Journal of Voice最新文献

{"title":"The Effects of Masked and Delayed Auditory Feedback on Fundamental Frequency Modulation in Vocal Vibrato","authors":"","doi":"10.1016/j.jvoice.2022.01.029","DOIUrl":"10.1016/j.jvoice.2022.01.029","url":null,"abstract":"<div><h3>Purpose</h3><p>Although relatively precise control over the extent and rate of fundamental frequency (<em>f</em>_o<span>) modulation may be needed for optimal production of vibrato, the role of auditory feedback<span> in controlling vibrato is not well understood. Previous studies altered the gain and timing of auditory feedback in singers producing vibrato and showed inconsistent effects on the extent and rate of </span></span><em>f</em>_o<span> modulation, which may have been related to small sample sizes or limited analyses. Therefore, the purpose of this study was to further investigate whether the gain or timing of auditory feedback impacts control of vibrato in a larger sample of speakers and with advanced statistical analyses.</span></p></div><div><h3>Method</h3><p>Ten classically-trained singers produced sustained vowels with vibrato while their auditory feedback was masked with pink noise or multi-talker babble to reduce the gain of their auditory feedback and while their auditory feedback was delayed by about 200 or 300 milliseconds to alter the timing of their auditory feedback. Acoustical analyses measured changes in the extent and rate of <em>f</em>_o modulation in the masked and delayed trials relative to control trials. Bayesian modeling was used to analyze the effects of noise-masked, babble-masked, and delayed auditory feedback on the extent and rate of <em>f</em>_o modulation.</p></div><div><h3>Results</h3><p>There was compelling evidence that noise masking increased the extent of <em>f</em>_o modulation, and babble masking increased the variability in the rate of <em>f</em>_o modulation (ie, jitter of <em>f</em>_o modulation). Masked auditory feedback did not affect the average rate of <em>f</em>_o modulation. Delayed auditory feedback did not affect the extent, rate, or jitter of <em>f</em>_o modulation.</p></div><div><h3>Conclusions</h3><p>The current study demonstrated that reducing the gain of the auditory feedback with noise masking increased the extent of <em>f</em>_o modulation but did not affect the average rate of <em>f</em>_o modulation in classically-trained singers producing vibrato. Reducing the gain of the auditory feedback with babble masking and altering the timing of auditory feedback with imposed delays did not affect the average extent or rate of <em>f</em>_o modulation. However, babble masking increased the jitter of <em>f</em>_o modulation rate, which suggests that modulated auditory feedback may affect the periodicity of <em>f</em>_o modulation from one modulation cycle to the next. These findings clarify the role of auditory feedback in controlling vibrato and may inform the current reflex-resonance models of vibrato.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for Voice and Communication Training Software for Transgender and Nonbinary People","authors":"","doi":"10.1016/j.jvoice.2022.03.002","DOIUrl":"10.1016/j.jvoice.2022.03.002","url":null,"abstract":"<div><p>Transgender and gender diverse people often experience voice-gender incongruence, which is inversely correlated with health and quality of life. Such incongruence could be reduced with voice and communication training, but expert-administered training is often inaccessible while self-guided training is difficult and potentially risky. Training could alternatively be provided through software (eg, smartphone apps), but such software is at an early stage. This qualitatively driven mixed-methods study thus includes surveys and interviews with 21 transfeminine, transmasculine and nonbinary people to identify general views of voice and communication training software as well as most desirable features of such software. Participants were positive about the general idea and described ways to effectively implement four critical features: feedback, accountability, automated goal setting, and training characteristics other than pitch. They also discussed optional or undesirable features. These findings may inform development of voice and communication training software, thus improving health and quality of life for gender minorities.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72540473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Gender Affirming Voice Training for Transfeminine Clients: A Comparison of Traditional Versus Intensive Delivery Schedules","authors":"","doi":"10.1016/j.jvoice.2022.03.001","DOIUrl":"10.1016/j.jvoice.2022.03.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Gender affirming voice training is a service provided by speech language pathologists to members of the trans and gender diverse community. While there is some evidence to support the effectiveness of this training, the evidence base is limited by a lack of prospective studies with large sample sizes. Finally, there has been only limited research investigating the effectiveness of this training when delivered on intensive (compressed) schedules, even though such schedules are used in clinical practice and may have practical benefits such as increasing service access for this vulnerable population.</p></div><div><h3>Methodology</h3><p>This study aimed to investigate and compare the effectiveness gender affirming voice training among 34 trans individuals presumed male at birth aiming to develop a perceptually feminine/female-sounding voice. Among these 34 participants, 17 received their training on a traditional schedule (one 45-minute session per week over 12 weeks) and 17 on an intensive scheduled (three 45-minute sessions per week over 4 weeks). Building on a previous mixed methodological study which indicated that these two training groups were equally satisfied with training outcomes, the current study utilised a wide range of self-report, acoustic, and auditory-perceptual outcome measures (including self-ratings and listener-ratings of voice) to investigate training effectiveness.