Research Article| Volume 33, ISSUE 5, P804.e13-804.e22, September 2019

Immediate Impact of Vocal Demand on Musical Theater Singers in Brazil

  • Claudia Pacheco
    Address correspondence and reprint requests to Claudia Pacheco, Centro de Estudos da Voz—CEV, R. Machado Bittencourt, 361/1001, Vila Mariana, São Paulo (SP) 04044-001, Brazil.
    Universidade Federal de São Paulo, São Paulo, Brazil

    Centro de Estudos da Voz—CEV, São Paulo, Brazil
    Search for articles by this author
  • Mara Behlau
    Universidade Federal de São Paulo, São Paulo, Brazil

    Centro de Estudos da Voz—CEV, São Paulo, Brazil
    Search for articles by this author



      The purpose of this research was to evaluate the immediate impact of vocal demand on musical theater singers in Brazil and to explore its relationship with the presence of voice symptoms.


      A total of 264 musical theater singers participated in this research. The group was formed by 126 women and 138 men, with a mean age of 33. All of them answered two questionnaires immediately after a show: (1) demographic data, vocal self-assessment, and a voice symptoms/signs list; and (2) Evaluation of the Ability to Sing Easily (EASE) Scale, translated and culturally adapted to Brazilian Portuguese as EASE-BR.


      The data from the two scales were correlated. The results showed that EASE-BR total and subscales scores were lower in singers with more years of singing practice. Singers who had other professional activities besides musical theater, such as opera and solo singing, also presented lower scores. The singers presented only 1.56 voice symptoms/signs. Those with more voice symptoms/signs also presented higher scores in the EASE-BR. There was a weak correlation between the voice symptoms/signs and EASE-BR. No significance was found between gender, age, singing practice hours and singing lessons and the EASE-BR scores.


      The immediate impact of vocal demand after a show is perceived as positive, and the singers considered their voices ready for a new performance. EASE-BR can be used to identify vocal changes, and it can also be used by itself because it has a weak correlation with the list of symptoms/signs.

