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An elevated sense of vocal effort due to increased vocal demand is frequently reported by patients with voice disorders. However, effects of vocal warm-up on self-assessed vocal effort have not been thoroughly examined. A recently developed version of the Borg CR-10 Scale facilitates vocal effort assessments, following different vocal warm-up tasks.Effects of a short (5 min) vocal warm-up on self-assessed vocal effort was evaluated using the Borg CR-10. Twenty-six vocally healthy participants (13F, 13M, mean age 22.6), in two randomised groups, underwent sessions of either reading aloud or semi-occluded vocal tract exercises (SOVTE). Vocal effort was evaluated at four times: pre to post vocal warm-up and two silence periods. Non-parametric analyses for repeated measures and calculations for within-subject standard deviation were applied in group comparisons.Following vocal warm-up, vocal effort ratings were increased to a statistically significant degree in both intervention groups compared to baseline ratings. After a 5-min rest in silence following completion of the vocal warm-up, vocal effort ratings returned to baseline levels in both groups. The drop in ratings immediately post warm-up compared to 5 min later was statistically significant for the SOVTE group.Five minutes of vocal warm-up caused increased self-perceived vocal effort in vocally healthy individuals. The increased sense of effort dissipated faster following warm-up for the SOVTE group. When using the Borg CR-10 scale to track vocal effort, it may be beneficial to apply experience-based anchors.

This study compared acoustic and neural changes accompanying two treatments matched for intensive dosage but having two different treatment targets (voice or articulation) to dissociate the effects of treatment target and intensive dosage in speech therapies. Nineteen participants with Parkinsonian dysphonia (11 F) were randomized to three groups: intensive treatment targeting voice (voice group, n = 6), targeting articulation (articulation group, n = 7), or an untreated group (no treatment, n = 6). The severity of dysphonia was assessed by the smoothed cepstral peak prominence (CPPS) and neuronal changes were evaluated by cerebral blood flow (CBF) recorded at baseline, posttreatment, and 7-month follow-up. Only the voice treatment resulted in significant posttreatment improvement in CPPS, which was maintained at 7 months. Following voice treatment, increased activity in left premotor and bilateral auditory cortices was observed at posttreatment, and in the left motor and auditory cortices at 7-month follow-up. Articulation treatment resulted in increased activity in bilateral premotor and left insular cortices that were sustained at a 7-month follow-up. Activation in the auditory cortices and a significant correlation between the CPPS and CBF in motor and auditory cortices was observed only in the voice group. The intensive dosage resulted in long-lasting behavioral and neural effects as the no-treatment group showed a progressive decrease in activity in areas of the speech motor network out to a 7-month follow-up. These results indicate that dysphonia and the speech motor network can be differentially modified by treatment targets, while intensive dosage contributes to long-lasting effects of speech treatments.

Body posture is a commonly discussed component of voice training and therapy. However, body postures, postural changes, related posturing muscle monitoring, and the potential changes in voice production (eg, glottal aerodynamic changes, acoustic differences) have been inconsistently described in the literature, leaving room for free interpretation and possible misunderstandings. The primary purpose of this pilot study was to compare the magnitude of electromyographical activation of muscles involved in phonation-breathing functions and their changes due to four standardized body postures in experienced singers. Secondly, to identify which body posture produces greater changes in aerodynamic parameters, vocal pitch, and loudness.Eight healthy adults with experience in singing voice performed a vocal task during different body postures commonly used in both voice training and therapy. A 3D-capture system was used to control and quantify the alignment of each posture. During the performances, surface electromyography (sEMG) was used to measure the muscular activity involved in the breathing/phonation and posture processes. A nonparametric Kruskal-Wallis test was used to compare the sEMG activity of phonatory muscles and aerodynamic voice variables between postures.Our study did not reveal significant differences in sEMG activity, aerodynamic parameters, vocal pitch, and loudness among body postures during vocal task productions. However, the vocal pitch (in semitones) revealed significant differences in the unstable surface when compared to the upright posture, modified upright, and leaning postures.The body postures selected did not generate voice aerodynamic modifications of the voice nor in the levels of activation of muscles involved in the phonation-breathing process in individuals with experience in singing voice. Modifications of body posture as a tool for voice therapy should be further investigated, considering the population with voice problems and no voice training experience.

