| 1. |
- Andrade, Pedro Amarante, et al.
(författare)
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The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises
- 2016
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Ingår i: Journal of Voice. - : Mosby-Elsevier. - 0892-1997 .- 1873-4588. ; 30:1, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- This experimental study investigated the back pressure (Pback) versus flow (U) relationship for 10 different tubes commonly used for semi-occluded vocal tract exercises, that is, eight straws of different lengths and diameters, a resonance tube, and a silicone tube similar to a Lax Vox tube. All tubes were assessed with the free end in air. The resonance tube and silicone tube were further assessed with the free end under water at the depths from 1 to 7 cm in steps of 1 cm. The results showed that relative changes in the diameter of straws affect Pback considerably more compared with the same amount of relative change in length. Additionally, once tubes are submerged into water, Pback needs to overcome the pressure generated by the water depth before flow can start. Under this condition, only a small increase in Pback was observed as the flow was increased. Therefore, the wider tubes submerged into water produced an almost constant Pback determined by the water depth, whereas the thinner straws in air produced relatively large changes to Pback as flow was changed. These differences may be taken advantage of when customizing exercises for different users and diagnoses and optimizing the therapy outcome.
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| 2. |
- Geneid, A., et al.
(författare)
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Long-term follow-up of patients with spasmodic dysphonia and improved voice despite discontinuation of treatment
- 2017
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Ingår i: Folia Phoniatrica et Logopaedica. - : S. Karger. - 1021-7762 .- 1421-9972. ; 68:3, s. 144-151
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate voice function in patients with adductor spasmodic dysphonia (AdSD) who discontinued botulinum toxin (BTX) treatment because they felt that their voice had improved sufficiently. Patients and Methods: Twenty-eight patients quit treatment in 2004, of whom 20 fulfilled the inclusion criteria for the study, with 3 subsequently excluded because of return of symptoms, leaving 17 patients (11 males, 6 females) included in this follow-up study. A questionnaire concerning current voice function and the Voice Handicap Index were completed. Audio-perceptual voice assessments were done by 3 listeners. The inter- and intrarater reliabilities were r > 0.80. Results: All patients had a subjectively good stable voice, but with differences in their audio-perceptual voice assessment scores. Based on the pre-/posttreatment auditory scores on the overall degree of AdSD, patients were divided into 2 subgroups showing more and less improvement, with 10 and 7 patients, respectively. The subgroup with more improvement had shorter duration from the onset of symptoms until the start of BTX treatment, and included 7 males compared to only 4 males in the subgroup with less improvement. Conclusion: It seems plausible that the symptoms of spasmodic dysphonia may decrease over time. Early intervention and male gender seem to be important factors for long-term reduction of the voice symptoms of AdSD.
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| 3. |
- Granqvist, Svante, et al.
(författare)
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Resonance tube phonation in water : High-speed imaging, electroglottographic and oral pressure observations of vocal fold vibrations - A pilot study
- 2015
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Ingår i: Logopedics, Phoniatrics, Vocology. - : Taylor & Francis. - 1401-5439 .- 1651-2022. ; 40:3, s. 113-121
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Tidskriftsartikel (refereegranskat)abstract
- Phonation into glass tubes (resonance tubes), keeping the free end of the tube in water, has been a frequently used voice therapy method in Finland and more recently also in other countries. The purpose of this exploratory study was to investigate what effects tube phonation with and without water has on the larynx. Two participants were included in the study. The methods used were high-speed imaging, electroglottographic observations of vocal fold vibrations, and measurements of oral pressure during tube phonation. Results showed that the fluctuation in the back pressure during tube phonation in water altered the vocal fold vibrations. In the high-speed imaging, effects were found in the open quotient and amplitude variation of the glottal opening. The open quotient increased with increasing water depth (from 2 cm to 6 cm). A modulation effect by the water bubbles on the vocal fold vibrations was seen both in the high-speed glottal area tracings and in the electroglottography signal. A second experiment revealed that the increased average oral pressure was largely determined by the water depth. The increased open quotient can possibly be explained by an increased abduction of the vocal folds and/or a reduced transglottal pressure. The back pressure of the bubbles also modulates glottal vibrations with a possible massage effect on the vocal folds. This effect and the well-defined average pressure increase due to the known water depth are different from those of other methods using a semi-occluded vocal tract.