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        • Sundberg J.
        The Science of the Singing Voice.
        Northern Illinois University, DeKalb, IL1987: 226
        • Hirano M.
        Vocal mechanisms in singing: laryngological and phoniatric aspects.
        J Voice. 1988; 2: 51-69
        • Chapman J.L.
        Singing and Teaching Singing: A Holistic Approach to Classical Voice.
        Plural, San Diego, CA2006: 311
        • Miller R.
        On the Art of Singing.
        Oxford University, New York, NY1996: 318
        • Sataloff R.T.
        Professional Voice: The Science and Art of Clinical Care.
        Singular, San Diego, CA1997: 541
        • LeBorgne W.D.
        • Rosenberg M.
        The Vocal Athlete.
        Plural, San Diego, CA2014: 217-240
        • Björkner E.
        Musical theater and opera singing—why so different? A study of subglottal pressure, voice source, and formant frequency characteristics.
        J Voice. 2008; 22: 533-540
        • LeBorgne W.D.
        • Lee L.
        • Stemple J.C.
        • et al.
        Perceptual findings on the Broadway belt voice.
        J Voice. 2010; 24: 678-689
        • Titze I.
        Mechanical stress in phonation.
        J Voice. 1994; 8: 99-105
        • Titze I.
        Princípios da Produção Vocal.
        National Center of Voice and Speech, Salt Lake City, UT2013: 407-413
        • Castelblanco L.
        • Habib M.
        • Stein D.J.
        • et al.
        Singing voice handicap and videostrobolaryngoscopy in healthy professional singers.
        J Voice. 2014; 28: 608-613
        • Kitch J.A.
        • Oates J.
        The perceptual features of vocal fatigue as self-reported by a group of actors and singers.
        J Voice. 1994; 8: 207-217
        • Miller M.
        • Verdolini K.
        Frequency and risk factors for voice problems in teachers of singing and control subjects.
        J Voice. 1995; 9: 348-362
        • Carroll T.
        • Nix J.
        • Hunter E.
        • et al.
        Objective measurements of vocal fatigue in classical singers: a vocal dosimetry pilot study.
        Otolaryngol Head Neck Surg. 2006; 135: 595-602
        • Schloneger M.J.
        Graduate student voice use and vocal efficiency in an opera rehearsal week: a case study.
        J Voice. 2010; 25: 265-273
        • Watson A.W.
        • Oakeshott P.
        • Kwame I.
        • et al.
        A comparison of Voice Handicap Index—10 scores between medical and musical theater students.
        J Voice. 2013; 27 (e21-129.e23): 129
        • Buekers R.
        Are voice endurance tests able to assess vocal fatigue?.
        Clin Otolaryngol. 1998; 23: 533-538
        • Solomon N.P.
        Vocal fatigue and its relation to vocal hyperfunction.
        Int J Speech Lang Pathol. 2008; 10: 254-266
        • McCabe D.J.
        • Titze I.R.
        Chant therapy for treating vocal fatigue among public school teachers: a preliminary study.
        Amer J Speech Lang Pathol. 2002; 11: 356-369
        • Phyland D.J.
        • Pallant J.F.
        • Benninger M.S.
        • et al.
        Development and preliminary validation of the EASE: a tool to measure perceived singing voice function.
        J Voice. 2013; 27: 454-462
        • Cohen S.M.
        • Jacobson B.H.
        • Garrett C.G.
        • et al.
        Creation and validation of the Singing Voice Handicap Index.
        Ann Otol Rhinol Laryngol. 2007; 116: 402-406
        • Silver F.
        Auditioning for the musical theatre.
        Newmarket Press, New York, NY1988
        • Bourne T.
        • Garnier M.
        • Kenny D.
        Music theatre voice: production, physiology and pedagogy.
        J Singing. 2011; 67: 437-444
        • LoVetri J.
        Contemporary commercial music.
        J Voice. 2008; 22: 260-262
        • Phyland D.J.
        • Oates J.
        • Greenwood K.M.
        Self-report voice problems among three groups of professional singers.
        J Voice. 1999; 13: 602-611
        • Sataloff R.T.
        Voice impairment, disability, handicap, and medical-legal evaluation.
        in: Sataloff R.T. Professional Voice: The Science and the Art of Clinical Care. 2nd ed. Singular, San Diego, CA2005: 1433-1441
        • Phyland D.J.
        • Pallant J.F.
        • Thibeault S.L.
        • et al.
        Measuring vocal function in professional music theater singers: construct validation of the Evaluation of the Ability to Sing Easily (EASE).
        Folia Phoniatr Logop. 2014; 66: 100-108
        • Miles B.
        • Hollien H.
        Whither belting?.
        J Voice. 1990; 4: 64-70
        • Schutte H.K.
        • Miller D.G.
        Belting and pop, nonclassical approaches to the female middle voice: some preliminary considerations.
        J Voice. 1993; 17: 142-150
        • Edwin R.
        Belting 101.
        J Singing. 1998; 55: 53-55
        • Gehling D.
        • Sridharan S.
        • Fritz M.
        • et al.
        Backstage at Broadway: a demographic study.
        J Voice. 2014; 28: 311-315
        • Green K.
        • Freeman W.
        • Edwards M.
        • et al.
