1. |
- Abrahamsson, Malin, et al.
(author)
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Effects of Voice Therapy: A Comparison Between Individual and Group Therapy
- 2018
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In: Journal of Voice. - : Elsevier BV. - 0892-1997. ; 32:4, s. 437-442
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Journal article (peer-reviewed)abstract
- Objective. The primary aim of this clinical evaluation project is to study the effect of voice therapy given in the speech-language pathology clinic, as individual and group therapy, as well as finding out some of the reasons for not attending the recommended therapy. Method. All patients visiting the speech-language department during the study period were asked to participate in a clinical evaluation project. The project included filling out the questionnaire Swedish Voice Handicap Index (VHI-11) twice: at their first visit at the clinic, and approximately 1 year later. Depending on the degree of voice problems, the patients were offered either individual or group therapy. Result. The study included 187 patients at their first visit to the clinic and 109 patients at follow-up. All participants completed self-evaluation of voice function with the VHI-11 and separate questions regarding overall voice problems, hoarseness, and vocal fatigue. For the patients who responded to the follow-up survey, statistically significant improvements of self-perceived voice function were demonstrated in individual and group therapy. The improvement between the first visit and the follow-up was found to be of moderate to large effect size, with statistically significant improvements for both patients who attended individual therapy and those who attended group therapy. The most common reason for not attending the recommended voice therapy was lack of time. Conclusion. Individual and group therapy is effective, resulting in improved VHI-11 scores. The magnitude of improvement is similar when comparing individual and group therapy. Patients with higher scores of the VHI-11 were generally recommended individual voice therapy.
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2. |
- Millgård, Moa, et al.
(author)
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Flow Glottogram Characteristics and Perceived Degree of Phonatory Pressedness
- 2016
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In: Journal of Voice. - : Elsevier BV. - 0892-1997 .- 1873-4588. ; 30:3, s. 287-292
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Journal article (peer-reviewed)abstract
- Objectives. Phonatory pressedness is a clinically relevant aspect of voice, which generally is analyzed by auditory perception. The present investigation aimed at identifying voice source and formant characteristics related to experts' ratings of phonatory pressedness. Study Design. Experimental study of the relations between visual analog scale ratings of phonatory pressedness and voice source parameters in healthy voices. Methods. Audio, electroglottogram, and subglottal pressure, estimated from oral pressure during /p/ occlusion, were recorded from five female and six male subjects, each of whom deliberately varied phonation type between neutral, flow, and pressed in the syllable /pae/, produced at three loudness levels and three pitches. Speech-language pathologists rated, along a visual analog scale, the degree of perceived phonatory pressedness in these samples. Results. The samples were analyzed by means of inverse filtering with regard to closed quotient, dominance of the voice source fundamental, normalized amplitude quotient, peak-to-peak flow amplitude, as well as formant frequencies and the alpha ratio of spectrum energy above and below 1000 Hz. The results were compared with the rating data, which showed that the ratings were closely related to voice source parameters. Conclusions. Approximately, 70% of the variance of the ratings could be explained by the voice source parameters. A multiple linear regression analysis suggested that perceived phonatory pressedness is related most closely to subglottal pressure, closed quotient, and the two lowest formants.
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3. |
- Millgård, Moa, et al.
(author)
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Voice Quality in Laryngeal Cancer Patients: A Randomized Controlled Study of the Effect of Voice Rehabilitation.
- 2020
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In: Journal of Voice. - : Elsevier BV. - 0892-1997. ; 34:3
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Journal article (peer-reviewed)abstract
- Objectives The study aimed to investigate the short-term and long-term effects of voice rehabilitation in patients treated with radiotherapy for laryngeal cancer as measured by both the acoustic measure smoothed cepstral peak prominence (CPPS) and perceptual measures. A secondary aim was to investigate the relationship between acoustic and perceptual measures. Methods In total, 37 patients received voice rehabilitation post-radiotherapy and 37 patients constituted the irradiated control group. Outcome measures were mean CPPS for connected speech and ratings with the auditory-perceptual Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scale. Outcome measures were analyzed 1 (baseline), 6, 12, and 24 months post-radiotherapy, where voice rehabilitation was conducted between the first two time-points. Additional recordings were acquired from vocally healthy participants for comparison. Results CPPS values of the voice rehabilitation group and vocally healthy group were not significantly different at 24 months post-radiotherapy. Ten out of 19 patients who received voice rehabilitation yielded a CPPS value above the threshold for normal voice 24 months post-radiotherapy, compared to 11 out of 26 in the irradiated control group. No statistically significant correlations were found between CPPS and perceptual parameters of GRBAS. Conclusion Voice rehabilitation for irradiated laryngeal cancer patients may have positive effects on voice quality up to 24 months post-radiotherapy. The relationship between CPPS and GRBAS as well as the applicability of CPPS for evaluation over several points of measurement needs to be studied further.
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