Summary
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 I0 (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.
Key Words
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Article info
Publication history
Published online: January 19, 2021
Accepted:
December 23,
2020
Footnotes
The study was self-funded.
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
