SLPOtherJournal of voice : official journal of the Voice Foundation2020

The Effect of Pulmonary Function on the Incidence of Vocal Fatigue Among Teachers.

Eric J Hunter, Lynn Maxfield, Simone Graetzer

PMID 30686633

WHAT IT FOUND

Female teachers who reported more voice discomfort had lower unadjusted lung capacity, peak flow and first-second volume; this link disappeared after adjusting for body size and age.

Male teachers showed no such link.

Key findings

01In female teachers, each one-unit increase in standardized vocal discomfort score was associated with 0.18 L lower raw forced vital capacity, 0.15 L lower forced expiratory volume in the first second, and 0.40 L/s lower peak expiratory flow.

02The association was absent in male teachers and was not present when pulmonary values were normalized to predicted normal values.

03Female teachers had higher mean vocal discomfort scores than male teachers, with Factor 2 means of 5.98 and 3.85 respectively.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study measured pulmonary function and vocal fatigue in one assessment session, so it describes association rather than cause. The sample was unequal by gender, with 96 female and 26 male teachers, and the authors note caution for comparisons other than Factor 2. The female raw-lung association disappeared when pulmonary values were normalized to predicted normal values, so body size and age matter. Only spirometry and the Vocal Fatigue Index were analysed, so other factors that could explain gender differences were not measured. The authors note uncertainty in measurement, sample size, unequal sample distributions, and whether the participants represent all teachers.

The easy way to misread this

Do not conclude that low lung capacity causes vocal fatigue or that spirometry screening should be used routinely. The association was only with unadjusted measures in female teachers, it disappeared after adjustment, and the screening pathway was proposed but not tested.

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