        Trends in musical theatre voice: an analysis of audition requirements for singers.
        J Voice. 2014; 28: 324-327
        • Welham N.
        • Maclangan M.
        Vocal fatigue: current knowledge and future directions.
        J Voice. 2003; 17: 21-30
        • Hunter J.H.
        • Titze I.R.
        Quantifying vocal fatigue recovery: dynamic vocal recovery trajectories after a vocal loading exercise.
        Ann Otol Rhinol Laryngol. 2009; 118: 449-460
        • Colton R.H.
        • Casper J.K.
        Compreendendo os problemas da voz—uma perspectiva fisiológica ao diagnóstico e ao tratamento.
        Artes Médica, Porto Alegre, Brazil1996: 5-10
        • Nanjundeswaran C.
        • Jacobson B.H.
        • Gartner-Schmidt J.
        • et al.
        Vocal Fatigue Index (VFI): development and validation.
        J Voice. 2015; 29: 433-440
        • de Andrada e Silva M.A.
        • de Duprat A.
        Avaliação do paciente cantor.
        in: Marquezan I. Justino H. Tomé M.C. Tratado de fonoaudiologia. 1 ed. Guanabara Koogan, Rio de Janeiro, Brazil2015: 206-211
        • Rocha B.R.
        • Moreti F.
        • Amin E.
        • et al.
        Cross cultural adaptation of the Brazilian version of the protocol Evaluation of the Ability to Sing Easily.
        Codas. 2014; 26 (English, Portuguese): 535-539
        • Roy N.
        • Merrill R.M.
        • Thibeault S.
        • et al.
        Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.
        J Speech Lang Hear Res. 2004; 47: 542-551
        • Mukaka M.M.
        Statistics corner: a guide to appropriate use of correlation coefficient in medical research.
        Malawi Med J. 2012; 24: 69-71
        • Behlau M.
        • Madazio G.
        • Feijó D.
        • et al.
        Avaliação da Voz.
        in: Behlau M. Voz: O Livro do Especialista. 1 ed. Revinter, Rio de Janeiro, Brazil2001: 83-245
        • Evans R.W.
        • Evans R.I.
        • Carvajal S.
        • et al.
        A survey of injuries among Broadway performers.
        Am J Public Health. 1996; 86: 77-80
        • Kitch J.A.
        • Oates J.
        • Greenwood K.
        Performance effects on the voice of 10 choral tenors: acoustic and perceptual findings.
        J Voice. 1996; 10: 217-227
        • Moreti F.
        • Rocha C.
        • Borrego M.C.M.
        • et al.
        Voice handicap in singing: analysis of the Modern Singing Handicap Index—MSHI questionnaire.
        Rev Soc Bras Fonoaudiol. 2011; 16 (English, Portuguese): 146-151
        • Barbanti V.J.
        Treinamento Físico: bases científicas.
        CLR Balieiro, São Paulo, Brazil1986: 54 (e 55, 95-97)
        • Vintturi J.
        • Paavo A.
        • Eija-Riitta L.
        • et al.
        Objective analysis of vocal warm-up with special references to ergonomic factors.
        J Voice. 2001; 15: 36-53
        • Zambon F.C.
        Fadiga vocal em professores e sua relação com a fadiga geral ao longo de um ano letivo [tese].
        Universidade Federal de São Paulo, São Paulo, Brazil2015
        • Donahue E.M.
        • LeBorgne W.D.
        • Brehm S.B.
        • et al.
        Reported vocal habits of first-year undergraduate musical theater majors in a preprofessional training program: a 10-year retrospective study.
        J Voice. 2014; 28: 316-323
        • Ávila M.E.
        • Oliveira G.
        • Behlau M.
        Classical singing handicap index (CSHI) in erudite singers.
        Pro Fono. 2010; 22 (English, Portuguese): 221-226
        • Moreti F.
        • Ávila M.E.
        • Rocha C.
        • et al.
        Influence of complaints and singing style in singers voice handicap.
        J Soc Bras Fonoaudiol. 2012; 24 (English, Portuguese): 296-300
        • Behlau M.
        • Zambon F.
        • Guerrieri A.C.
        • et al.
        Epidemiology of voice disorders in teachers and non-teachers in Brazil: prevalence and adverse effects.
        J Voice. 2012; 26 (e9-18): 665
        • Behlau M.
        • Feijó D.
        • Madazio G.
        • et al.
        Voz Profissional: aspectos gerais e atuação fonoaudiológica.
        in: Behlau M. Voz: O Livro do Especialista. 2 ed. Revinter, Rio de Janeiro, Brazil2005: 288-367
        • Sivansankar M.
        • Leydon C.
        The role of hydration in vocal fold physiology.
        Curr Opin Otolaryngol Head Neck Surg. 2010; 18: 171-175
        • Powers S.K.
        • Howley E.T.
        Fisiologia do exercício—teoria e aplicação ao condicionamento e ao desempenho.
        8a ed. Manole, Barueri, Brazil2014: 218-245 (p. 260-311)
        • Stemple J.C.
        • Stanley J.
        • Lee L.
        Objective measures of voice production in normal subjects following prolonged voice use.
        J Voice. 1995; 9: 127-133
        • Solomon N.P.
        • DiMattia M.S.
        Effects of a vocally fatiguing task and systematic hydration on phonation threshold pressure.
        J Voice. 2000; 14: 341-362
        • Titze I.
        • Svec J.G.
        • Popolo O.S.
        Vocal dose measures: quantifying accumulated vibration exposure in vocal fold tissues.
        J Speech Lang Hear Res. 2003; 46: 919-932