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| Name | Class |
|---|---|
| Bahia State Secretariat of Education, Brazil | UNKNOWN |
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The purpose of this study is to verify the effects of two speech-pathology interventions: vocal warm-up and respiratory training in teachers who work in a public school of the city of Salvador-Bahia, with or without complaints of vocal disorders. It is a preventive study and the hypothesis is that both approaches can produce positive voice changes, but the Vocal Warm-up will produce the most significant changes.
Randomized Clinical Trial where participants were allocated into groups: Vocal Warm-up (to perform exercises of resistance and flexibility for 13 minutes before teaching, during six weeks) and Respiratory Muscle Training (to perform exercises to strengthen the respiratory muscles through the use of incentive respiratory equipment. Five repetitions of exhales with an interval of thirty seconds between each one were performed. It was requested rest for two minutes, repeating the procedure four times with the total of five series. These exercises were performed for 13 minutes before teaching, during six weeks).
Outcomes analyzed: demographics and teaching activity characteristics; symptoms, habits and factors associated with voice disorders; self-reported voice handicap (Voice Handicap Index-VHI-10); vocal severity rating (Vocal Severity Scale); and acoustic parameters through the computerized acoustic voice analysis program VoxMetria (CTS Informatics).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vocal Warm-up | Experimental | Vocal Warm-up group performed 13 minutes of vocal warm-up exercises everyday before teaching over a course of 6 weeks, with one session exercise per day. |
|
| Respiratory Muscle Training | Experimental | Respiratory Muscle Training group performed 13 minutes of Respiratory Muscle Training everyday before teaching over a course of 6 weeks, with one session exercise per day. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vocal Warm-up | Behavioral | Vocal Warm-up group performed 13 minutes of vocal warm-up exercises everyday before teaching over a course of 6 weeks, with one session exercise per day. |
| Measure | Description | Time Frame |
|---|---|---|
| Voice Handicap Index (VHI-10) | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Baseline, 6 weeks |
| Acoustic Analysis (Fundamental Frequency) | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Baseline, 6 weeks |
| Acoustic Analysis (Jitter) | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Baseline, 6 weeks |
| Acoustic Analysis (Shimmer) | The shimmer measures the amplitude's disturbance, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5%. | Baseline, 6 weeks |
| Acoustic Analysis (Noise) | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB |
| Measure | Description | Time Frame |
|---|---|---|
| Post-treatment Questionnaire (Voice Symptoms Improvement) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maria Lucia V Masson, PhD | Federal University of Bahia | Principal Investigator |
| Lilian Paternostro, MS | Federal University of Bahia | Study Chair |
| Fernando M Carvalho, PhD | Federal University of Bahia | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Federal University of Bahia | Salvador | Estado de Bahia | 40.026-010 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26465664 | Derived | Pereira LP, Masson ML, Carvalho FM. Vocal warm-up and breathing training for teachers: randomized clinical trial. Rev Saude Publica. 2015;49:67. doi: 10.1590/S0034-8910.2015049005716. Epub 2015 Oct 9. |
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The population sample was selected by convenience criteria. All the school's teachers were invited to participate and were selected according to eligibility criteria in the beginning of the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Vocal Warm-up | Vocal Warm up group performed 13 minutes of vocal warm-up exercises everyday before teaching over a course of 6 weeks, with one session exercise per day. |
| FG001 | Respiratory Muscle Training | Respiratory Muscle Training group performed 13 minutes of Respiratory Muscle Training everyday before teaching over a course of 6 weeks, with one session exercise per day. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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|
Two different analyses were performed:
1) Between-group (Vocal Warm-up vs. Respiratory Muscle Training) comparison analysis (n=31); 2a) Within-group (Respiratory Muscle Training Baseline vs Respiratory Muscle Post-test) comparison analysis (n=17); 2b) Within-group (Vocal Warm-up Baseline vs Vocal Warm-up Post-test) comparison analysis (n=14).
