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

• Published in: Archives of Endocrinology and Metabolism Vol. 66; no. 2; pp. 198 - 205
• Main Authors: de Andrade, Bruna M R, Valença, Eugenia H O, Salvatori, Roberto, Oliveira, Neto, Luiz A, Souza, Anita H O, Oliveira, Alaíde H A, Oliveira, Mario C P, Melo, Enaldo V, de Carvalho, Susana, Sales, Neuza J, Monteiro, Gisane C, de Lima, José Marcel, Annunziato, Marcos Felipe Harder, Mannis, Guilherme Daniel Breternitz, de A Souza, Lucas E, Goes, Yasmin D, Carvalho, Thayza S, de Farias, Celiane, Dos Santos, Michela P, Cardoso, Gabriela P F, Pereira Sousa, Carla S, Santana, Julia Rodrigues, Sales, Ester Almeida, d'Avila, Jeferson Sampaio, Aguiar-Oliveira, Manuel H
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Endocrinologia e Metabologia 28-04-2022; Brazilian Society of Endocrinology and Metabolism
• Subjects: Adult; auditory-perception analysis; Dwarfism, Pituitary; Growth Hormone; Human Growth Hormone; Humans; Original; Quality of Life; Singing; voice; Voice Quality; Voice Training; voice; Growth Hormone; singing; quality of life; auditory-perception analysis
• ISSN: 2359-3997; 2359-4292
• DOI: 10.20945/2359-3997000000449

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.
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).
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.
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.