Summary
Vocal fatigue has remained an elusive construct—despite its significant impact on
communication, vocation, and quality of life. Current frameworks define vocal fatigue
in the context of vocal demands and vocal demand-responses. However, the impact of
factors like individuals’ baseline vocal fitness and perception of the demand are
not well understood. What is also not well understood are the effects of specific
vocal demand ingredients on an individual's vocal demand responses. Furthermore, current
outcome measures utilized to capture vocal fatigue lack sensitivity and underlying
mechanisms are poorly understood. These gaps have led to inconclusive next steps in
how to best define, assess, monitor, and manage vocal fatigue. A conceptual framework
is needed to study and better understand vocal fatigue constructs. Such a framework
should consider the individual's baseline physiology, psychology, key vocal demand
ingredients, and biophysiological mechanisms underlying demand responses. The objective
of this paper is to help the reader better understand the complex and heterogeneous
nature of vocal fatigue and its impact on reliable assessment and monitoring. Future
studies will require better elucidation of vocal demand ingredients, will need more
sensitive vocal demand response measures, and will need to take in to account an individual's
baseline physiology and psychological factors.
Key Words
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References
- Chant therapy for treating vocal fatigue among public school teachers: a preliminary study.Am J Speech Lang Pathol. 2002; 11: 356
- Toward a consensus description of vocal effort, vocal load, vocal loading, and vocal fatigue.J Speech Lang Hear Res. 2020; 63: 509-532https://doi.org/10.1044/2019_JSLHR-19-00057
- Vocal attrition in teachers: survey findings.Eur J Disord Commun. 1993; 28: 177-185
- Occupational risk factors associated with voice disorders among teachers.Ann Epidemiol. 2004; 14: 786-792https://doi.org/10.1016/j.annepidem.2004.03.004
- The perceptual features of vocal fatigue as self-reported by a group of actors and singers.J Voice. 1994; 8: 207-214https://doi.org/10.1016/S0892-1997(05)80291-7
- Vocal fatigue among teachers.FPL. 1993; 45: 120-129https://doi.org/10.1159/000266237
- The interaction of surface hydration and vocal loading on voice measures.J Voice. 2017; 31: 211-217https://doi.org/10.1016/j.jvoice.2016.07.005
- Design of a clinical vocal loading test with long-time measurement of voice.J Voice. 2015; 29: 261.e13-261.e27
- Respiratory and laryngeal function in teachers: pre-and post-vocal loading challenge.J Voice. 2019; 33: 302-309
- Vocal impact of a prolonged reading task at two intensity levels: objective measurements and subjective self-ratings.J Voice. 2012; 26: e177-e186
- Quantitative high-speed laryngoscopic analysis of vocal fold vibration in fatigued voice of young karaoke singers.J Voice. 2013; 27: 753-761
- Vocal impact of a prolonged reading task in dysphonic versus normophonic female teachers.J Voice. 2012; 26: 820.E1-820.E13
- The effectiveness of low-level light therapy in attenuating vocal fatigue.J Voice. 2017; 31: 384.e15-384.e23
- Vocal fatigue in prospective vocal professionals.J Voice. 2021; 35: 247-258
- Vocal fatigue—do young speech-language pathologists practice what they preach?.J Voice. 2018; https://doi.org/10.1016/j.jvoice.2018.11.015
- Physiologic features of vocal fatigue: electromyographic spectral-compression in laryngeal muscles.Laryngoscope. 2006; 116: 959-965
- Gender differences in the reporting of vocal fatigue in teachers as quantified by the vocal fatigue index.Anna Otol Rhinol Laryngol. 2017; 126: 813-818https://doi.org/10.1177/0003489417738788
- Objective measurement of vocal fatigue in classical singers: a vocal dosimetry pilot study.Otolaryngol Head Neck Surg. 2006; 135: 595-602
- Dynamically monitoring vocal fatigue and recovery using aerodynamic, acoustic, and subjective self-rating measurements.J Voice. 2019; 33: 809.e11-809.e18
- The effect of pulmonary function on the incidence of vocal fatigue among teachers.J Voice. 2020; 34: 539-546
- Acoustic changes of the voice as signs of vocal fatigue in radio broadcasters: preliminary findings.Acta Otorrinolaringol (English Edition). 2013; 64: 176-183
