Long-Time Voice Accumulation During Work, Leisure, and a Vocal Loading Task in Groups With Different Levels of Functional Voice Problems

Objective. The study aimed to examine the vocal behavior and self-assessed vocal health in women with varying everyday vocal load and functional voice problems, including patients with functional dysphonia, in three conditions: work, leisure, and a vocal loading task (VLT). Study Design. This is a longitudinal controlled, clinical trial. Methods. Fifty (n = 50) female subjects were tracked during 7 days' voice accumulation accompanied by a voice health questionnaire, containing general assessments with visual analogue scale and specific voice health questions. Subjects were divided into four vocal subgroups according to everyday vocal load and functional vocal complaints. Accumulation time was divided into three conditions: a VLT, work, and leisure. The following behavioral parameters were measured: (1) relative phonation time (%), (2) phonatory sound pressure/voice level (dB sound pressure level), (3) ambient noise level (dB sound pressure level), and (4) phonatory fundamental frequency (Hz). Results. Patients with functional dysphonia reported significantly higher specific voice problems across conditions and worse general voice problems during work and leisure than other groups. Women with high everyday vocal load and voice complaints showed higher phonation times and fundamental frequency during work than voice healthy controls. They also reported the highest incidence of general voice problems in the VLT. Conclusions. Vocal loading relates to prolonged phonation time at high fundamental frequencies. Patients with functional dysphonia experience general and specific voice problems permanently, whereas women with everyday vocal load and voice complaints recover during leisure. This may explain why the latter group does not seek voice therapy.