Syftet med studien är också att, med hjälp av en enkät, undersöka yrkesverksamma logopeders inställning till RHI som verktyg för bedömning av röstproblematik och utvärdering av röstbehandling. Patientdata inkluderar resultaten från 350 patienters självskattningar. Enkätmaterialet innehåller svaren från 23 respondenter. Wilcoxon teckenrangtest visar en signifikant skillnad i RHI-poäng före (Md = 42) och efter (Md = 23) behandling med en genomsnittlig minskning av 19 medianpoäng i RHI-indexet med en observerat stor effektstyrka (.55). Den observerade differensen, både totalt och inom varje enskilt delområde, överstiger tidigare föreslagna gränsvärden för behandlingseffekt som angavs vid utvecklandet att VHI och RHI. Analyser av materialet visar att den vanligaste förekommande röstpatienten är en kvinna i 50-årsåldern med dysfoni. Förekomsten av olika diagnoser varierade stort mellan de deltagande regionerna. Hög ålder hos patienten påverkade medianvärdet på RHI vid behandlingsstart och behandlingsslut, men inte den observerade skillnaden mellan de två skattningarna. Beroende på vilken mottagning som tillhandahöll behandlingen observerades signifikanta skillnader i hur många behandlingstillfällen som gavs, hur lång behandlingsperioden blev och hur stor skillnaden i RHI-poäng var efter genomgången behandling. Utifrån enkätutskicket föreföll de deltagande logopederna generellt övervägande positiva till RHI som verktyg för att utvärdera röstproblematik och röstbehandling. En majoritet nämnde dock svagheter med RHI som utvärderingsredskap. / In accordance to the Swedish law of Health- and medical treatments, every intervention should systematically evolve and be improved in terms of safety (HSL, SFS 1982:763). Voice therapy is no exception. Six voice clinics participated in a collaborative project between Linköping University and the south-east hospital region by letting every patient receiving voice therapy complete the Swedish version of the Voice Handicap Index, RHI, at the beginning and end of their treatment. This study has a two-parted aim. The first aim of this study was to examine whether the sum of the participants’ scores on RHI changed after completed therapy and if gender, age, vocal strain within the occupation or the number of therapy sessions had an effect on their score. The second aim of the study was to construct a survey to analyze working speech-language pathologist’s views on RHI as a tool for evaluating voice problems and voice therapy. The material from the survey consisted of the answers from 23 respondents.  The patient data includes the results from 350 patients’ scores. Analysis of the data reveals that the typical voice patient is a woman in her fifties with the diagnosis dysphonia. The prevalence of certain diagnoses varies greatly between the participating voice clinics. Wilcoxon sign rank test points to a significant difference in RHI-scores before (MD = 42) and after (MD = 23) therapy with an average decrease of 19 median points in the RHI-index with a substantial observed effect size (.55). The observed difference surpasses the previously suggested threshold limit for clear intervention effect during the development of VHI and RHI. Age had a significant effect on the median score of RHI at the start and end of therapy, but the observed difference between the two measurements were not affected. Differences could be observed between the voice clinics regarding the average number of therapeutic appointments, the average length of the therapy and the average difference in RHI-scores after completed therapy. From the responses in the survey, the participating SLPs were generally predominately positive to the idea of RHI as a tool for evaluating voice problems and voice therapy. The majority of the respondents did however mention weaknesses in RHI when used as a tool for evaluation.

No description available.