Due to elevated vocal health risk in industries such as call centers, there is a need to have accessible and quick self-report tools for voice symptoms. This study aimed to determine if the concurrent and construct validity of three visual analog scales (VASs) of voice quality and symptoms could be used as a screening tool in call center agents.A cross-sectional study was carried out in three call center companies. The Voice Handicap Index-10 (VHI-10) and a vocal hygiene and symptoms survey were administered to 66 call center workers. Further, acoustic parameters including harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), L1-L0 slope, and Alpha ratio were collected. Finally, workers completed three VASs capturing self-perception of vocal effort (VAS-1), voice quality (VAS-2), and vocal fatigue (VAS-3). Linear regression models with bootstrapping evaluated the possible relationship between the three VASs measurements, self-perceived vocal symptoms, and acoustic parameters.VAS-1 scores were associated with HNR and voice breaks, VAS-2 with voice breaks, and VAS-3 with Alpha ratio. Using the area under a receiver operating characteristic curve (AUC), the highest AUC for detecting an altered VHI-10 questionnaire score was observed for the three VASs. Also, the highest AUC for detecting altered CPPs was reached for the VAS-1.VAS as a self-report instrument of vocal symptoms is related to psychosocial voice impairment and alterations of acoustic voice parameters in call center workers. Such instruments could be easily implemented to identify voice complaints in these populations.Level 2 (Diagnosis research question) Laryngoscope, 2022.

The optimization of vocal effort given a response to a voice demand is a common clinical and vocal performance goal. Increases in vocal effort are often in response to communication limitations from both the interlocutors and the communication environment. This study investigates the relationship between vocal effort and vocal demands from changes and limitations imposed by the communication environment.Thirty-seven participants rated their vocal effort associated with a map description task in a range of communication demands. These demands included communication distance (from 1 m to 4 m), loudness goal (54 dB-66 dB), and excess background noise (53 dBA-71 dBA). The vocal effort ratings were compared across the different types and extents of vocal demand conditions.As would be expected, there were significant increases in vocal effort levels from the control condition to the extremes of the distance and loudness goal vocal demands. Each increase in background noise resulted in distinct increases in vocal effort level. Participants were able to use the vocal effort scale to efficiently quantify expected increases in vocal demands.Increases of vocal effort level accompany increases to vocal demands that exceed the habitual or expected communication. While voice training and vocal therapy are essential for reducing internal vocal demands, clients with a goal to reduce vocal effort should also consider external vocal demands such as communication distance and background noise.

Background: College professors expose themselves to different vocal demands during teaching. During the COVID-19 pandemic, college professors were exposed to extra working loads associated with working from home, with less-than-optimal acoustic conditions. This is the reason why it was needed to think of easy-to-implement and low-cost solutions for online teaching from home. Objective: To evaluate the effect of an insulating cabin prototype on the voice acoustic parameters of college professors during homeworking. Methodology: Longitudinal study with the participation of 32 (thirty-two) full-time college professors. Participants were asked to fill out a questionnaire before reading a paragraph of around 30 seconds of duration with and without the portable sound booth. A type I sound level meter was used to measure the background noise in professors' teaching environments with and without the cabin prototype. Results: Voice acoustic parameters changed when voice production was performed with the portable sound booth. Therefore, this low-cost solution is a good alternative to prevent vocal effort and vocal fatigue among teachers.

Vocal effort is the most common symptom that in patients with voice disorders and decreasing vocal effort is often a therapeutic goal. Previous studies indicate that a vocal effort goal can elicit voice production with very similar acoustic parameters. The purpose of this study is to clarify the effort and acoustic parameter dependencies on different types of phrases elicited with different goals. Three types of speech (automatic, read, structured spontaneous) were elicited at using three communication goals (confidential, conversational, raised) with vocal effort quantified using a Borg CR100 scale. Participants’ vocal level reliably changed between the three elicited communication goals. Further, there was some trending differences depending on the length and type of speech. Further details will be presented. The results indicate the utility of the Borg CR100 in tracking effort in voice production that is repeatable with respect to vocal level (dB). Additional acoustic parameters as well as speech differences will be discussed.

