This research addresses an important public need, the protection of an approximate 5-10 percent of the U.S. workforce who use their voice as a primary tool of trade. Evidence has been growing that occupational voice users, such as teachers, interviewers, counselors, and telephone workers, are at risk for vocal injury because they get inadequate recovery times from prolonged speaking. The underlying hypothesis of our research is that there is a limited vibration dose that vocal fold tissues can absorb. As to hand vibration transmitted by power tools, a safe dose is governed by frequency, tissue acceleration, and duration of exposure. We propose to design and test a dosimeter that measures these governing variables in vocalization, both in a controlled laboratory setting and on the job. We also propose to relate this vibration dose, and recovery times for the dose, to auto-perception of vocal fatigue. Since auto-perception requires little sophisticated instrumentation, we anticipate that a self-monitoring strategy will eventually evolve for all occupational voice users. Voice-economy oriented therapy will be administered to a group of teachers and compared to electronic amplification in its ability to prevent fatigue. The voice- economy therapy is driven by energy conservation principles, derived theoretically on computer simulation models of phonation, as well as by clinically accepted techniques that have withstood a test of time and are used currently by vocal performers.
Specific aims are to (1) design and construct the dosimeter, (2) to measure the daily and weekly dose received by approximately 120 teachers on the job, (3) to provide a voice-economy oriented therapy program to a subset of about 60 of these, (4) to relate vibration dose at the larynx to vocal output, (5) to relate auto- perceptive measures of recovery time to vocal fatigue, short term rest periods and tissue health, and 6) to provide amplification to another subset of 20 teachers who are in a classroom setting. The Wilbur James Gould Voice Research Center, a division of the Denver Center for the Performing Arts, is well suited to conduct this study because it already has an active outreach program to the public schools and the business sector. It also has a residency theatre company.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC004224-04
Application #
6647667
Study Section
Special Emphasis Panel (ZRG1-BBBP-7 (01))
Program Officer
Shekim, Lana O
Project Start
2000-09-01
Project End
2005-08-31
Budget Start
2003-09-01
Budget End
2004-08-31
Support Year
4
Fiscal Year
2003
Total Cost
$350,477
Indirect Cost
Name
Denver Center for the Performing Arts
Department
Type
DUNS #
010615888
City
Denver
State
CO
Country
United States
Zip Code
80204
Titze, Ingo R; Hunter, Eric J (2015) Comparison of Vocal Vibration-Dose Measures for Potential-Damage Risk Criteria. J Speech Lang Hear Res 58:1425-39
Kapsner-Smith, Mara R; Hunter, Eric J; Kirkham, Kimberly et al. (2015) A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols. J Speech Lang Hear Res 58:535-49
Hunter, Eric J (2012) Teacher response to ambulatory monitoring of voice. Logoped Phoniatr Vocol 37:133-5
Choi, Jeong-Seok; Kim, Nahn Ju; Klemuk, Sarah et al. (2012) Preservation of viscoelastic properties of rabbit vocal folds after implantation of hyaluronic Acid-based biomaterials. Otolaryngol Head Neck Surg 147:515-21
Hunter, Eric J; Halpern, Angela E; Spielman, Jennifer L (2012) Impact of four nonclinical speaking environments on a child's fundamental frequency and voice level: a preliminary case study. Lang Speech Hear Serv Sch 43:253-63
Titze, Ingo R; Klemuk, Sarah A; Lu, Xiaoying (2012) Adhesion of a monolayer of fibroblast cells to fibronectin under sonic vibrations in a bioreactor. Ann Otol Rhinol Laryngol 121:364-74
Hunter, Eric J; Kapsner-Smith, Mara; Pead, Patrick et al. (2012) Age and speech production: a 50-year longitudinal study. J Am Geriatr Soc 60:1175-7
Hunter, Eric J; Tanner, Kristine; Smith, Marshall E (2011) Gender differences affecting vocal health of women in vocally demanding careers. Logoped Phoniatr Vocol 36:128-36
Titze, Ingo R; Hunter, Eric J (2011) Feasibility of measurement of a voice range profile with a semi-occluded vocal tract. Logoped Phoniatr Vocol 36:32-9
Klemuk, Sarah A; Lu, Xiaoying; Hoffman, Henry T et al. (2010) Phonation threshold pressure predictions using viscoelastic properties up to 1,400 Hz of injectables intended for Reinke's space. Laryngoscope 120:995-1001

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