Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency

Bruna M.R. de Andrade, Celiane de Farias, Eugenia H.O. Valença, Michela P. Dos Santos, Gabriela P.F. Cardoso, Carla S.Pereira Sousa, Julia Rodrigues Santana, Guilherme Daniel Breternitz Mannis, Ester Almeida Sales, Lucas E.de A. Souza, Yasmin D. Goes, Susana de Carvalho, Thayza S. Carvalho, Roberto Salvatori, Luiz A. Oliveira-Neto, Alaíde H.A. Oliveira, Enaldo V. Melo, Manuel H. Aguiar-Oliveira, Anita H.O. Souza, Mario C.P. OliveiraNeuza J. Sales, Gisane C. Monteiro, José Marcel de Lima, Marcos Felipe Harder Annunziato, Jeferson Sampaio D’avila

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves “short long-lived people”, rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Material and methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusions: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.

Original languageEnglish (US)
JournalArchives of endocrinology and metabolism
Volume66
Issue number2
DOIs
StatePublished - 2022

Keywords

  • Growth Hormone
  • auditory-perception analysis
  • quality of life
  • singing
  • voice

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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