Investigation of the Effectiveness of Vocal Warm-Up Exercises in Postmenopausal Women and Young Women

Year 2022, , 233 - 253, 30.12.2022

Elçin Tadıhan Özkan , Rojda Özalp

https://doi.org/10.58563/dkyad-2022.53.1

Abstract

Purpose: In this study, the aim is to examine the effectiveness of vocal warm-up exercises by measuring the acoustic parameters of postmenopausal women and young women before and after vocal warm-up exercises. Method: 23 postmenopausal women and 23 young women were included in the study. Comprehensive voice warm-up exercises were applied to the two groups in one session. In the study, acoustic (fundemental frequency, jjtter, shimmer, noise harmonic ratio and soft phonation index) parameters of young women and menopausal women were measured with MDVP, and the data were compared within and between groups. The obtained data were analyzed with the SPSS 22.0 package program. In the comparisons between the groups, the data of the parametric parameters were analysed by Independent Sample t-Test; The data of the non-parametric parameters were analyzed with the Mann-Whitney U test. In within group comparisons, analyzes were performed independently for younger women and menopausal women; the data of the parametric parameters were analysed by Paired Sample t-Test; The data of the non-parametric parameters were analyzed with the Wilcoxon Signed Ranks test. Results: In the first measurements between the groups, the fundamental frequency was found to be significantly lower in postmenopausal women than in young women; shimmer, noise harmonic ratio and soft phonation index parameters were found to be significantly higher than young women. In the last measurements between the groups after the vocal warm-up exercises the mean of the last measurement of the fundamental frequency of the young women was found to be significantly higher than the mean of the last measurement of the fundamental frequency of the women in the postmenopausal period. However, no significant difference was found in the parameters of jitter, shimmer, noise harmonic ratio and soft phonation index. As a result of the comparison of the pre-test and post-test data of the postmenopausal women for the group after the vocal warm-up exercises, it was found that the fundamental frequency was significantly higher after the exercises, and there was a significant decrease in the parameters of the jitter, shimmer and soft phonation index. It was found that there was no significant difference in the noise harmonic ratio parameter after the application. In young women, as a result of the comparison of the pre-test and post-test data within the group after the vocal warm-up exercises, it was found that the fundamental frequency increased, and there was a significant decrease in the jitter and soft phonation index parameter values. However, no significant difference was found in the parameters of shimmer and noise harmonic ratio after the application. Conclusion: As a result of the findings obtained from the study, it is seen that the voice characteristics of women may vary during the menopause period and that the vocal warm-up exercises applied in women in this period are effective on acoustic parameters.

Keywords

voice, menopause, hormone, vocal warm-up exercises, acoustic parameters

Postmenopoz Dönem Kadınlar ve Genç Kadınlarda Ses Isıtma Egzersizlerinin Etkililiğinin İncelenmesi

Abstract

Amaç: Yapılan çalışmada postmenopoz dönemdeki kadınlar ile genç kadınların ses ısıtma egzersizleri öncesi ve sonrası, ses ısıtma egzersizlerinin akustik parametreler üstündeki etkililiğinin incelenmesi amaçlanmıştır. Yöntem: Çalışmaya yaş ortalaması 49,30 (± 2,90) olan postmenopoz dönemdeki 23 kadın katılımcı ile yaş ortalaması 25,09 (± 3,25) olan 23 genç kadın katılımcı dahil edilmiştir. Oluşturulan iki gruba bir seans kapsamlı ses ısıtma egzersizleri uygulanmıştır. Katılımcılara ait akustik veriler (temel frekans, jitter, shimmer, gürültü harmonik oranı ve yumuşak fonasyon indeksi) MDVP ile ölçülmüş olup, elde edilen veriler grup içi ve gruplar arası olarak SPSS 22.0 programı ile istatiksel olarak karşılaştırılmıştır. Gruplar arası karşılaştırmalarda verilerin normal dağılıp dağılmadığı dikkate alınarak Bağımsız Örneklem t-Testi ya da Mann-Whitney U testi kullanılmıştır. Grup içi karşılaştırmalarda ise yine normal dağılım varsayımı dikkate alınarak Bağımlı Örneklem t-Test veya Wilcoxon İşaretli Sıralar testi ile incelenmiştir. Bulgular: Gruplar arası ilk ölçümlerde temel frekans postmenopoz kadınlarda genç kadınlara göre anlamlı düzeyde daha düşük görülürken; shimmer, gürültü harmonik oranı ve yumuşak fonasyon indeksi parametreleri genç kadınlara göre anlamlı olarak daha yüksek bulunmuştur. Ses ısıtma egzersizleri sonrası gruplar arası son ölçümlerde temel frekans genç kadınlarda postmenopoz dönem kadınlara göre daha yüksek bulunurken; jitter shimmer, gürültü harmonik oranı ve yumuşak fonasyon indeksi parametrelerinde gruplar arası farklılık bulunmamıştır. Postmenopoz dönem kadınların ses ısıtma egzersizleri sonrası grup içi ön test-son test verilerinin karşılaştırılması sonucunda temel frekansın uygulama sonrası arttığı; jitter, shimmer ve yumuşak fonasyon indeksi parametrelerinde azalma olduğu ancak gürültü harmonik oranında anlamlı bir farklılık olmadığı bulunmuştur. Genç kadınların ses ısıtma egzersizleri sonrası grup içi ön test-son test verilerinin karşılaştırılması sonucunda temel frekansta artma, jitter ve yumuşak fonasyon indeksi değerlerinde azalma bulunurken shimmer ve gürültü harmonik oranı değerlerinde anlamlı bir farklılaşma bulunmamıştır. Sonuç: Çalışmadan elde edilen bulguların sonucunda menopoz döneminde kadınların ses karakteristiklerinin değişkenlik gösterebileceği ve bu dönemdeki kadınlarda uygulanan ses ısıtma egzersizlerinin akustik parametreler üzerinde etkili olduğu görülmektedir.