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| ID | Title | Description |
|---|---|---|
| BG000 | Vocal Warm-up | Vocal Warm up group was performed during 13 minutes of vocal warm-up exercises everyday before teaching over a course of 6 weeks, with one session exercise per day. |
| BG001 | Respiratory Muscle Training |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Voice Handicap Index (VHI-10) | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | units on a scale | Baseline, 6 weeks |
|
6-week intervention period
The participants were monitored daily throughout the intervention period.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Vocal Warm-up | Vocal Warm-up group performed 13 minutes of vocal warm-up exercises everyday before teaching over a course of 6 weeks, with one session exercise per day. |
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Small and not probabilistic sample; type I error; type II error; strike in the last week of the study; healthy worker effect.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Lilian Paternostro | Federal University of Bahia | +55 (71) 8191-9730 | lilian_fono@hotmail.com |
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| ID | Term |
|---|---|
| D014832 | Voice Disorders |
| ID | Term |
|---|---|
| D007818 | Laryngeal Diseases |
| D012140 | Respiratory Tract Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D009461 | Neurologic Manifestations |
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| ID | Term |
|---|---|
| D001945 | Breathing Exercises |
| ID | Term |
|---|---|
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026241 | Exercise Movement Techniques |
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| Respiratory Muscle Training | Behavioral | Respiratory Muscle Training group performed 13 minutes of Respiratory Muscle Training everyday before teaching over a course of 6 weeks, with one session exercise per day. |
|
| Baseline, 6 weeks |
| Acoustic Analysis (GNE) | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Baseline, 6 weeks |
| Voice Handicap Index (VHI-10) 2 | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Baseline, 6 weeks |
| Acoustic Analysis (Fundamental Frequency) 2 | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Baseline, 6 weeks |
| Acoustic Analysis (Jitter) 2 | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Baseline, 6 weeks |
| Acoustic Analysis (Shimmer) 2 | The shimmer measures the amplitude's disturbance, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5%. | Baseline, 6 weeks |
| Acoustic Analysis (Noise) 2 | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB | Baseline, 6 weeks |
| Acoustic Analysis (GNE) 2 | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Baseline, 6 weeks |
| Change in Voice Handicap Index (VHI-10) | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Baseline, 6 weeks |
| Change in Fundamental Frequency | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Baseline, 6 weeks |
| Change in Jitter | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Baseline, 6 weeks |
| Change in Shimmer | Shimmer measures the amplitude perturbations, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5% | Baseline, 6 weeks |
| Change in Noise | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB | Baseline, 6 weeks |
| Change in GNE | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Baseline, 6 weeks |
| After 6 weeks of intervention |
| Post-treatment Questionnaire (Voice Clearer) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. | After 6 weeks of intervention |
| Post-treatment Questionnaire (Easier to Talk) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. | After 6 weeks of intervention |
| Post-treatment Questionnaire (Compliance With Intervention) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their degree of compliance on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). It was considered compliance the answers "moderate" and "a lot" in comparison of "not at all/somewhat", considered as no compliance. The results were presented in frequency/percentage of subjects in each intervention. | After 6 weeks of intervention |
Respiratory Muscle Training group was performed during 13 minutes of Respiratory Muscle Training everyday before teaching over a course of 6 weeks, with one session exercise per day.
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| OG001 | Respiratory Muscle Training (Posttest) | Respiratory Muscle Training group performed 13 minutes of respiratory muscle training everyday before teaching over a course of 6 weeks, with one session exercise per day. |
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|
| Primary | Acoustic Analysis (Fundamental Frequency) | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Hertz (Hz) | Baseline, 6 weeks |
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|
|
| Secondary | Post-treatment Questionnaire (Voice Symptoms Improvement) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. | Between-group analysis | Posted | Number | percentage of participants | After 6 weeks of intervention |
|
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|
|
| Primary | Acoustic Analysis (Jitter) | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | percentage of jitter | Baseline, 6 weeks |
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|
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| Primary | Acoustic Analysis (Shimmer) | The shimmer measures the amplitude's disturbance, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5%. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | percentage of shimmer | Baseline, 6 weeks |
|
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|
|
| Primary | Acoustic Analysis (Noise) | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
|
|
|
| Primary | Acoustic Analysis (GNE) | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
|
|
|
| Primary | Voice Handicap Index (VHI-10) 2 | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | units on a scale | Baseline, 6 weeks |
|
|
|
|
| Primary | Acoustic Analysis (Fundamental Frequency) 2 | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Hertz (Hz) | Baseline, 6 weeks |
|
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|