</p></div><div><h3>Discussion</h3><p>Results from this study indicated that both training programs were similarly effective, producing positive statistically significant change among participants on a range of outcome measures. Participants in both groups demonstrated significant auditory-perceptual and acoustic voice change and reported increased satisfaction with voice, increased congruence between gender identity and expression, and a reduction in the negative impact of voice concerns on everyday life. However, as has been the case in past studies, training was not sufficient for all participants to achieve their goal of developing a consistently feminine/female-sounding voice.</p></div><div><h3>Conclusion</h3><p>This study provides evidence to suggest that gender affirming voice training for transfeminine clients may be similarly effective whether delivered intensively or traditionally. This study provides evidence to support the practice of using a wide range of outcome measures to gain holistic insight into client progress in gender affirming voice training programs.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72754821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of Primary School Teachers Towards Voice Problems and Vocal Health-Seeking Behaviors: A qualitative study","authors":"","doi":"10.1016/j.jvoice.2022.03.022","DOIUrl":"10.1016/j.jvoice.2022.03.022","url":null,"abstract":"<div><h3>Objective</h3><p><span>Teachers are the most common occupational group reporting to the voice clinics with </span>dysphonia across the globe. However, less is known about teachers’ perceptions about their voice and voice problems. Hence the present study aimed to explore teachers’ perception about their teaching voice, voice problems and vocal health-seeking behaviors.</p></div><div><h3>Method</h3><p>A qualitative phenomenological research<span> design using semi-structured interviews were conducted with fifteen female primary school teachers. Participants were asked to express their perception of teaching voice, vocal health care knowledge, and vocal hygiene practices. Using inductive analysis, the researchers converted the raw data into concepts or themes and discussed.</span></p></div><div><h3>Result</h3><p>The present study results showed that teachers perceive voice as the primary tool for their profession. However, teachers consider voice problems as part of their professional commitments. Despite knowing the harmful effects of voice problems, teachers’ pay less attention to their voice problems and perceive them as usual, unavoidable and part of their profession. Due to their demanding work schedule and not getting enough support from the management, they hesitate to consult medical professionals unless it severely affects them.</p></div><div><h3>Conclusions</h3><p>The data obtained from this study can be used to improve the teachers’ knowledge regarding vocal health and convince the school management to extend their support for the successful implementation of the vocal health training programs for teachers.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87701519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure, Flow, and Glottal Area Waveform Profile Changes During Phonation Using the Acapella Choice Device","authors":"","doi":"10.1016/j.jvoice.2022.02.010","DOIUrl":"10.1016/j.jvoice.2022.02.010","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Vibratory positive expiratory pressure (PEP) devices are now commonly used as a resource for voice therapy. PEP devices promote improved vocal economy with the added benefit of producing a massage effect in the </span>vocal tract<span>. Although the benefits of PEP devices for voice have already been demonstrated, their impact on the vocal source is still not very clear. This study assesses the impact of phonation into the </span></span>Acapella Choice (a type of PEP device) on the voice.</p></div><div><h3>Methods</h3><p>Three normophonic subjects underwent high-speed videoendoscopy assessment while pressure, flow and electroglottographic data was collected.</p></div><div><h3>Results</h3><p><span>Phonation into the Acapella device produces large changes in the pressure and flow profiles consequently affecting the voice source. In specific, when intraoral pressure increases as a consequence of the downward movement of the rocker arm in the Acapella device (reduction of the airflow outlet), phonation is hindered, demonstrated by the lower amplitude of vibration of the </span>vocal folds and weaker modulation of the pressure and flow values by the glottal cycle. When the rocker arm in the Acapella device opens (increasing the airflow outlet), the opposite trend is observed where vocal fold vibration is aided and the modulation of pressure and flow by the vocal cycle increases. Based on the pressure and flow signals, we can assume that the impedance of the vocal tract alternates between two dominant regimes: increased inertive reactance (aided vibration) and increased resistance (hindered vibration).</p></div><div><h3>Conclusions</h3><p>PEP devices, such as the Acapella device, are efficient in modulating the pressure and flow profiles in the vocal tract leading to the alternation of glottal vibration from aided to hindered. These changes in the glottal vibration can be considered an additional consequence of the massage effect caused by the Acapella device.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79033915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and Validation of the Lithuanian Version of the Pediatric Voice Handicap Index","authors":"","doi":"10.1016/j.jvoice.2022.02.012","DOIUrl":"10.1016/j.jvoice.2022.02.012","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to develop the Lithuanian version of the Pediatric<span> Voice Handicap Index (pVHI) and to assess its psychometric characteristics.