Keywords

ses, menopoz, hormon, ses ısıtma egzersizleri, akustik parametreler

References

• Abitbol, J., Abitbol, P., & Abitbol, B. (1999). Sex hormones and the female voice. Journal of voice, 13(3), 424-446.
• Amir, O. (2004). The impact of hormonal fluctuations on female vocal folds. Current opinion in otolaryngology & head and neck surgery, 12(3), 180-184.
• Andrade, P. A., Wood, G., Ratcliffe, P., Epstein, R., Pijper, A., & Svec, J. G. (2014). Electroglottographic study of seven semi-occluded exercises: LaxVox, straw, lip-trill, tongue-trill, humming, hand-over-mouth, and tongue-trill combined with hand-over-mouth. Journal of Voice, 28(5), 589-595.
• Andrews, M. L. (2002). Voice treatment for children and adolescent (2. Basım.). Thomson.
• Brockmann-Bauser, M., Balandat, B., & Bohlender, J. (2020). Immediate lip trill effects on the standard diagnostic measures voice range profile, jitter, maximum phonation time, and dysphonia severity index. Journal of Voice, 34(6), 874-883.
• Büyüköztürk, Ş., Kılıç-Çakmak, E., Akgün, Ö., Karadeniz, Ş., & Demirel, F. (2018). Bilimsel araştırma yöntemleri (10. Basım). Pagem Akademi
• Martins, R. H. G., Ribeiro, C. B. H., de Mello, B. M. Z. F., Branco, A., & Tavares, E. L. M. (2012). Dysphonia in children. Journal of Voice, 26(5), 674-e17.
• D'haeseleer, E., Depypere, H., Claeys, S., & Van Lierde, K. M. (2011). The relation between body mass index and speaking fundamental frequency in premenopausal and postmenopausal women. Menopause, 18(7), 754-758.
• D'haeseleer, E., Depypere, H., Claeys, S., Wuyts, F. L., Baudonck, N., & Van Lierde, K. M. (2011). Vocal characteristics of middle-aged premenopausal women. Journal of Voice, 25(3), 360-366.
• D'haeseleer, E., Depypere, H., & Van Lierde, K. (2013). Comparison of speaking fundamental frequency between premenopausal women and postmenopausal women with and without hormone therapy. Folia Phoniatrica et Logopaedica, 65(2), 78-83.
• Eklund, R. (2008). Pulmonic ingressive phonation: Diachronic and synchronic characteristics, distribution and function in animal and human sound production and in human speech. Journal of the International Phonetic Association, 235-324.
• Ferraz, P. R. R., Bertoldo, S. V., Costa, L. G. M., Serra, E. C. N., Silva, E. M., Brito, L. M. O., & Da Costa Chein, M. B. (2013). Vocal parameters and voice-related quality of life in adult women with and without ovarian function. Journal of Voice, 27(3), 355-360.
• Firat, Y., Engin-Ustun, Y., Kizilay, A., Ustun, Y., Akarcay, M., Selimoglu, E., & Kafkasli, A. (2009). Effect of intranasal estrogen on vocal quality. Journal of Voice, 23(6), 716-720.
• Gallup, G & Nathan, R. (2012). The unique impact of menstruation on the female voice: Implications for the evolution of menstrual cycle cues. Ethology, 118(3), 281-291.
• Göktaş, M. (2016). Yetişkin bireylerde vokal ısınma egzersizlerinin etkililiğinin incelenmesi. [Yayınlanmamış Doktora Tezi]. Anadolu Üniversitesi, Sağlık Bilimleri Enstitüsü, Eskişehir.
• Harries, M. L., Walker, J. M., Williams, D. M., Hawkins, S., & Hughes, I. A. (1997). Changes in the male voice at puberty. Archives of disease in childhood, 77(5), 445-447.
