Summary
Objectives
To examine the effect of a vocal loading task on measures of vocal structure and function
in females with benign vocal fold lesions (BVFLs) and determine if change is observed
in voice and lesion characteristics.
Study Design
Prospective cohort study.
Methods
Twenty-eight (n = 28) female subjects with phonotraumatic BVFLs completed a vocal
loading task of 30 minutes of reading aloud at 75-85 dBA. Multidimensional voice evaluation
was completed pre- and post-load, including audio and videostroboscopy recordings
and images for expert perceptual ratings and acoustic and aerodynamic evaluation.
Subjects also scored themselves using a 10 cm visual analogue scale for Perceived
Phonatory Effort, and completed the Evaluation of Ability to Voice Easily, a 12 item
self-report scale of current perceived speaking voice function. An exploratory rather
than confirmatory approach to data analysis was adopted. The direction and magnitude
of the change scores (pre- to post-load) for each individual, across a wide variety
of instrumental and self-report measures, were assessed against a Minimal Clinically
Important Difference criteria.
Results
Observations of change and the direction of change in vocal response of individuals
with BVFLs to 30 minutes of loud vocal load was variable. Minimal to no change was
noted for participants pre- to post-load as rated perceptually, for auditory and videostroboscopy
samples. For most instrumental measures, change was shown for many participants including
an overall improvement in aerodynamic and acoustic measures of function and efficiency
post-load for 20 participants (77%) and decline in function for 4 participants (15%).
Self-reported effort and vocal function post-load was multidirectional with similar
numbers of participants reporting no change, improved function or a decline.
Conclusion
Subjects with BVFLs demonstrate change in vocal function following 30 minutes of vocal
load. While this change can be variable and multidirectional, overall improvement
was observed in instrumental measures of function and efficiency for most participants.
Some participants perceived this change to be an increase in effort, some a reduction
in effort and some perceived no change. Improved vocal function despite relative lesion
stability can seemingly occur after loading in some pathological voices.
Key Words
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Article info
Publication history
Published online: December 23, 2021
Accepted:
November 9,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