While vocal pathology can elevate vocal effort, communication situations also have an effect. Previous work on vocal effort and communication situations have relied on listener ratings of effort rather than talker-centric vocal effort. Towards that end, in this study, talker-centric vocal effort was related to different communication demands. Additionally, vocal performance was measured to investigate potential relationships between effort, production, and communication demand. In an anechoic chamber, participants described to an interlocutor various maps. The communication demands were communication distance (1, 2, 4 m), loudness goal (54, 60, 66 dB), and background noise (53, 62, 71 dBA). Talkers rated their vocal effort after each task with a Borg CR100 scale and were recorded with a calibrated head-worn microphone. There were significant increases in ratings of vocal effort, fundamental frequency, intensity, and cepstral-peak prominence (CPP) from the control condition to the extremes of the distance and loudness goal vocal demands which are consistent with previously observed Lombard responses. This study shows that communication demands that exceed typical conditions (such as talking at 4 m) result in increases in vocal effort and a Lombard-like response. Therefore, considerations to potential communication barriers are important for the reduction of vocal effort.

The ability to perform high-pitched and loud tasks have been associated with lower risks of penetration and aspiration in people with oropharyngeal dysphagia (OD). Previous studies suggest that these two vocal tasks may improve swallowing-related kinematics; laryngeal elevation and glottic closure. This study aims to identify which types of vocal exercises can maximize pitch elevation and vocal loudness. This ongoing project involved five subjects with OD who were asked to perform three vocal exercises: effortful pitch glide, straw phonation, and water resistance therapy (WRT). Fundamental frequency (fo) and maximum dB SLP were obtained during their performance; moreover, the vocal effort was quantified using a Borg CR100 scale. Descriptive statistics were used to characterize the differences between the three proposed exercises. WRT was the exercise that allowed toobtain higher pitch elevation values with less vocal effort (median fo = 603Hz), over EPG(594 Hz), and then straw phonation (512 Hz). Furthermore, EPG allowed reaching a higher vocal loudness during its performance. These preliminary results indicate that WRT could be a potential therapeutic adjunct to improve swallowing-related biomechanics. Further details will be presented. Future studies could incorporate accelerometry to obtain more accurate fo and dB SPL measures during vocal exercise performance.

School teachers have an elevated risk of voice problems due to the vocal demands in the workplace. This presentation summarizes the results of several studies investigating voice use in real and simulated classroom settings. The first study used 57 teachers, who were monitored all day for 2 weeks in teaching and nonteaching environments. In the second study of short-term responses to room conditions, the speech of 20 talkers was analyzed in order to evaluate how voice production and effort were affected by speaking style, room acoustics (added background noise, presence of early reflections), and short-term vocal fatigue in a single room. A third study investigated the effects of voice production and perception due to visually concealed acoustic changes (both noise and reverberation) while speaking in a room. In all studies, talkers significantly adjusted their voice production to both dramatic and seemingly small acoustic changes. Both teaching experience and biological sex were factors in participant response differences.

School teachers’ voice problems are widespread and influence the learning process. Voice amplification systems in classrooms are a common response and a preventative strategy. The primary purpose of this study was to (1) determine the relationship between teacher vocal fatigue and use of classroom amplification; and (2) identify factors influencing amplification usage. Teachers throughout the US completed questionnaires regarding vocal health, classroom conditions, lifestyle habits, and access to and use of vocal amplification systems. Responses indicated that biological female teachers who used voice amplification or taught grades kindergarten to middle school were more likely to report higher levels of vocal fatigue. Further, teachers with access to amplification systems were more likely to use them if they were teachers in lower grade levels, who smoked occasionally, drank alcohol frequently, and taught in larger capacity classrooms. In conclusion, it maybe that those using the amplifications are using them because of pre-existing voice issues. Finally, the work-related factors associated with the use of amplification systems (e.g., grade level, classroom capacity) may be indicators of adjustments to reduce the occurrence of voice problems among teachers. Ongoing studies reviewing the available classroom amplification equipment and use from a school administrators perspective will be discussed.