</span></p></div><div><h3>Methods</h3><p>The Lithuanian version of the pVHI was prepared according to the standard requirements for the questionnaire translation and adaptation procedure. It also included forward and backward translations of the original questionnaire, as well as a committee review and psychometric testing of the final version of the pVHI. A total of 126 children between 4 and 13 years of age were included in the study. Two study groups were formed: a group consisting of children with dysphonia (n = 70) and a control group of children without any alterations in their voice (n = 56). The questionnaire was always completed by their parents. The results were statistically analysed to assess the reliability, validity, sensitivity and specificity of the Lithuanian version of the pVHI.</p></div><div><h3>Results</h3><p>High internal consistency of the Lithuanian version of the pVHI was determined (Cronbach's α = 0.938). The test-retest analysis also showed a high correlation between the two tests (r = 0.949) for both the dysphonic and control groups. The mean overall pVHI score was significantly higher (<em>P</em> &lt; 0.001) in the dysphonic group than in the control group: 26.16 ± 11.84 and 2.43 ± 2.61, respectively. Similar results were obtained for all domains of pVHI. The most sensitive and specific limiting value for discrimination between the clinical and control groups was the sum of 8 points.</p></div><div><h3>Conclusions</h3><p>The Lithuanian version of the pVHI is a reliable and valid instrument for the evaluation of the Voice Handicap Index in the pediatric population and can be easily applied in daily clinical practice.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76073786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Initial Psychometric Evaluation of the Self-Efficacy Scale for Voice Modification in Trans Women","authors":"","doi":"10.1016/j.jvoice.2022.03.015","DOIUrl":"10.1016/j.jvoice.2022.03.015","url":null,"abstract":"<div><h3>Objective</h3><p>To develop a self-efficacy questionnaire for voice modification related to gender affirmation and to examine the internal consistency and test-retest reliability of the questionnaire among a cohort of trans women.</p></div><div><h3>Methods</h3><p><span>This study was undertaken in two phases. In phase I, four Speech- Language Pathologists (SLPs) and four trans women informed the development of the Self-Efficacy Scale for Voice Modification in Trans Women (SES-VMTW). In phase II, using </span>classical test theory, data from 31 Australian and 27 Swedish trans women who completed the SES-VMTW twice with an interim period of 3-6 weeks were analyzed for internal consistency and test-retest reliability. During this second phase, the 19 items of the SES-VMTW were subcategorized by consensus among the authors into like groups.</p></div><div><h3>Results</h3><p><span>Phase I resulted in the 19-item SES-VMTW and four subcategories were identified: 1) Change (items related to changing voice); 2) Perception (items related to the ability to perceive changes in voice; 3) Psychological (items related to engaging in voice practice despite psychological barriers; 4) Logistical (items related to engaging in voice practice despite logistical barriers). In Phase II, initial psychometric<span> analysis was applied to the full questionnaire as well as to the subcategories. The Cronbach's alpha for the full questionnaire (</span></span><em>α</em> = 0.86) at both the test and retest timepoints indicates a high level of internal consistency. Item-total correlation analysis indicated that individual items correlated with the questionnaire total score, but that they generally correlated more strongly with the total score for the relevant subcategory. The Cronbach's alpha for the four subcategories of the SES-VMTW were variable but all coefficients exceeded 0.6, thus supporting the reliability of the new scale. Good test-retest reliability was demonstrated for the full questionnaire (intraclass correlation coefficient = 0.84; 95% confidence interval, 0.73-0.90, <em>P</em> &lt; 0.001) and was moderate to good for the four subcategories.</p></div><div><h3>Conclusion</h3><p>The findings of the current study are promising, suggesting that both the full SES-VMTW and the four subcategories can provide consistent and reliable insight into self-efficacy for trans women aiming to modify their voice as part of their gender affirmation.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73507813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of Cricothyroid Visor Maneuver (CVM) therapy on the voice characteristics of patients with muscular tension dysphonia: A Case Series Study","authors":"","doi":"10.1016/j.jvoice.2022.02.016","DOIUrl":"10.1016/j.jvoice.2022.02.016","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess the effects of a novel manual therapy, the Cricothyroid visor maneuver (CVM) therapy, on acoustic, auditory perceptual and self-assessment ratings in Muscle tension dysphonia (MTD) patients.</p></div><div><h3>Study design</h3><p>This was a retrospective study of 6 clinical cases.</p></div><div><h3>Materials and Method</h3><p>The study comprised 6 Persian speakers with MTD (2 men and 4 women) and mean age 38.50 ± 5.32 years. All patients underwent therapy between April and June 2021. Therapy was provided in five 30-minute sessions. This study used of acoustic measurement including smoothed cepstral peak prominence (CPPs), Dysphonia Severity Index (DSI), self-assessment scales include vocal tract<span><span> discomfort scale (VTD), voice related quality of life (V-RQOL) and Consensus Auditory- Perceptual Evaluation of Voice (CAPE-V) for auditory </span>perceptual assessment in pre- and post-CVM sessions.