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Introduction. Laryngeal disorders are characterized by a change in the vibratory pattern of the vocal folds. This disorder may have an organic origin described by anatomical fold modification, or a functional origin caused by vocal abuse or misuse. The most common diagnostic methods are performed by invasive imaging features that cause patient discomfort. In addition, mild voice deviations do not stop the in-dividual from using their voices, which makes it difficult to identify the problem and increases the possibility of complications. Aim. For those reasons, the goal of the present paper was to develop a noninvasive alternative for the identification of voices with a mild degree of vocal deviation ap-plying the Wavelet Packet Transform (WPT) and Multilayer Perceptron (MLP), an Artificial Neural Network (ANN). Methods. A dataset of 74 audio files were used. Shannon energy and entropy mea-sures were extracted using the Daubechies 2 and Symlet 2 families and then the processing step was performed with the MLP ANN. Results. The Symlet 2 family was more efficient in its generalization, obtaining 99.75% and 99.56% accuracy by using Shannon energy and entropy measures, re-spectively. The Daubechies 2 family, however, obtained lower accuracy rates: 91.17% and 70.01%, respectively. Conclusion. The combination of WPT and MLP presented high accuracy for the identification of voices with a mild degree of vocal deviation
ntroducción. Los trastornos laríngeos se caracterizan por un cambio en el patrón vibratorio de los pliegues vocales. Este trastorno puede tener un origen orgánico, descrito como la modificación anatómica de los pliegues vocales, o de origen fun-cional, provocado por abuso o mal uso de la voz. Los métodos de diagnóstico más comunes se realizan mediante procedimientos invasivos que causan malestar al pa-ciente. Además, los desvíos vocales de grado leve no impiden que el individuo utilice la voz, lo que dificulta la identificación del problema y aumenta la posibilidad de complicaciones futuras.Objetivo. Por esas razones, el objetivo de esta investigación es desarrollar una he-rramienta alternativa, no invasiva para la identificación de voces con grado leve de desvío vocal aplicando Transformada Wavelet Packet (WPT) y la red neuronal artifi-cial del tipo Perceptrón Mutlicapa (PMC). Métodos. Fue utilizado un banco de datos con 78 voces. Fueron extraídas las me-didas de energía y entropía de Shannon usando las familias Daubechies 2 y Symlet 2 para después aplicar la red neuronal PMC. Resultados. La familia Symlet 2 fue más eficiente en su generalización, obteniendo un 99.75% y un 99.56% de precisión mediante el uso de medidas de energía y en-tropía de Shannon, respectivamente. La familia Daubechies 2, sin embargo, obtuvo menores índices de precisión: 91.17% y 70.01%, respectivamente. Conclusión. La combinación de WPT y PMC presentó alta precisión para la iden-tificación de voces con grado leve de desvío vocal
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Humanos , Prega Vocal , Afonia/diagnóstico , Distúrbios da Voz , Pacientes , Voz , Afonia/fisiopatologia , Laringe/anormalidadesRESUMO
The use of body signals for health care applications has become ubiquitous in the last decade. One utilization of such measurements is the monitoring of respiratory flow for physiotherapy assistance. This application is based on relative flow measures which can rely on inexpensive sensors. Based on that, we present a low-cost electronic device that detects blows and suctions with a pressure sensor and emulates a keyboard for interfacing with computers. This joystick allows children to control free internet games by associating blows and suctions with different intensities to keyboard actions. Also, the intensity can be calibrated according to the user's pulmonary capacities. This feature is adequate for gradual respiratory physiotherapy and can be customized for each patient. In order to verify the operation of the proposed device, practical tests were performed with three online free games, where the joystick functionality was assessed with different therapeutic configurations.