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| 4. |
- Hagberg, Emilie, et al.
(författare)
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The Impact of Maxillary Advancement on Consonant Proficiency in Patients With Cleft Lip and Palate, Lay Listeners' Opinion, and Patients' Satisfaction With Speech
- 2019
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Ingår i: The Cleft Palate-Craniofacial Journal. - : NLM (Medline). - 1055-6656 .- 1545-1569. ; 56:4, s. 454-461
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study investigates the impact of maxillary advancement (Le Fort Iosteotomy) on consonant proficiency in patients with cleft lip and palate (CLP) and explores how these patients and lay people perceive their speech 1 year post Le Fort I osteotomy. Design: Retrospective group study before and after treatment. Participants: All patients with CLP who had undergone Le Fort I osteotomy for maxillary retrognathia between 2007 and 2010 at Karolinska University Hospital, Sweden (n = 21). Six patients were excluded due to additional malformations and missing data. Two experienced speech and language pathologists assessed consonant proficiency, and speech accuracy was determined by lay listeners from pre- and postoperative standardized audio recordings. The patients' satisfaction with speech postoperatively was collected from medical records. Main Outcome Measures: Percentage of oral consonants correct and acoustic analysis of /s/, lay listeners' opinion, and patients' satisfaction with speech. Results: One year postoperation, 11 of the 15 patients had improved articulation, especially on the /s/-sound, without speech intervention. The mean percentage of oral consonants correct before treatment (82%) was significantly improved later (95%; P > .01). This assessment was supported by the patients' satisfaction with speech. However, lay listeners' opinion on accuracy was inconsistent. Length of maxillary advancement or change in occlusion did not correlate with change in articulation. Conclusion: Maxillary advancement performed to normalize occlusion and facial profile improved consonant proficiency in patients with CLP 1 year postoperation. Lay listeners' and patients' perceptions of speech need further exploration.
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| 5. |
- La, Filipa M. B., et al.
(författare)
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Real-Time Visual Feedback of Airflow in Voice Training : Aerodynamic Properties of Two Flow Ball Devices
- 2017
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Ingår i: Journal of Voice. - : MOSBY-ELSEVIER. - 0892-1997 .- 1873-4588. ; 31:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Flow ball devices have been used as teaching tools to provide visual real-time feedback of airflow during singing. This study aims at exploring static back pressure and ball height as function of flow for two devices, marketed as flow ball and floating ball game. Study Design. This is a comparative descriptive study. Methods. A flow-driven vocal tract simulator was used to investigate the aerodynamic properties of these two devices, testing them for four different ball sizes. The flow range investigated was between 0 and 0.5 L/s. Audio, flow, pressure, and ball height were recorded. Results. The flow pressure profiles for both tested devices were similar to those observed in previous studies on narrow tubes. For lifting the ball, both devices had a flow and a pressure threshold. The tested floating ball game required considerably higher back pressure for a given flow as compared with the flow ball. Conclusions. Both tested devices have similar effects on back pressure as straws of 3.7 and 3.0 mm in diameter for the flow ball and the floating ball game, respectively. One might argue that both devices could be used as tools for practicing semi-occluded vocal tract exercises, with the additional benefit of providing real-time visual feedback of airflow during phonation. The flow threshold, combined with the flow feedback, would increase awareness of flow, rather than of pressure, during exercises using a flow ball device.
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| 6. |
- Lohmander, Anette, et al.
