Felipe Moreti

Desvantagem vocal no canto: análise do protocolo Índice de Desvantagem para o Canto Moderno - IDCM

PURPOSE: To assess the sensitivity of the Italian self-assessment questionnaire Modern Singing Handicap Index - MSHI, translated and culturally adapted to Brazilian Portuguese as Indice de Desvantagem para o Canto Moderno - IDCM, comparing scores of amateur choir singers with or without voice complaints and non-singers according to gender, singing voice classification and singing activities. METHODS: Two hundred twenty-six adults with ages between 16 and 66 years were divided into three groups: 58 singers with vocal complaints - SC; 112 singers without vocal complaints - SwC and 56 non-singers without vocal complaints - NS. The singers were selected from five university choirs of a capella Brazilian popular music, lead by the same conductor. The non-singers were recruited at the same institutions of the singers with similar demographic characteristics. The subjects filled the IDCM individually. The IDCM is a questionnaire with 30 items divided into three subscales: disability (functional domain), handicap (emotional domain) and impairment (organic domain). The singers also did a self-assessment of their singing activities. RESULTS: The mean IDCM score of the SC group (26.91) was higher than the that of the SwC (16.61), and both were higher than that of the NS group (7.79). For the three groups, the impairment subscale showed higher scores, followed by disability and handicap. There were no score differences regarding gender, singing voice classification and singing activities. CONCLUSION: The questionnaire proved to be sensitive for modern singers with vocal complaints. Choir singers with vocal complaints had higher self-reported handicap in comparison to choir singers without vocal complaints and non-singers. Aspects of organic nature were highlighted with larger deviations.

Influence of complaints and singing style in singers voice handicap

The aim of this research was to verify whether the difference of singing styles and the presence of vocal complaints influence the perception of voice handicap of singers. One hundred eighteen singing voice handicap self-assessment protocols were selected: 17 popular singers with vocal complaints, 42 popular singers without complaints, 17 classic singers with complaints, and 42 classic singers without complaints. The groups were similar regarding age, gender and voice types. Both protocols used--Modern Singing Handicap Index (MSHI) and Classical Singing Handicap Index (CSHI)--have specific questions to their respective singing styles, and consist of 30 items equally divided into three subscales: disability (functional domain), handicap (emotional domain) and impairment (organic domain), answered according to the frequency of occurrence. Each subscale has a maximum of 40 points, and the total score is 120 points. The higher the score, the higher the singing voice handicap perceived. For statistical analysis, we used the ANOVA test, with 5% of significance. Classical and popular singers referred higher impairment, followed by disability and handicap. However, the degree of this perception varied according to the singing style and the presence of vocal complaints. The classical singers with vocal complaints showed higher voice handicap than popular singers with vocal complaints, while the classic singers without complaints reported lower handicap than popular singers without complaints. This evidences that classical singers have higher perception of their own voice, and that vocal disturbances in this group may cause greater voice handicap when compared to popular singers.

Dores corporais em teleoperadores e sua relação com o uso da voz em atividades laborais

Purpose: To characterize types of body aches presented by call center operators and to verify the relationship of the selected body aches with voice use in work activities. Methods: 235 call center operators and 235 individuals from the general population responded to a questionnaire with closed questions about body aches (classified into proximal and distal larynx aches), voice problems, profes sional activity and search for specialized help. It was investigated whether there was a relationship between each type of pain and the other aspects addressed by the questionnaire. Results: Body aches were reported by both groups; however call center operators reported a greater number of them. Call center operators also reported having greater need of calling sick and more aches (shoulders, neck, head, back, arms, hands and ears) than the general population. There was a relationship between most of the body aches with voice problem, absenteeism from work due to voice problems and appointment with an otolaryngologist in the group of call center operators. In the general population, the workload tended to relate to chest and hand pains. There was no difference between the groups when the body aches were compared. Conclusion: Call center operators suffer from more body aches that are both proximal to and distal from the larynx and have greater need to call sick due to voice problems than the general population, fact that highlights the vocal and physical fatigue of these professionals.