• Kadaika, S., Carlson, D. & Sataloff, R. T. (2013). The effect of hormones on the voice. J. Sing, 69(5), 571-574.
• Kang, J., Xue, C., Chou, A., Scholp, A., Gong, T., Zhang, Y., & Jiang, J. J. (2019). Comparing the exposure response relationships of physiological and traditional vocal warm-ups on aerodynamic and acoustic parameters in untrained singers. Journal of Voice, 33(4), 420-428.
• Kılıç, M. A. (2010). Ses problemi olan hastanın objektif ve subjektif yöntemlerle değerlendirilmesi. Türkiye Klinikleri, 6(2), 257-265.
• Kılıç, M. A., & Oğuz, H. (2009). Klinik ses bozuklukları (4. Basım). Nobel Kitabevi.
• Lã, F. M., & Ardura, D. (2020). What voice related metrics change with menopause? A systematic review and meta analysis study. Journal of Voice. 20(5), 200-210.
• Laureano, J. M., Sá, M. F. S., Ferriani, R. A., & Romao, G. S. (2009). Variations of jitter and shimmer among women in menacme and postmenopausal women. Journal of Voice, 23(6), 687-689.
• Lindholm, P., Vilkman, E., Raudaskoski, T., Luukkonen, E., & Kauppila, A. (1997). The effect of postmenopause and postmenopausal HRT on measured voice values and vocal symptoms. Maturitas, 28(1), 47-53.
• Marrison, M., & Rammage, L. (1994). The management of voice disorders (1 Basım). Singular Publishing.
• Meerschman, I., D’haeseleer, E., Catry, T., Ruigrok, B., Claeys, S.,& Van Lierde, K. (2017). Effect of two isolated vocal facilitating techniques glottal fry and yawn-sigh on the phonation of female speech-language pathology students: A pilot study. Journal of Communication Disorders, 66, 40-50.
• Meurer, E. M., Wender, M. C. O., Von Eye Corleta, H., & Capp, E. (2004). Female suprasegmental speech parameters in reproductive age and postmenopause. Maturitas, 48(1), 71-77.
• Park, J., Alnouri, G., Eichorn, D., & Sataloff, R. T. (2020). Correlation Between Presbylarynx and Laryngeal EMG. Journal of Voice, 36 (3), 413-416.
• Prat, Y. (2019). Animals have no language, and humans are animals too. Perspectives on Psychological Science, 14(5), 885-893.
• Raj, A., Gupta, B., Chowdhury, A., & Chadha, S. (2010). A study of voice changes in various phases of menstrual cycle and in postmenopausal women. Journal of Voice, 24(3), 363-368.
• Rubin, J. S., Sataloff, R. T., & Korovin, G. S. (2014). Diagnosis and treatment of voice disorders. Plural Publishing.
• Sabol, J. W., Lee, L., & Stemple, J. C. (1995). The value of vocal function exercises in the practice regimen of singers. Journal of Voice, 9(1), 27-36.
• Schneider, B., Van Trotsenburg, M., Hanke, G., Bigenzahn, W., & Huber, J. (2004). Voice impairment and menopause. Menopause, 11(2), 151-158.
• Singh, R. (2019). Profiling humans from their voice. Springer.
• Sovani, P. V., & Mukundan, G. (2010). Comparison of post menopausal voice changes across professional and non-professional users of the voice. South African Journal of Communication Disorders, 57(1), 76.
• Yang, J., & Xu, W. (2020). Characteristics of functional dysphonia in children. Journal of Voice, 34(1), 156-e1.