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Computadores , Criança , HumanosRESUMO
OBJECTIVE: The objective of this study was to validate the Vocal Tract Discomfort Scale (VTD) Argentine version. STUDY DESIGN: Nonrandomized, cross-sectional prospective study with control group. MATERIAL AND METHODS: The VTD Scale was culturally and linguistically adapted to Argentinian Spanish according to the recommended requirements of translation, closely observing the methodology that was suggested (translation, summary, review and back-translation). The scale Argentine version (Escala de disconfort del tracto vocal) was administered to 107 patients with muscle-tension dysphonia (MTD) (23 men and 84 women, mean ages being: 32.30 ± 9.09 years old for MTD type I, and 31.23 ± 8.45 years old for MTD type II) and 30 volunteers with no vocal pathology (9 men and 21 women, mean ages being: 44.3 ± 8.72 years old). All patients completed the Escala de disconfort del tracto vocal before and after Mathieson Laryngeal Manual Therapy. The results of the VTD Scale administered in both patients and vocally healthy subjects were initially compared; the changes arising from pre and post therapy were also compared in the second phase. The internal consistency of the VTD Scale was assessed using Cronbach alpha coefficient. RESULTS: The internal consistency assessed was considered acceptable for both subscales within the VTD Scale. The values obtained for frequency, severity, and total score of the Scale were similar in patients with MTD I and MTD II, marking a difference with those obtained in the control group of healthy volunteers. A lump feeling in the throat was one of the most frequent symptoms in both MTD and vocally healthy groups. CONCLUSION: The VTD Scale shows an acceptable consistency, so it is a highly reproducible, reliable, and valuable instrument of evaluation to assess Argentinian patients with voice disorders.
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Autoavaliação Diagnóstica , Disfonia/diagnóstico , Prega Vocal/fisiopatologia , Qualidade da Voz , Adulto , Argentina , Percepção Auditiva , Estudos Transversais , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVES: We conducted a study to obtain quantitative parameters of the vocal dynamic using high-speed videolaryngoscopy and to characterize the vocal fold vibration pattern of healthy individuals by analyzing glottal area waveforms and high-speed kymography. METHODS: Laryngeal images of 45 healthy individuals were captured using high-speed videolaryngoscopy. The open and speed quotients of the glottal area waveforms and high-speed kymography were obtained and statistically analyzed according to the gender of each individual. RESULTS: Glottal area waveforms revealed average values of 0.85 and 1.16 for open and speed quotients, respectively, for women, and 0.70 and 1.19 for men. Using high-speed kymography, quantitative parameters of open and speed quotients for women were 0.62 and 1.02, respectively, and for men were 0.57 and 1.12. By gender, a significant statistical difference emerged for open quotients obtained from both glottal area waveforms (P = 0.004) and high-speed kymography (P = 0.013). CONCLUSION: Obtained by using computational tools specifically for analyzing laryngeal images from high-speed videolaryngoscopy, quantitative parameters of glottal area waveforms and high-speed kymography in healthy individuals provide reference data and normality for future studies.
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Glote/fisiologia , Quimografia , Laringoscopia , Fonação , Gravação em Vídeo , Prega Vocal/fisiologia , Adolescente , Adulto , Fenômenos Biomecânicos , Brasil , Feminino , Glote/anatomia & histologia , Voluntários Saudáveis , Humanos , Interpretação de Imagem Assistida por Computador , Quimografia/normas , Laringoscopia/normas , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Padrões de Referência , Fatores Sexuais , Fatores de Tempo , Vibração , Gravação em Vídeo/normas , Prega Vocal/anatomia & histologia , Adulto JovemRESUMO
Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation...
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Humanos , Distúrbios da Voz/diagnóstico , Laringoscopia , Estroboscopia , Disfonia , Cisto Epidérmico , Prega VocalRESUMO
Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.
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PURPOSE: To propose and verify the feasibility of a vocal program intervention in patients with presbylarynx signs with or without vocal complaints. METHOD: Among 20 elder participants of the current research, 3 female patients with median age of 67 years were chosen for the pilot study. Laryngological examination, vocal recording with CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice) protocol, and Screening Protocol of Risk of Dysphonia (SPRD) were conducted before and after the program intervention. They joined the Cognitive Vocal Program for presbyphonia based on the genetic epistemology by Jean Piaget associated with vocal techniques based on scientific literature. This program is structured with six sessions and each one of them is focused in different aspects of vocal production. RESULTS: After the program intervention, some aspects such as loudness, coordination between breathing and speaking, accuracy in articulatory movements, jitter, and harmonics-to-noise ratio improved with parameters within the expected range for the age group. Three female participants were observed for better vocal quality, higher fundamental frequency, and better maximum phonation time. In two cases, tension related to loudness elevation and better scores on SPRD was observed. Using by high-speed laryngeal image, we also observed reduction of presbylarynx signs, and remarkable improvement in glottis closure competence and mucosal wave movement of the patients with and without vocal complaints. CONCLUSION: The preliminary results suggest encouraging prospects for the proposal with improvement in the aspects analyzed. This program was well designed and did not require any further adjustments.