(författare)
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Reliability of auditory perceptual assessment of hypernasality in speech using different scales
- 2018
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Ingår i: Fechner Day 2018. - : International Society for Psychophysics. ; , s. 43-44
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Auditory-perceptual assessment has been criticized because of its inherent subjectivity. However, perceptual judgments are the primary tool in the clinical assessment of voice and resonance parameters and a key task for the speech–language pathologist/therapist (SLP/T). Decision on treatment or further examination is based on the perceptual speech assessment which need to be reliable. Of all perceptual dimensions used to distinguish normal from abnormal speech the most difficult to judge reliably is hypernasality (Watterson et al., 2017). Nevertheless, the final decision regarding whether an individual has nasality or other speech problems is based on the listener’s subjective measurement (Moll, 1λ64). Nasality is present in normal voice production and refers to perceived nasal sounds arising from the coupling of the oral and nasal resonating cavities. Nasal consonants are common in the languages. Normal nasal resonance has a range of acceptability and is perceived along a continuum, while nasal resonance disorders are associated with defects or dysfunction in the palate. In the current study the reliability of perceptual assessment of hypernasality with three different methods were compared. Standardised audio recordings of 5-year-old Swedish-speaking children with repaired cleft palate consisting of 73 stimuli in three different randomised orders were perceptually assessed by four experienced speech-language pathologists using three different methods: a sort and rate procedure (VISOR) allowing comparison between and ordering stimuli along a visual analogue scale; a 2- step method beginning with determination whether the speech resonance is within normal range or not. If not, the stimulus is rated along a 3 point ordinal category scale; a combined category-ratio scale (Borg centiMax®(cM)), where verbally well-defined categories are levelanchored to a ratio scale. Each listener completed a total of 657 hypernasality ratings (73 stimuli in 3 orders by 3 methods) for the rating task. Good to excellent intra-rater reliability was found within each listener for all methods. The highest inter-rater reliability was demonstrated for VISOR and the Borg cM. High consistency within each method was found with the highest for the Borg cM. In conclusion, both the VISOR and the Borg centiMax® seem appropriate for auditory-perceptual assessment of hypernasality with similar and high reliability. However, the Borg cM showed slightly better consistency and seems easiest to use in a clinical setting. Further research should aim for valid definitions of how hypernasality corresponds to the categories along the scale.
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| 7. |
- Paciello Yamashita, Renata, et al.
(författare)
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Reliability of Hypernasality Rating : Comparison of 3 Different Methods for Perceptual Assessment
- 2018
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 55:8, s. 1060-1071
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare reliability in auditory-perceptual assessment of hypernasality for 3 different methods and to explore the influence of language background.Design: Comparative methodological study. Participants and Materials: Audio recordings of 5-year-old Swedish-speaking children with repaired cleft lip and palate consisting of 73 stimuli of 9 nonnasal single-word strings in 3 different randomized orders. Four experienced speech-language pathologists (2 native speakers of Brazilian-Portuguese and 2 native speakers of Swedish) participated as listeners. After individual training, each listener performed the hypernasality rating task. Each order of stimuli was analyzed individually using the 2-step, VISOR and Borg centiMax scale methods.Main Outcome Measures: Comparison of intra- and inter-rater reliability, and consistency for each method within language of the listener and between listener languages (Swedish and Brazilian-Portuguese).Results: Good to excellent intra-rater reliability was found within each listener for all methods, 2-step:kappa = 0.59-0.93; VISOR: intraclass correlation coefficient (ICC) = 0.80-0.99; Borg centiMax (cM) scale: ICC = 0.80-1.00. The highest inter-rater reliability was demonstrated for VISOR (ICC = 0.60-0.90) and Borg cM-scale (ICC = 0.40-0.80). High consistency within each method was found with the highest for the Borg cM scale (ICC = 0.89-0.91). There was a significant difference in the ratings between the Swedish and the Brazilian listeners for all methods.Conclusions: The category-ratio scale Borg cM was considered most reliable in the assessment of hypernasality. Language background of Brazilian-Portuguese listeners influenced the perceptual ratings of hypernasality in Swedish speech samples, despite their experience in perceptual assessment of cleft palate speech disorders.
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| 8. |
- Sramkova, Hana, et al.
