Treatment for Teachers With Vocal Fatigue

Study Overview
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Brief Summary
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Teachers are a population at high risk for voice disorders given their occupational demands. In a teaching career, a common debilitating symptom among all vocal symptoms experienced is - vocal fatigue, impacting teachers' occupational performance and increasing health care costs. It is therefore essential to identify potential treatment options to alleviate the symptom of vocal fatigue. The purpose of this study is to utilize a body-system level cardiovascular training protocol in comparison to traditional voice production training to alleviate the symptoms of vocal fatigue.

Official Title
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Cardiovascular Conditioning in the Treatment of Vocal Fatigue

Conditions
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Vocal Fatigue, Treatment

Intervention / Treatment
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* Behavioral: Cardiovascular Conditioning Protocol
* Other: Voice Production Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female teachers between the ages of 21-60 years Female instructors and college professors between the ages of 21-60 years A score of ≥ 15 on factor 1 of the VFI (tiredness and avoidance of voice use) or a score of ≤ 5 on factor 3 of the VFI (improvement of symptoms or lack thereof with rest) Sedentary- wherein participants will need to be completing mild intensity cardiovascular exercise less than 150 minutes in less than 5 days per week Exclusion Criteria: Trained athletes Trained singers Smoking in the past 6months Prior history of a vocal fold pathology and current vocal fold pathology

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cardiovascular Conditioning Protocol<br>Participants will complete a sub maximal cardiovascular training program twice per week for a period of 4 weeks. | Behavioral: Cardiovascular Conditioning Protocol<br>* Participants will be randomized to either one of the treatment arms to receive treatment for a period of 4 weeks.<br>|
| Active Comparator: Voice Production Exercises<br>Participants will complete voice production exercises twice per week for a period of 4 weeks. | Other: Voice Production Exercises<br>* Participants will be randomized to either one of the treatment arms to receive treatment for a period of 4 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Physiologic Cost of Speaking | Physiologic Cost of Speaking is measured as the rate of oxygen consumption at steady state/ rate of speech (wpm) for each of the two reading tasks | At baseline, at 4 weeks after treatment | 
| Changes in Oxygen Uptake Kinetics | Oxygen Uptake Kinetics is measured as the pattern of oxygen use during each of the two reading tasks | At baseline, at 4 weeks after treatment | 
| Changes in Post Task Physiological Recovery | Post Task Physiological Recovery is measured as the time, seconds, to reach baseline of oxygen consumption post task (within 0.2ml/kg/min) following each of the reading tasks | At baseline, at 4 weeks after treatment | 
| Changes in Excess Post Exercise Consumption (EPOC) | EPOC is measured as the magnitude of recovery oxygen consumption, ml/kg/min for each of the reading tasks | At baseline, at 4 weeks after treatment | 
| Changes in Ratings of Perceived Exertion (RPE) | Borg Scale of Ratings of Perceived Exertion (RPE)- measures the self-report of vocal effort for each of the reading tasks | At baseline, at 4 weeks after treatment | 
| Changes in Vocal Fatigue Index (VFI) | Vocal Fatigue Index (VFI) is a retrospective scale that measures self-reported symptoms of vocal fatigue | At baseline, at 4 weeks after treatment | 
| Changes in Global Rating of Vocal Fatigue (VAS 100mm) | Global Rating of Vocal Fatigue (VAS 100mm) measures the ability to sustain voice with no fatigue at the end of a working day | At baseline, at 4 weeks after treatment |