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Distúrbios da Voz/reabilitação , Voz , Idoso , Feminino , Serviços de Saúde para Idosos , Humanos , Laringe/patologia , Estudos Longitudinais , Avaliação de Programas e Projetos de Saúde , Prega Vocal/fisiopatologia , Distúrbios da Voz/fisiopatologia , Qualidade da VozRESUMO
Purpose: To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. Methods: Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. Results: After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. Conclusion: We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search. .
OBJETIVO: Identificar efeitos imediatos das vibrações sonorizadas e do som basal em indivíduos saudáveis por meio de parâmetros acústicos e quimografia de alta velocidade. MÉTODOS: Participaram 30 sujeitos, 12 homens e 18 mulheres (19 a 45 anos) sem alterações laríngeas. As vozes foram gravadas à taxa de 44.100 amostras/segundo e as videolaringoscopias de 4.000 quadros/segundo, antes e depois dos exercícios vocais. Foi desenvolvida uma rotina computacional para extrair Jitter e Shimmer. Foram geradas quimografias de alta velocidade a partir das imagens laríngeas para a análise dos tempos de fase: fechada (FF); aberta (FA); de fechamento (Ff) e de abertura (Fa), e usados o Teste t de Student pareado e o teste Mann-Whitney, com nível de significância de 0,05. RESULTADOS: Após as vibrações sonorizadas, houve diminuição de Jitter (0,018 para homens e p<0,01para mulheres) para ambos os gêneros e diminuição de Shimmer (p<0,01) ao gênero feminino. Houve diminuição de FF (p=0,046) e de Ff (p=0,026) e aumento de FA (p=0,05) em pregas vocais femininas. Após o som basal, foram identificados diminuição de Jitter (p<0,01) em vozes femininas e da Ff (p=0,026) em pregas vocais masculinas. CONCLUSÃO: Foi possível verificar mais efeitos imediatos positivos após as vibrações sonorizadas principalmente em qualidade vocal e pregas vocais de mulheres. No entanto, são necessárias pesquisas com maior número de amostras masculinas e investigação sobre o tempo adequado do som basal para corroboração dos resultados desta pesquisa. .
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Quimografia , Vibração , Prega Vocal/fisiologia , Qualidade da Voz/fisiologia , Fatores SexuaisRESUMO
Introduction: The effects of voiced vibration technique can be assessed by laryngeal imaging. Kymographic images derived from high-speed videoendoscopy allow actual visualization of vocal folds vibration. Purpose: The aim of this study is to identify the immediate effects of the voiced vibration technique in healthy vocal folds using high-speed digital laryngeal imaging. Methods: Samples were obtained from 15 healthy subjects with no history of voice disorders (6 men and 9 women aged 21 to 43 years). High-speed videoendoscopy recordings were performed before and after the voiced vibration technique. Kymographic images were obtained using high-speed videoendoscopy. The vocal folds were examined in their open and closed positions and the characteristics of the opening and closing phases were determined. A customize computational routine was used quantify these parameters. The closing, opening, and speed quotients were also calculated. Results: In this study, women displayed statistically significant differences in opened phase (P= 0.05*), closed phase (P= 0.046*), and closing phase (P= 0.026*) phase characteristics. Men displayed the highest difference rate in opening time characteristics (P= 0.06). The closing and opening quotients for the female group showed significant differences (P= 0.029* and P= 0.049*, respectively). The speed quotient exhibited statistically significant differences in the male group (P= 0.048*). Conclusion: The kymographic images indicated that the immediate effect of the voiced vibration technique was smooth contact in healthy vocal fold vibration...
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Humanos , Masculino , Feminino , Adulto , Quimografia , Intensificação de Imagem Radiográfica , Vibração , Voz , Treinamento da VozRESUMO
PURPOSE: To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS: Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS: After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION: We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.