(författare)
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The softest sound levels of the human voice in normal subjects
- 2015
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Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 137:1, s. 407-418
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Tidskriftsartikel (refereegranskat)abstract
- Accurate measurement of the softest sound levels of phonation presents technical and methodological challenges. This study aimed at (1) reliably obtaining normative data on sustained softest sound levels for the vowel [a:] at comfortable pitch; (2) comparing the results for different frequency and time weighting methods; and (3) refining the Union of European Phoniatricians' recommendation on allowed background noise levels for scientific and equipment manufacturers' purposes. Eighty healthy untrained participants (40 females, 40 males) were investigated in quiet rooms using a head-mounted microphone and a sound level meter at 30 cm distance. The one-second-equivalent sound levels were more stable and more representative for evaluating the softest sustained phonations than the fast-time-weighted levels. At 30 cm, these levels were in the range of 48-61 dB(C)/41-53 dB(A) for females and 49-64 dB(C)/35-53 dB(A) for males (5% to 95% quantile range). These ranges may serve as reference data in evaluating vocal normality. In order to reach a signal-to-noise ratio of at least 10 dB for more than 95% of the normal population, the background noise should be below 25 dB(A) and 38 dB(C), respectively, for the softest phonation measurements at 30 cm distance. For the A-weighting, this is 15 dB lower than the previously recommended value.
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| 9. |
- Švec, J.G., et al.
(författare)
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Tutorial and guidelines on measurement of sound pressure level in voice and speech
- 2018
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 61:3, s. 441-461
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Sound pressure level (SPL) measurement of voice and speech is often considered a trivial matter, but the measured levels are often reported incorrectly or incompletely, making them difficult to compare among various studies. This article aims at explaining the fundamental principles behind these measurements and providing guidelines to improve their accuracy and reproducibility. Method: Basic information is put together from standards, technical, voice and speech literature, and practical experience of the authors and is explained for nontechnical readers. Results: Variation of SPL with distance, sound level meters and their accuracy, frequency and time weightings, and background noise topics are reviewed. Several calibration procedures for SPL measurements are described for stand-mounted and head-mounted microphones. Conclusions: SPL of voice and speech should be reported together with the mouth-to-microphone distance so that the levels can be related to vocal power. Sound level measurement settings (i.e., frequency weighting and time weighting/averaging) should always be specified. Classified sound level meters should be used to assure measurement accuracy. Head-mounted microphones placed at the proximity of the mouth improve signal-to-noise ratio and can be taken advantage of for voice SPL measurements when calibrated. Background noise levels should be reported besides the sound levels of voice and speech.
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| 10. |
- Szabo, Annika, 1972-, et al.
(författare)
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Vocal Behavior in Environmental Noise : Comparisons Between Work and Leisure Conditions in Women With Work-related Voice Disorders and Matched Controls
- 2018
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Ingår i: Journal of Voice. - : Elsevier. - 0892-1997 .- 1873-4588. ; 32:1, s. 126.e23-126.e38
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study aimed to assess vocal behavior in women with voice-intensive occupations to investigate differences between patients and controls and between work and leisure conditions with environmental noise level as an experimental factor. Methods: Patients with work-related voice disorders, 10 with phonasthenia and 10 with vocal nodules, were matched regarding age, profession, and workplace with 20 vocally healthy colleagues. The sound pressure level of environmental noise and the speakers’ voice, fundamental frequency, and phonation ratio were registered from morning to night during 1 week with a voice accumulator. Voice data were assessed in low (≀55 dBA), moderate, and high (\textgreater70 dBA) environmental noise levels. Results: The average environmental noise level was significantly higher during the work condition for patients with vocal nodules (73.9 dBA) and their controls (73.0 dBA) compared with patients with phonasthenia (68.3 dBA) and their controls (67.1 dBA). The average voice level and the fundamental frequency were also significantly higher during work for the patients with vocal nodules and their controls. During the leisure condition, there were no significant differences in average noise and voice level nor fundamental frequency between the groups. The patients with vocal nodules and their controls spent significantly more time and used their voices significantly more in high–environmental noise levels. Conclusions: High noise levels during work and demands from the occupation impact vocal behavior. Thus, assessment of voice ergonomics should be part of the work environmental management. To reduce environmental noise levels is important to improve voice ergonomic conditions in communication-intensive and vocally demanding workplaces.
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