PMID- 33483225
OWN - NLM
STAT- MEDLINE
DCOM- 20230307
LR  - 20230307
IS  - 1873-4588 (Electronic)
IS  - 0892-1997 (Linking)
VI  - 37
IP  - 2
DP  - 2023 Mar
TI  - Outcomes of Vocal Hygiene Program in Facilitating Vocal Health in Female School 
      Teachers With Voice Problems.
PG  - 295.e11-295.e22
LID - S0892-1997(21)00018-7 [pii]
LID - 10.1016/j.jvoice.2020.12.041 [doi]
AB  - BACKGROUND: Teachers suffer greater impacts of voice problems due inappropriate 
      voice use and other contributing factors such as physiological, environmental, 
      and individual & work related issues. Structured vocal hygiene programs (VHP) 
      prevent/reduce the risk of vocal trauma and promote vocal health in teachers. 
      This study aimed to estimate the outcome of instituting a sociocultural relevant 
      vocal hygiene program in facilitating vocal health among female school teachers 
      using a comprehensive voice assessment protocol. METHOD: VHP was developed 
      emphasizing adequate hydration, healthy vocal diet, posture and alignment, vocal 
      practices while teaching, and ideal speaking environment. This was administered 
      via a face to face session to seventeen female teachers with voice concerns. All 
      underwent a comprehensive voice assessment (subjective, objective, and 
      self-perceptual vocal measures) before and four weeks after the VHP. Inter-rater 
      reliability for perceptual and visual examination was estimated using Intra-Class 
      Coefficient. Wilcoxon signed ranks test was used to compare the pre- and 
      post-treatment measures of continuous variables (acoustic, Maximum phonation 
      time, s/z ratio, Vocal Fatigue Index [VFI] & Voice Disorder Outcome Profile 
      [V-DOP]), and McNemar test was used for categorical variables (vocal health 
      questionnaire, visual examination of larynx and perceptual evaluation of voice). 
      RESULTS: Teachers reported reduction of unhealthy vocal & nonvocal practices 
      after VHP. Improvements in vocal and related symptoms such as sensation of heart 
      burn (P = 0.031), discomfort around the throat (P = 0.008), inadequate breath 
      control while speaking (P = 0.016) were noticed. Perceptually, minimal 
      improvement was seen in voice quality (overall grade). However, MPT & s/z ratio 
      showed no significant difference. Improvement was observed in frequency range 
      (P = 0.004), low I(0) (P = 0.044), shimmer (P = 0.017), and DSI (P = 0.013). 
      Changes were evident in all parameters of stroboscopic evaluation (except 
      nonvibratory portion & ventricular fold hyper-adduction). V-DOP scores indicated 
      positive change in the overall severity (P = 0.002), physical (P = 0.003) and 
      functional domain (P = 0.034). VFI indicated improvement in teachers voice after 
      a period of voice rest (P = 0.048). CONCLUSION: Though VHP facilitated in 
      improving the teachers' awareness of at risk phono-traumatic behaviors and vocal 
      health, its efficiency was limited in producing physiological improvement in 
      teachers' voice. The comparison of vocal metrics before & after the treatment 
      provides information on changes that can be expected in teachers after guiding 
      them through a systematic VHP.
CI  - Copyright (c) 2021 The Voice Foundation. Published by Elsevier Inc. All rights 
      reserved.
FAU - Nallamuthu, Aishwarya
AU  - Nallamuthu A
AD  - Department of Speech Language & Hearing Sciences, Sri Ramachandra Institute of 
      Higher Education & Research, Chennai, Tamil Nadu, India.
FAU - Boominathan, Prakash
AU  - Boominathan P
AD  - Department of Speech Language & Hearing Sciences, Sri Ramachandra Institute of 
      Higher Education & Research, Chennai, Tamil Nadu, India.
FAU - Arunachalam, Ravikumar
AU  - Arunachalam R
AD  - Pro-Vice Chancellor (Medical & Health Sciences), SRM Medical College Hospital & 
      Research Centre, Kattankulathur, Tamil Nadu, India.
FAU - Mariswamy, Pushpavathi
AU  - Mariswamy P
AD  - All India Institute of Speech and Hearing, (Ministry of Health & Family Welfare, 
      Govt. of India), Manasagangothri, Mysuru, India.
LA  - eng
PT  - Journal Article
DEP - 20210119
PL  - United States
TA  - J Voice
JT  - Journal of voice : official journal of the Voice Foundation
JID - 8712262
SB  - IM
MH  - Humans
MH  - Female
MH  - School Teachers
MH  - Reproducibility of Results
MH  - *Voice Disorders
MH  - *Voice
MH  - Hygiene
MH  - *Occupational Diseases
OTO - NOTNLM
OT  - Female school teachers
OT  - Vocal health
OT  - Vocal hygiene program
OT  - Vocal metrics
COIS- Conflict of interest The authors declare that they have no conflict of interest.
EDAT- 2021/01/24 06:00
MHDA- 2023/03/08 06:00
CRDT- 2021/01/23 05:32
PHST- 2020/10/30 00:00 [received]
PHST- 2020/12/22 00:00 [revised]
PHST- 2020/12/23 00:00 [accepted]
PHST- 2021/01/24 06:00 [pubmed]
PHST- 2023/03/08 06:00 [medline]
PHST- 2021/01/23 05:32 [entrez]
AID - S0892-1997(21)00018-7 [pii]
AID - 10.1016/j.jvoice.2020.12.041 [doi]
PST - ppublish
SO  - J Voice. 2023 Mar;37(2):295.e11-295.e22. doi: 10.1016/j.jvoice.2020.12.041. Epub 
      2021 Jan 19.