Voice symptoms and vocal deviation self-assessment in different types of dysphonia

PURPOSE To identify the relationship among the type of dysphonia, vocal deviation self-assessed and the presence of voice symptoms in adults. METHODS One hundred sixty-four subjects of both genders (58 males and 106 females, mean age 42.89 years) diagnosis of dysphonia, divided into three groups according to the type of dysphonia: 87 individuals with functional dysphonia, 35 individuals with organofunctional dysphonia and 42 individuals with organic dysphonia, answered the Brazilian validated version of Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV), that consists of 30 questions with four scores: Impairment, Emotional, Physical and Total, and self-assessed their voices as excellent, very good, good, fair or poor. RESULTS According to the dysphonia type, there were differences in ESV Impairment, Emotional and Total mean scores, which was not found in the Physical score. The Impairment, Emotional and Total mean scores were higher in organic dysphonia, followed by organofunctional dysphonia and finally functional dysphonia. When the vocal self-assessment is poor, the higher are the deviations in the Impairment, Emotional and Total ESV scores. CONCLUSIONS Individuals with organic dysphonia reported higher perception of voice symptoms, followed by subjects with organofunctional dysphonia and finally individuals with functional dysphonia. In general, individuals with dysphonia presented physical voice symptoms, regardless of the type of the dysphonia. Finally, there are direct correlations between Impairment, Emotional and Total ESV scores and the vocal self-assessment.

Grau de quantidade de fala e intensidade vocal de teleoperadores em ambiente laboral e extralaboral

PURPOSE: To investigate self-perceived talkativeness and vocal loudness in call center operators during labor and extra-labor situations and compare it with vocal self-assessment and perceptual analysis. METHODS: Participants were 299 male and female call center operators working in an inbound and outbound mode. Their average age was 27.1 years. The procedures were as follows: Talkativeness and Vocal Loudness Test in two situations of communication - work and extra-work; vocal self-assessment and perceptual analysis. RESULTS: There are more women than men working in telemarketing. Regarding gender, women talk more in the work situation when compared to men. By comparing talkativeness and vocal loudness in work and extra-work situations, increased talkativeness and vocal loudness were observed in the work environment. CONCLUSION: The call center operator is a voice professional that reports speaking more and more loudly in work situations. Women talk more than men in any of the situations evaluated. There was no significant correlation between talkativeness, vocal loudness and self-assessment of voice.

Efeitos da reabilitação fonoaudiológica na desvantagem vocal de cantores populares profissionais

Purpose To verify the effect of a vocal rehabilitation program in voice handicap by a self-reported questionnaire in popular professional singers with dysphonia. Methods Forty-nine professional popular singers, between 18 and 45 years old, assessed by the ENT and diagnosed with behavioral dysphonia, with or without mass lesions, that were related to of vocal behavior, were submitted to vocal rehabilitation. The singers were divided into two groups: Experimental Group (EG), with 29 singers undergoing voice therapy and a Control Group (CG), with 20 singers on the clinical waiting list for vocal rehabilitation. The CG was attended after the research finished. All participants completed the Moderns Singing Handicap Index (MSHI) and self-assessed their speaking and singing voices at the first and last session of therapy (assessment and reassessment). Results There were significant differences between the experimental and control groups in the post- therapy for all MSHI protocol scores. There were no changes in the number of singing lessons after the intervention. The EG reported perceiving improvement in the speaking and singing vocal qualities. Conclusion Professional popular singers who performed voice therapy had lower self-assessed of voice handicap while singing, when compared with singers with vocal complaints and without treatment.

Eficiência e valores de corte do Perfil de Participação e Atividades Vocais para não professores e professores

PURPOSE To identify the efficiency characteristics and cutoff values of the dimensions of the Voice Activity and Participation Profile (VAPP) protocol, which discriminates the dysphonic and vocally healthy individuals; to verify if the cutoff values remain the same for a sample of teachers. METHODS Efficiency characteristics and cutoff values of VAPP data from 171 subjects were analyzed by receiver-operating characteristic (ROC) curve: 90 teachers (60 dysphonic and 30 vocally healthy individuals, with a similar mean age, p=0.418) and 81 nonteachers (48 dysphonic and 33 vocally healthy individuals, with a similar mean age, p=0.934). RESULTS The area under the ROC curve (AUC) and the cutoff values of the total score of VAPP for discriminating the individuals with and without dysphonia are different for the nonteachers and teachers. The nonteachers presented AUC=0.986 (p<0.001) and 4.5 points of cutoff of the total score of VAPP (sensitivity=95.8%; specificity=90.9%); the teachers presented AUC=0.872 (p<0.001) and 14.6 points of cutoff of the total score of VAPP (sensitivity=91.7%, specificity=75.9%). CONCLUSION The cutoff values of VAPP are different for the nonteachers and teachers, being higher for the teachers but with greater sensitivity and specificity for the nonteachers, and can be used to screen large populations with the risk of voice disorders.