While acoustic speech analysis is non-invasive, the utility has been mixed due to the range of voice types. For vocal health practitioners to efficiently and quickly assess and document voice changes, knowing which voice parameter would be sensitive to vocal change is crucial. Using a database of 296 individual voices including 8 voice pathology types and typical voice samples, the sensitivity of a range of acoustic speech parameters to differentiate common voice pathology types was investigated. Both traditional and contemporary acoustic speech metrics were estimated for the samples using a custom MATLAB script and PRAAT (e.g., jitter, shimmer HNR, CPPS, Alpha ratio, PPE). Analysis then evaluate the predictability value of the metrics to discriminate pathology type. From the pool of parameters, 11 were able to identify pathological voices from normal controls and several of the parameters were more sensitive to some pathology. For example, CPPs and jitter values could discriminate neuropathological voices whereas HNR and Shimmer cold discriminate muscle-based pathologies. These results indicate how the sensitivity of acoustic speech metrics to the voice pathology types can allow for the identification of individual metrics (or combinations of metrics) which could be used to track changes in vocal health.

To increase the reliability and comparability of vocal loading studies, this paper proposes the use of a standardized approach with experiments that are [1] grounded on consistent definitions of terms related to vocal fatigue (vocal effort, vocal demand, and vocal demand response), and [2] designed to reduce uncertainty and increase repeatability. In the approach, a semi-automated vocal loading task that also increases efficiencies in collecting and preparing vocal samples for analysis was used to answer the following research question: To what extent is vocal effort and vocal demand response sensitive to changes in vocal demands (ie, noise only, noise plus duration)? Results indicate that the proposed protocol design consistently induced change in both vocal effort and vocal demand response, indicating vocal fatigue. The efficacy of future vocal loading studies would be improved by adopting a more consistent methodology for quantifying vocal fatigue, thus increasing interstudy comparability of results and conclusions.

The physical production of speech level dynamic range is directly affected by the physiological features of the speaker such as vocal tract size and lung capacity; however, the regulation of these production systems is affected by the perception of the communication environment and auditory feedback. The current study examined the effects of room acoustics in an artificial setting on voice production in terms of sound pressure level and the relationship with the perceived vocal comfort and vocal control. Three independent room acoustic parameters were considered: gain (alteration of the sidetone or playback of one’s own voice), reverberation time, and background noise. An increase in the sidetone led to a decrease in vocal sound pressure levels, thus increasing vocal comfort and vocal control. This effect was consistent in the different reverberation times considered. Mid-range reverberation times (T30 ≈ 1.3 s) led to a decrease in vocal sound pressure level along with an increase in vocal comfort and vocal control, however, the effect of the reverberation time was smaller than the effect of the gain. The presence of noise amplified the aforementioned effects for the variables analyzed.

Two vocal qualities, twang and yawn, were synthesized and rated perceptually. The stimuli consisted of synthesized vocal productions of a sentence-length utterance 'ya ya ya ya ya,' which had speech-like intonation. In a continuum transformation from normal to twang, the area in the pharynx was gradually decreased, along with vocal tract shortening and a decreased open quotient in the glottal airflow. In a continuum transformation toward yawn, the area in the pharynx was gradually increased, along with vocal tract lengthening and an increased open quotient. The normal (untransformed) vocal tract area was pre-determined by earlier studies involving MRI scans of a human subject's vocal tract. Listeners were asked to rate (on a scale from 1-10) the 'amount of twang' in one listening session and the 'amount of yawn' in another listening session. Overall, the perception of twang increased directly with pharyngeal area narrowing, vocal tract shortening, and decreased open quotient. The perception of yawn increased with pharyngeal area widening, vocal tract lengthening, and increased open quotient. Adjustments of one parameter alone yielded less significant perceptual changes than the above combinations, with open quotient showing the greatest effect in isolation. Listeners demonstrated variable perceptions in both continua with poor inter-subject, intra-subject, and inter-group reliability.