- Phonatory function after prolonged voice use in brazilian woman.CoDAS. 2015; 27: 392-399
- Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading task: a study of vocal fatigue.J Voice. 2004; 18: 454-466
- Physiological attributes of vocal fatigue and their acoustic effects: a synthesis of findings for a criterion-based prevention of acquired voice disorders.J Voice. 2009; 24: 324-336
- Objective measures of voice production in normal subjects following prolonged voice use.J Voice. 1995; 9: 127-133
- Acoustic measures of and self-reports of vocal fatigue by female teachers.J Voice. 2008; 22: 283-289
- Fatigue, effort and vocal discomfort in teachers after teaching activity.CoDAS. 33. Sociedade Brasileira de Fonoaudiologia, Brazil2021
- Vocal fatigue in dysphonic teachers who seek treatment.CoDAS. 31. Sociedade Brasileira de Fonoaudiologia, Brazil2019
- Cepstral measures to analyze vocal fatigue in individuals with hyperfunctional voice disorder.J Voice. 2021; 35: 815-821
- Mitigating the effects of acute vocal exertion in individuals with vocal fatigue.Laryngoscope. 2021; 131: 2732-2739
- Vocal fatigue in doctors: evaluation with subjective and objective acoustic parameters.Logoped Phoniatr Vocol. 2021; 46: 35-41
- Vocal fatigue in professors at the beginning and end of the school year.CoDAS. 32. Sociedade Brasileira de Fonoaudiologia, Brazil2019
- Self-assessment of vocal fatigue in muscle tension dysphonia and vocal nodules: a preliminary analysis of the discriminatory potential of the croatian adaptation of the Vocal Fatigue Index (VFI-C).J Voice. 2021; 35 (-e1): 325
- The impact of a vocal loading task on voice characteristics of female speakers with benign vocal fold lesions.J Voice. 2021; (Published online)https://doi.org/10.1016/j.jvoice.2021.11.009
- Characterization of primary muscle tension dysphonia using acoustic and aerodynamic voice metrics.J Voice. 2021; (Published online)https://doi.org/10.1016/j.jvoice.2021.05.019
- Translating fatigue to human performance.Med Sci Sports Exercise. 2016; 48: 2228-2238
- A semiautomated protocol towards quantifying vocal effort in relation to vocal performance during a vocal loading task.J Voice. 2022; (Published online)https://doi.org/10.1016/j.jvoice.2022.01.003
- Metabolic mechanisms of vocal fatigue.J Voice. 2017; 31: 378.e1-378.e11https://doi.org/10.1016/j.jvoice.2016.09.014
- Muscle bioenergetic considerations for intrinsic laryngeal skeletal muscle physiology.J Speech Lang Hear Res. 2017; 60: 1254-1263https://doi.org/10.1044/2016_JSLHR-S-16-0192
- Ovine vocal fold tissue fatigue response to accumulated, large-amplitude vibration exposure at phonatory frequencies.J Speech Lang Hear Res. 2019; 62: 4291-4299https://doi.org/10.1044/2019_JSLHR-S-19-0181
- Quantifying vocal fatigue recovery: dynamic vocal recovery trajectories after a vocal loading exercise.Ann Otol Rhinol Laryngol. 2009; 118: 449-460https://doi.org/10.1177/000348940911800608
- Effects of a vocally fatiguing task and systemic hydration on phonation threshold pressure.J Voice. 2000; 14: 341-362
- The effect of anesthesia of the internal branch of the superior laryngeal nerve upon phonation: an Aerodynamic Study.Folia Phoniatr Logop. 1975; 27: 337-349https://doi.org/10.1159/000264005
- Laryngeal myotatic reflexes and phonation.Folia Phoniatr Logop. 1974; 26: 249-264https://doi.org/10.1159/000263784
- Spiral nerve-endings (proprioceptors) in the human vocal muscle.Nature. 1961; 190: 726-727https://doi.org/10.1038/190726b0
- On the role of the reticular formation in vocal pattern generation.Behav Brain Res. 2007; 182: 308-314https://doi.org/10.1016/j.bbr.2006.11.027
- Neural pathways underlying vocal control.Neurosci Biobehav Rev. 2002; 26: 235-258https://doi.org/10.1016/S0149-7634(01)00068-9
- Neuroendocrine and substrate responses to altered brain 5-HT activity during prolonged exercise to fatigue.J Appl Physiol. 1993; 74: 3006-3012https://doi.org/10.1152/jappl.1993.74.6.3006
- Vocal Fatigue Index (VFI): development and validation.J Voice. 2015; 29: 433-440https://doi.org/10.1016/j.jvoice.2014.09.012
Article info
Publication history
Published online: August 06, 2022
Accepted:
July 7,
2022
Publication stage
In Press Corrected ProofFootnotes
Funding: None.
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