Triagem da Afinação Vocal: comparação do desempenho de musicistas e não musicistas

PURPOSE To develop a simple and quick-to-apply procedure for pitch-matching scanning that contains vocal imitation tasks of musical sounds of different tones and the temporal ordination of three different tones; to verify its applicability, by comparing the performance of musicians and non-musicians. METHODS Participants were 32 adults of both genders without vocal, hearing and/or auditory processing complaints. They were equally divided into two groups: musicians group--MG and non-musicians group--NMG. All participants underwent the Pitch-matching Scanning that included musical stimuli compatible with men and women singing vocal range gathered into two types of tasks: isolate tones and three-tone sequences. Participants were instructed to listen to them and to reproduce them vocally. Voice samples were recorded, analyzed acoustically, and right and wrong matches for the two tasks were characterized. The variables regarding the comparison between groups and types of tasks were statistically analyzed. RESULTS A difference was found between groups, and the MG presented greater number of right matches in both tasks. CONCLUSION The Pitch-matching Scanning was developed and was sensitive to evaluate and compare the performance between groups. Thus, it can be used as a tool for pitch-matching tracking. Musicians presented better performance than non-musicians in the Pitch-matching Scanning.

Desconforto do trato vocal em professores após atividade letiva

Purpose To evaluate the vocal tract discomfort (VTD) reported by teachers, comparing their vocal self-assessment at three different times: before teaching, after four hours of teaching, and after eight hours of teaching. Methods The study sample was composed of 50 teachers: 42 women and eight men. The participating teachers were divided into two groups according to the cutoff value of the Voice Symptom Scale (VoiSS): Vocal Risk Group (VRG) and Vocally Healthy Group (VHG). The List of Vocal Signs and Symptoms (LVSS) was used to identify the number of vocal symptoms in each group. The groups were evaluated at three specific moments (before (BT) and after four (4HT) and eight (8HT) hours of teaching) by means of the Vocal Tract Discomfort Scale (VTD scale) and vocal self-assessment. Results The VRG presented more vocal signs and symptoms of the LVSS than the VHG (total: VHG=0.56/VRG=1.60, p<0.001; work-related VHG=0.79/VRG=2.49, p<0.001). The VHG did not report change in discomfort for both frequency (p=1.132) and severity (p=0.431) and showed better vocal self-assessment (BT=0.67; 4HT=0.96; 8HT=0.96, p=0.007). However, the VRG presented vocal tract discomfort after four and eight hours of teaching for both frequency (BT=1.60; 4HT=2.49; 8HT=2.95, p<0.001) and severity (BT=1.79; 4HT=2.52; 8HT=3.12, p<0.001) and worse voice self-assessment (BT=2.00; 4HT=2.42; 8HT=3.00, p<0.001). Conclusion Teachers at vocal risk present worse vocal self-assessment and increased vocal tract discomfort throughout the teaching working day.

CONDICIONAMENTO VOCAL INDIVIDUALIZADO PARA PROFISSIONAIS DA VOZ CANTADA – RELATO DE CASOS

This study is about the development of customized vocal conditioning programs to a specific demand of three professional singers. We selected three professional singers that were undergoing voice therapy to participate in this study: a singer and actress of Brazilian musical theater, country music singer and a rock singer. All subjects underwent speech-language pathology and ENT assessment. They all presented complaints related to tiredness and fatigue after vocal used and/or vocal improvement. The customized vocal conditioning program was one of the stages involving vocal therapy and it was customized according to the singers demand, need and availability. The singer and actress of Brazilian musical theater joined easily to the customized vocal conditioning proposal, reporting a better physiological mobilization, which gave her improvements before starting the artistical technique she was used too. The country singer also joined easily to the customized vocal conditioning program, without any difficulty, and reported extreme improvement in his comfort and his performance when singing after undergoing the selected vocal exercises. The rock singer showed greater flexibility on his vocal tract, on the stability issue in singing, on the expansion of his vocal range, he also showed an articulatory accuracy improvement and reduction of the excessive global constriction after beginning the customized vocal conditioning program. The customized vocal conditioning program shows positive effects, especially for singers, because it works exactly over the demand that will be used by the singers, working on specific exercises and focusing on their needs.