Context:Many researchers have investigated the effectiveness of different cryotherapy agents at decreasing intramuscular tissue temperatures. However, no one has looked at the effectiveness of adding salt to an ice bag.Objective:To compare the cooling effectiveness of different ice bags (wetted, salted cubed, and salted crushed) on cutaneous and intramuscular temperatures.Design:Repeated-measures counterbalanced design.Setting:University research laboratory.Participants:24 healthy participants (13 men, 11 women; age 22.46 ± 2.33 y, height 173.25 ± 9.78 cm, mass 74.51 ± 17.32 kg, subcutaneous thickness 0.63 ± 0.27 cm) with no lower-leg injuries, vascular diseases, sensitivity to cold, compromised circulation, or chronic use of NSAIDs.Interventions:Ice bags made of wetted ice (2000 mL ice and 300 mL water), salted cubed ice (intervention A; 2000 mL of cubed ice and 1/2 tablespoon of salt), and salted crushed ice (intervention B; 2000 mL of crushed ice and 1/2 tablespoon of salt) were applied to the posterior gastrocnemius for 30 min. Each participant received all conditions with at least 4 d between treatments.Main Outcome Measure:Cutaneous and intramuscular (2 cm plus adipose thickness) temperatures of nondominant gastrocnemius were measured during a 10-min baseline period, a 30-min treatment period, and a 45-min rewarming period.Results:Differences from baseline were observed for all treatments. The wetted-ice and salted-cubed-ice bags produced significantly lower intramuscular temperatures than the salted-crushed-ice bag. Wetted-ice bags produced the greatest temperature change for cutaneous tissues.Conclusions:Wetted- and salted-cubed-ice bags were equally effective at decreasing intramuscular temperature at 2 cm subadipose. Clinical practicality may favor salted-ice bags over wetted-ice bags.

Speakers adjust their vocal production when communicating in different room acoustics, when instructed to speak at different volumes and when experiencing vocal fatigue. The present paper reports on the effects of speech style, reverberation time, and external auditory feedback on time dose and fundamental frequency. Ten male and ten female subjects were recorded while reading a text in normal and loud styles, in three rooms—anechoic, semi-reverberant, and reverberant—and with and without acrylic glass panels at 0.5 m from the mouth, which increased external auditory feedback. Longer time doses were accumulated in more reverberant rooms, especially when loud voice was used. Higher fundamental frequency was measured in less reverberant rooms. Subjects increased their fundamental frequency in the loud speech style versus the normal style, but this effect was weaker when the level of external auditory feedback was high. A larger fundamental frequency range was detected for females than males and for the loud...

We present an assessment of the practical value of existing traditional and non-standard measures for discriminating healthy people from people with Parkinson?s disease (PD) by detecting dysphonia. We introduce a new measure of dysphonia, Pitch Period Entropy (PPE), which is robust to many uncontrollable confounding effects including noisy acoustic environments and normal, healthy variations in voice frequency. We collected sustained phonations from 31 people, 23 with PD. We then selected 10 highly uncorrelated measures, and an exhaustive search of all possible combinations of these measures finds four that in combination lead to overall correct classification performance of 91.4%, using a kernel support vector machine. In conclusion, we find that non-standard methods in combination with traditional harmonics-to-noise ratios are best able to separate healthy from PD subjects. The selected non-standard methods are robust to many uncontrollable variations in acoustic environment and individual subjects, and are thus well-suited to telemonitoring applications.

Computer models used to study crashes require data describing the vehicles. Data such as weight, length, wheelbase, tire locations, crush stiffness, tire parameters, etc. all require some source of information. Usually the tire parameters are difficult to obtain and analysts will routinely use default or “typical” values. Engineering Dynamics Corp. (EDC), with support from many in the field of crash reconstruction, conducted a tire test series in 1999 to obtain tire data that will be used in studying motor vehicle performance. The computer simulations in use today require some type of tire data coefficients or lookup tables that must be extracted from the raw collected data. This paper presents a basic overview of the tire test data and presents a technique for extracting the required tire parameters for use in computer simulation modeling.