Browsing by Author "Hunter, Eric J."

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    Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers
    (2024) Castillo-Allendes, Adrián; Cantor-Cutiva,Lady Catherine; Fuentes López, Eduardo; Hunter, Eric J.
    Objective. This study examines factors predicting self-reported voice symptoms in call center workers.Methods. Multivariate analysis and predictive modeling assess personal, work-re-lated, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Re-ceiver Operating Characteristic (ROC) curves are employed.Results. Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symp-tom complexity in call center professionals, necessitating comprehensive assessment.Limitations. This study recognizes its limitations, including a moderate-sized con-venience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis.Value. This research provides novel insights into the interplay of personal, occu-pational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of indi-vidual susceptibility to voice disorders.Conclusion. Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behav-iors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity
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    Muscle Activity and Aerodynamic Voice Changes at Different Body Postures: A Pilot Study
    (Elsevier Inc., 2022) Castillo Allendes, Adrián; Delgado Bravo, Mauricio Antonio; Reyes Ponce, Alvaro; Hunter, Eric J.
    © 2022 The Voice FoundationObjective: Body posture is a commonly discussed component of voice training and therapy. However, body postures, postural changes, related posturing muscle monitoring, and the potential changes in voice production (eg, glottal aerodynamic changes, acoustic differences) have been inconsistently described in the literature, leaving room for free interpretation and possible misunderstandings. The primary purpose of this pilot study was to compare the magnitude of electromyographical activation of muscles involved in phonation-breathing functions and their changes due to four standardized body postures in experienced singers. Secondly, to identify which body posture produces greater changes in aerodynamic parameters, vocal pitch, and loudness. Methods: Eight healthy adults with experience in singing voice performed a vocal task during different body postures commonly used in both voice training and therapy. A 3D-capture system was used to control and quantify the alignment of each posture. During the performances, surface electromyography (sEMG) was used to measure the muscular activity involved in the breathing/phonation and posture processes. A nonparametric Kruskal-Wallis test was used to compare the sEMG activity of phonatory muscles and aerodynamic voice variables between postures. Results: Our study did not reveal significant differences in sEMG activity, aerodynamic parameters, vocal pitch, and loudness among body postures during vocal task productions. However, the vocal pitch (in semitones) revealed significant differences in the unstable surface when compared to the upright posture, modified upright, and leaning postures. Conclusion: The body postures selected did not generate voice aerodynamic modifications of the voice nor in the levels of activation of muscles involved in the phonation-breathing process in individuals with experience in singing voice. Modifications of body posture as a tool for voice therapy should be further investigated, considering the population with voice problems and no voice training experience.
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    Tracking Occupational Voice State with a Visual Analog Scale: Voice Quality, Vocal Fatigue, and Effort
    (2023) Castillo‐Allendes, Adrián; Guzmán‐Ferrada, Daniel; Hunter, Eric J.; Fuentes Lopez, Eduardo
    Background: Due to elevated vocal health risk in industries such as call centers, there is a need to have accessible and quick self-report tools for voice symptoms. This study aimed to determine if the concurrent and construct validity of three visual analog scales (VASs) of voice quality and symptoms could be used as a screening tool in call center agents. Methods: A cross-sectional study was carried out in three call center companies. The Voice Handicap Index-10 (VHI-10) and a vocal hygiene and symptoms survey were administered to 66 call center workers. Further, acoustic parameters including harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), L1-L0 slope, and Alpha ratio were collected. Finally, workers completed three VASs capturing self-perception of vocal effort (VAS-1), voice quality (VAS-2), and vocal fatigue (VAS-3). Linear regression models with bootstrapping evaluated the possible relationship between the three VASs measurements, self-perceived vocal symptoms, and acoustic parameters. Results: VAS-1 scores were associated with HNR and voice breaks, VAS-2 with voice breaks, and VAS-3 with Alpha ratio. Using the area under a receiver operating characteristic curve (AUC), the highest AUC for detecting an altered VHI-10 questionnaire score was observed for the three VASs. Also, the highest AUC for detecting altered CPPs was reached for the VAS-1. Conclusions: VAS as a self-report instrument of vocal symptoms is related to psychosocial voice impairment and alterations of acoustic voice parameters in call center workers. Such instruments could be easily implemented to identify voice complaints in these populations. Level of Evidence: 2 (Diagnosis research question) Laryngoscope, 133:1676–1682, 2023