Laura E Toles1, Andrew J Ortiz2, Katherine L Marks3, Daryush D Mehta4, Jarrad H Van Stan4, Robert E Hillman4. 1. Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, Massachusetts; MGH Institute of Health Professions, Rehabilitation Science, Charlestown, Massachusetts. Electronic address: lauratoles@gmail.com. 2. Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, Massachusetts. 3. Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, Massachusetts; MGH Institute of Health Professions, Rehabilitation Science, Charlestown, Massachusetts. 4. Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, Massachusetts; MGH Institute of Health Professions, Rehabilitation Science, Charlestown, Massachusetts; Harvard Medical School, Department of Surgery, Boston, Massachusetts.
Abstract
OBJECTIVES: Singers, college students, and females are groups known to be at an elevated risk of developing functional/hyperfunctional voice disorders; therefore, female college students majoring in vocal performance may be at an even higher risk. To mitigate this risk, it would be helpful to know the "safe limits" for voice use that would help maintain vocal health in this vulnerable group, but there is a paucity of high-quality objective information upon which to base such limits. This study employed weeklong ambulatory voice monitoring in a large group of vocally healthy female college student singers to begin providing the types of objective data that could be used to help develop improved vocal health guidelines. METHODS: Participants included 64 vocally healthy females currently enrolled in a vocal performance or similar program at a college or university. An ambulatory voice monitor recorded neck-surface acceleration throughout a typical week. A singing classifier was applied to the data to separate singing from speech. Weeklong vocal dose measures and distributional characteristics for standard voice measures were computed separately for singing and speech, and for both types of phonation combined. RESULTS: Participants spent 6.2% of the total monitoring time speaking and 2.1% singing (with total phonation time being 8.4%). Singing had a higher fo mode, more pitch variability, higher average sound pressure level (SPL), negatively skewed SPL distributions, lower average CPP, and higher H1-H2 values than speaking. CONCLUSIONS: These results provide a basis for beginning to establish vocal health guidelines for female students enrolled in college-level vocal performance programs and for future studies of the types of voice disorders that are common in this group. Results also demonstrate the potential value that ambulatory voice monitoring may have in helping to objectively identify vocal behaviors that could contribute to voice problems in this population.
OBJECTIVES: Singers, college students, and females are groups known to be at an elevated risk of developing functional/hyperfunctional voice disorders; therefore, female college students majoring in vocal performance may be at an even higher risk. To mitigate this risk, it would be helpful to know the "safe limits" for voice use that would help maintain vocal health in this vulnerable group, but there is a paucity of high-quality objective information upon which to base such limits. This study employed weeklong ambulatory voice monitoring in a large group of vocally healthy female college student singers to begin providing the types of objective data that could be used to help develop improved vocal health guidelines. METHODS: Participants included 64 vocally healthy females currently enrolled in a vocal performance or similar program at a college or university. An ambulatory voice monitor recorded neck-surface acceleration throughout a typical week. A singing classifier was applied to the data to separate singing from speech. Weeklong vocal dose measures and distributional characteristics for standard voice measures were computed separately for singing and speech, and for both types of phonation combined. RESULTS: Participants spent 6.2% of the total monitoring time speaking and 2.1% singing (with total phonation time being 8.4%). Singing had a higher fo mode, more pitch variability, higher average sound pressure level (SPL), negatively skewed SPL distributions, lower average CPP, and higher H1-H2 values than speaking. CONCLUSIONS: These results provide a basis for beginning to establish vocal health guidelines for female students enrolled in college-level vocal performance programs and for future studies of the types of voice disorders that are common in this group. Results also demonstrate the potential value that ambulatory voice monitoring may have in helping to objectively identify vocal behaviors that could contribute to voice problems in this population.
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