A presente pesquisa teve como objetivo verificar se o tempo de execução do exercício de vibração sonorizada de língua interfere nas respostas perceptivoauditivas e acústicas da voz em mulheres com nódulos vocais. Além disso, se propôs identificar em qual momento há predomínio de respostas vocais positivas e negativas ao longo de sete minutos de execução deste exercício. Para tanto, participaram da pesquisa 27 mulheres, com idade entre 18 e 45 anos, disfônicas, com nódulos de pregas vocais. Todos os sujeitos da pesquisa foram incluídos no Grupo Experimental (GE), o qual realizou o Exercício de Vibração Sonorizada de Língua (EVSL) e apenas dez deles participaram também do Grupo-Controle (GC), onde foi feito o exercício placebo. Ambos foram realizados por sete minutos. As vozes foram registradas antes e após o primeiro, terceiro, quinto e sétimo minutos de execução dos exercícios e analisadas perceptivo- auditiva e acusticamente. Na análise perceptivo-auditiva, elas foram estudadas individualmente por meio do Protocolo CAPEV e aos pares, de forma comparativa, com a identificação da melhor voz para cada par examinado. Na análise acústica, utilizou-se o software VoxMetria versão 2.7h da CTS Informática na função Qualidade Vocal. Foram considerados os valores de frequência fundamental, jitter, shimmer, Glottal to Noise Excitation (GNE), irregularidade e ruído. De acordo com os resultados do CAPEV, o Exercício de Vibração Sonorizada de Língua (EVSL) provocou mudanças estatisticamente significantes em sete dos nove parâmetros investigados. A aplicação do teste estatístico ANOVA mostrou que no momento 5 (após o quinto minuto de execução do EVSL), a voz apresentou-se com melhor grau geral (p = 0,0004), menor rugosidade (p = 0,007), menor soprosidade (p < 0,001) e pitch agudo (p < 0,001). Porém, no momento 7 (após o sétimo minuto), a tensão apresentou-se significativamente mais alta (p = 0,016) em comparação a todos os outros momentos. Na análise pareada, houve prevalência de melhora vocal no pós-exercício em todos os momentos, com exceção do 7°. Não houve diferença estatisticamente significante entre os momentos 1 e 3. As vozes no momento 5 foram consideradas melhores do que nos momentos 3 (p = 0,013) e 7 (p = 0,013) no Grupo Experimental. Na análise acústica do grupo experimental houve aumento gradativo da frequência fundamental (p = 0,0030) e do GNE (p = 0,0011) após o terceiro minuto e diminuição do ruído (p = 0,0013) a partir do primeiro. Tanto na análise perceptivo-auditiva quanto na acústica, os resultados do Grupo Experimental foram superiores aos encontrados no Grupo-Controle no que diz respeito às melhoras vocais. Os resultados da presente pesquisa demonstram que o tempo de realização do EVSL interfere nas respostas vocais em mulheres disfônicas, sendo que no momento 5 há predomínio de respostas positivas em comparação aos momentos 1, 3 e 7. No 7, há aumento de tensão vocal e queda no desempenho do exercício. / The aim of this study was to assess whether tongue trills trill performance time interferes in the auditory perception and acoustic in women with vocal nodules. Furthermore, it was intended to identify at which moment during the 7-minute performance time the positive and negative responses predominate. This study comprised twenty-seven dysphonic women, who have vocal nodules, ranging from 18 to 45 years old. All subjects of this study were included in the experiment group which underwent tongue trills; only ten of these were also in the control group which underwent the placebo exercise. Both groups carried out the 7- minute performance time. The voices were recorded pre and post experimental and placebo exercises at the first, third, fifth and seventh minute of performance and auditory perception and acoustic were analyzed. In the auditory perception analysis the voices were analyzed individually according to the CAPEV protocol and in pairs, by comparison, to identify the better voice of the pair. The Voxmetria® program, version 2.7h by CTS Informática, was used to assess the vocal quality function. Fundamental frequency, jitter, shimmer, GNE, irregularity and noise were considered. According to the CAPEV results, the tongue trills caused statistically significant changes in seven out of the nine parameters analyzed. The use of the ANOVA analysis of variance showed that at moment 5 (after the fifth minute of experiment exercise) the voice presented the best overall rating, the least roughness, the least breathiness and high pitch. However, at moment 7 (after the seventh minute) the tension was significantly higher than at any other moment. In the paired comparison analysis, there was predominance of improved vocal in the post tongue trills at all moments, except the 7th. There was no statistically significant difference between moments 1 and 3. The voices at moment 5 were considered better that those at moment 3 and at moment 7 in the experiment group. In acoustic analysis of the experiment group there was gradual increase in the fundamental frequency and in the GNE after the 3rd minute and a decrease in noise as of the 1st minute. In the auditory perception analysis as well as in the acoustic analysis, the ratings for the experiment group were higher than those of the control group in relation to vocal improvement. The results of this study show the tongue trill performance time interferes in the vocal response of dysphonic women with positive response predominance at moment 5 compared to moments 1, 3 and 7. At moment 7 there is an increase of vocal tension and a drop in performance during tongue trills.

TITLE: Therapy of voice disorders AUTHOR: Michaela Horáková DEPARTMENT: Department of special education SUPERVISOR: Mgr. Miroslava Kotvová ABSTRACT: This diploma thesis deals with the voice disorders and their treatment options. The character of the thesis is mostly theoretical and the thesis is divided into four general parts. The first one elaborates the anatomy and physiology of the vocal tract as a basis for understanding mechanisms of voice pathology development, the second one is devoted to voice disorders and their categorization, and the third part deals with their therapy, as the czech literature reflects it. The last part of this thesis is dedicated to voice disorders therapy in the United States with a practical focus on therapeutical program Lee Silverman Voice Treatment (LSVT) widely used abroad during the treatment of voice disorders especially connected to Parkinson disease. The program is considered to be very effective and it is really popular outside of the Czech republic. LSVT is not well known in the Czech republic yet and there is actually only limited information devoted to this type of voice therapy. For this reason the thesis is based on analysis and comparison of the available foreign texts in order to inform the czech public about its theoretical basis, structure and system,...