| Objective: Compare and analyze the changes of voice handicap index(VHI),voice acoustic analysis,voice range profile(VRP)and voice fatigue test in occupational voice users before and after vocal training,to evaluate the effectiveness of vocal training in improving vocal function and voice fatigue in occupational voice users.So we can explore the role and value of VHI,voice acoustic analysis,voice range profile,and voice fatigue test in assessing of vocal function in occupational voice users.Methods: During the period from March 2017 to March 2018,a total of one hundred and ninety-eight qualified occupational voice users were selected according to the criterias for inclusion and exclusion.After follow-up again,132 occupational voice users such as hosts,salesmen,teachers,shopping assistants and so on were screened in this study,including 68 males and 64 females;the age ranged from 20 to 65 years,with an average of 42.2 years;the duration of symptoms was 0.5 ~ 30 years,average 3 years.All subjects had a vocal training which lasted 8 weeks.The subjects were required to have no continuous high-intensity experience during the vocal training or do not use the drugs which were change the vocal state.Before and after the training,VHI was used to perform the voice self-assessment of the subjects.What’s more,voice acoustic analysis,voice range profile mode and voice fatigue test mode in the German XION DIVAS system were used to have voice records in all occupational voice users.Then the vocal function of the subjects before and after vocal training was evaluated.Results: VHI: The value of VHI in all subjects decreased in different degrees after vocal training,and the difference was statistically significant(P<0.05).Voice acoustic analysis: After vocal training,the acoustic indicators of the subjects were improved to varying degrees.After vocal training,the average value of fundamental frequency perturbation(Jitter)was smaller than before,and the difference was statistically significant(P<0.05).Further more,the average value of amplitude perturbation(Shimmer)was also smaller after the training,and the difference was statistically significant(P<0.05).The average value of normalized noise energy(NNE)was also decreased after the training,and the difference was statistically significant(P<0.05).The average value of harmonice-noise ratio(NHR)was increased after the training,and the difference was statistically significant(P<0.05).Voice range profile(VRP): After vocal training,all indicators of VRP of the subjects were improved to varying degrees.The average of the maximum sound intensity was increased and the average of the minimum sound intensity was decreased after training,and the difference was statistically significant(P<0.05).What’s more,the average range of sound intensity,the averages of the maximum frequency,the minimum frequency and the average range of frequency were increased.The differences were statistically significant(P<0.05).By the time,the average of maximum phonation time(MPT)was prolonged than before,and the difference was statistically significant(P<0.05).The average of dysphonia severity index(DSI)was larger than before,and the difference was statistically significant(P<0.05).Before vocal training,DSI index of the subjects were mainly concentrated in moderate and severe degree.But after vocal training,the index was mainly focused on mild and normal.The distribution of DSI severity was improved after the vocal training,and the difference was statistically significant(P<0.05).Voice fatigue test: The failure rate of voice fatigue test was different in different time period,and the difference was statistically significant(P<0.05).There was a difference in the failure rate of voice fatigue test before and after vocal training(F=126.034,P=0.000).After the vocal training,the failure rate of voice fatigue test was lower and less prone to vocal fatigue than before.The difference was statistically significant(P<0.05).When the test sound intensity requirement was 75 dB,the failure rate was the highest in the 7th minute before the vocal training,and the failure rate after training was the highest in the 9th minute,when the test sound intensity requirement was 80 dB,the failure rate before training was the highest in the 4th minute,and the failure rate after training was the highest in the 10 th minute.When the sound intensity requirement was low,the failure rate was low.At the same time,when the sound intensity requirement was increased,the failure rate was increased.Because of the different requirements of the sound intensity in different time periods,there were alternate changes,so the failure rate in different time periods before and after vocal training also showed fluctuations.There was a difference in the change trend of the failure rate in voice fatigue test,and the difference was statistically significant(P<0.05).Mean value sound pressure level(MVSPL)and mean value fundamental frequency(MVF0):the average of MVSPL in different time period were stronger after vocal training than before,but the differences were statistically significant at the 1st,3th,4th,5th,6th,7th,8th,9th and 10 th minute(P<0.05).Besides,the average of MVSPL in the 4th,6th,8th minute could not reach the test requirement of 80 dB before vocal training.The average of MVSPL in the 7th minute could not achieve the test requirement of 75 dB before vocal training.The mean value fundamental frequency(MVF0)after training was lower than before,but the differences were statistically significant at the 1st,6th,8th and 10 th minute(P<0.05).Conclusion: Vocal training can effectively improve the voice function,and improve the fatigue state of the voice in occupational voice users through the study.At the same time,we can confirm that VHI,voice acoustic analysis,VRP and voice fatigue test are of great importance to evaluate the vocal function and therapeutic effect analysis of occupational voice users which can be used as important measures to evaluate the voice quality in the occupational voice user. |
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