</span></p></div><div><h3>Results</h3><p>In the present study the CPPs and DSI increased while only CPPs significantly changed in pre and post therapy (<em>P</em><span> &lt; 0.05). Also, having done the therapy the total severity of dysphonia (CAPE-V) and VTD significantly decreased (</span><em>P</em> &lt; 0.05) and V-RQOL significantly increased (<em>P</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>These results suggest that CVM can be an effective method for promote significant improvements in acoustic measurements, auditory perceptual and self-assessment scales in patients with MTD.</p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of Undesired Medial Surface Shape to Suboptimal Voice Outcome After Medialization Laryngoplasty","authors":"","doi":"10.1016/j.jvoice.2022.03.010","DOIUrl":"10.1016/j.jvoice.2022.03.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Voice production in pathological conditions or after surgical intervention often involves undesired medial surface shape such as reduced vertical thickness and/or left-right asymmetry in medial surface shape. The effect of such undesired medial surface on voice production remains unclear, and is often not taken into consideration during planning of surgical intervention, due to difficulty of imaging the medial surface in patients. This study aims to better understand how voice outcomes are impacted by undesired medial surface shape.</p></div><div><h3>Methods</h3><p>Computational simulations were conducted to parametrically manipulate medial surface shape and stiffness and observe its consequence on voice production.</p></div><div><h3>Results</h3><p>The results showed that undesired medial surface shape can result in incomplete glottal closure, weak voice production, increased phonation threshold, and significantly reduced vocal efficiency, particularly in the presence of left-right stiffness asymmetry.</p></div><div><h3>Conclusions</h3><p><span>In addition to approximating the vocal folds, medialization </span>laryngoplasty<span> should aim to sufficiently increase medial surface thickness, which may improve voice outcomes in patients whose voices remain unsatisfactory or suboptimal after initial intervention. While a divergent implant may increase medial surface thickness, precise implant placement in anticipation of tissue and implant deformation during the insertion process is equally important in order to achieve desired medial surface shape and optimal voice outcomes.</span></p></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73578714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Immediate Impact of Targeted Exercises on Voice Characteristics in Female Speakers With Phonotraumatic Vocal Fold Lesions","authors":"","doi":"10.1016/j.jvoice.2022.01.008","DOIUrl":"10.1016/j.jvoice.2022.01.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;To examine the immediate impact of 30 minutes of targeted voice exercises on measures of vocal function and lesion characteristics in female speakers with phonotraumatic vocal fold lesions (PVFLs).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;p&gt;Prospective cohort study.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;p&gt;Twenty-nine (n = 29) female subjects with PVFLs completed a 30 minutes targeted voice exercise protocol and a multidimensional voice analysis was conducted immediately pre and post-exercise. Analysis included expert perceptual evaluation of connected speech and stroboscopy&lt;span&gt; recordings, instrumental analysis by selected aerodynamic and acoustic parameters, and self-ratings of effort and vocal function by participants. The direction and magnitude of the change from pre- to post-exercise for each individual across parameters was assessed against a Minimal Clinically Important Difference criteria.&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Variability was observed among participants in their response to exercise and across parameters. Multidirectional change in function was demonstrated across instrumental parameters, with observations of both improvement and decline. The most consistent change observed was a reduced PTP post-exercises for 38% of participants (n = 11), and the greatest magnitude of change was observed in aerodynamic measures of airflow and pressure, and the acoustic parameter semitone range. Variability in the direction of change across instrumental measures was observed for 24% of participants (n = 7), while consistent improved function was seen for 45% (n = 13), declined function for 17% (n = 5) and no change for 14% (n = 4). Participant's self-reported effort and function post-exercise was also multidirectional, with the greatest number reporting improvement. Comparatively little change was observed in perceptual evaluation of speech and stroboscopy recordings. Findings suggest that individuals with all lesion types, sizes and liabilities have the potential to improve vocal function immediately post-exercises according to instrumental measures, with the greatest magnitude of change observed in participants with large lesions. Although participants’ characteristics did not differentiate, those with nodules or polyps tended to report improvement in function and reduced effort post-exercise, whereas those with a diagnosis of pseudocyst/s or a unilateral lesion appeared to report no change or declined function.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Change in measures of vocal function was observed in female speakers with PVFLs immediately following a 30 minutes targeted exercises protocol. Many demonstrated improvement but a high degree of variability was observed in the way speakers respond, and it is likely an individual's response is influenced by a range of factors. Self-rating scales, along with key instrumental parameters sensitive to the presence of PVFLs, may prove most useful in tracking initial change in the im","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39903617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}