|
| Primary | Acoustic Analysis (Jitter) 2 | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | percentage of jitter | Baseline, 6 weeks |
|
|
|
|
| Primary | Acoustic Analysis (Shimmer) 2 | The shimmer measures the amplitude's disturbance, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5%. | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | percentage of shimmer | Baseline, 6 weeks |
|
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| Primary | Acoustic Analysis (Noise) 2 | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
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|
|
| Primary | Acoustic Analysis (GNE) 2 | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Within-group analysis (pretest vs. posttest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
|
|
|
| Primary | Change in Voice Handicap Index (VHI-10) | The voice handicap index (VHI) is a self-assessment questionnaire which quantifies the functional, physical and emotional impacts of a voice disorder on the quality of life. The VHI-10 is a reduced version and it consists of 10 questions about the severity of the voice problem perceived by the subject. It is presented as an ordinal scale (range 0-4) that indicates how frequently the subject has experienced the same situation (0 = never; 1 = almost never; 2 = sometimes; 3= almost always; 4 = always). Total VHI Score ranges from 0 (never) to 40 (always). Higher scores indicate greater voice handicap. Abnormal values > 11. | Between-group analysis (mean difference posttest minus pretest) | Posted | Mean | Standard Deviation | units on a scale | Baseline, 6 weeks |
|
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|
| Primary | Change in Fundamental Frequency | The measurement of fundamental frequency directly reflects the rate of vibration of the vocal folds. The fundamental frequency term refers to the frequency of more occurrence of vocal fold vibration, featuring a certain production. | Between-group analysis (mean difference posttest minus pretest) | Posted | Mean | Standard Deviation | Hertz (Hz) | Baseline, 6 weeks |
|
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| Primary | Change in Jitter | Jitter is the perturbation cycle-to-cycle of the fundamental frequency. High levels of jitter are normally associated with pathological voice. The instability of the fundamental frequency can be attributed to changes in size, shape or firmness of the vocal folds. Normal values must be < 0.6%. | Between-group analysis (mean difference posttest minus pretest) | Posted | Mean | Standard Deviation | percentage of jitter | Baseline, 6 weeks |
|
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| Primary | Change in Shimmer | Shimmer measures the amplitude perturbations, e. g. how fast the amplitude changes on a sustained vowel for a few seconds. Shimmer high levels are normally associated with pathological voice. This can be attributed due to changes in size, shape or firmness of the vocal folds. Normal values < 6.5% | Posted | Mean | Standard Deviation | percentage of shimmer | Baseline, 6 weeks |
|
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|
|
| Primary | Change in Noise | Noise is the analysis of aperiodic components of the sound's signal. It is an important correlate of that the human ear considers voice disorders. Normal levels < 2.5 dB | Between-group analysis (mean difference posttest minus pretest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
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| Primary | Change in GNE | Glottal to Noise Excitation ratio (GNE) is an acoustic measurement to calculate the noise in a series of pulses produced by the oscillation of the vocal folds. This parameter is based on the hypothesis that resulting pulses of vocal fold collision generate a synchronous excitation of different frequency bands. Moreover, the noise produced by the vocal folds compressed generates uncorrelated excitations. Normal levels > 0.5 dB | Between-group analysis (mean difference posttest minus pretest) | Posted | Mean | Standard Deviation | Decibel (dB) | Baseline, 6 weeks |
|
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|
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| Secondary | Post-treatment Questionnaire (Voice Clearer) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. | Between-group analysis | Posted | Number | percentage of subjects | After 6 weeks of intervention |
|
|
|
|
| Secondary | Post-treatment Questionnaire (Easier to Talk) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their extent of improvement on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). The results were presented in frequency/percentage of subjects that answered "moderate/a lot" in each intervention. | Between-group analysis | Posted | Number | percentage of subjects | After 6 weeks of intervention |
|
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|
|
| Secondary | Post-treatment Questionnaire (Compliance With Intervention) | The post-treatment questionnaire was based on the original designed by Roy (2003) for assessing the teachers' perception of voice improvement and compliance with the intervention. Participants rated their degree of compliance on a 3-point Likert scale ("not at all/somewhat"; "moderate"; "a lot"). The questionnaire was applied only after the intervention. The answers were dichotomized in two categories ("moderate/a lot" and "not at all/somewhat"). It was considered compliance the answers "moderate" and "a lot" in comparison of "not at all/somewhat", considered as no compliance. The results were presented in frequency/percentage of subjects in each intervention. | Between-group analysis | Posted | Number | percentage of subjects | After 6 weeks of intervention |
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|
| 0 |
| 20 |
| 0 |
| 20 |
| EG001 | Respiratory Muscle Training | Respiratory Muscle Training group performed 13 minutes of Respiratory Muscle Training everyday before teaching over a course of 6 weeks, with one session exercise per day. | 0 | 21 | 0 | 21 |
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| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D026741 |
| Physical Therapy Modalities |