Publications by authors named "Ehsan Naderifar"

8 Publications

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Relation Between Dysphonia Severity Index (DSI) and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).

J Voice 2020 Aug 1. Epub 2020 Aug 1.

Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Objectives: This study aims to conduct a relationship survey between subjective voice assessment (the Persian version of consensus auditory perceptual evaluation of voice (called ATSHA)) and the Dysphonia Severity index (DSI).

Study Design: Cross-sectional, methodological study.

Methods: Our sample included 144 adults; 48 patients with different voice disorders and 96 volunteers without voice disorders, hearing complaints or any auditory-perceptual voice disorders. The vocal tasks included in the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the DSI were performed and recorded. We used subjective and objective assessments to investigate the correlation between the CAPE-V perceptual-auditory assessment parameters and the DSI. Finally, through using the univariate-linear regression and other statistical analyses, we examined the correlation and prediction value of subjective assessment by the DSI.

Results: The result of correlation of the total DSI value and individual items with the CAPE-V parameters demonstrated the strongest correlation between the DSI and breathiness (R = 0/563) in the second sentence of the CAPE-V scale, and the weakest correlation between the DSI and overall severity (R = 0/202) in the sixth sentence. The results of the univariate linear regression model indicated that the highest predictive power was obtained for the DSI and breathiness (R = 0/427) in the sixth sentence in the dysphonic group, while the lowest predictive power was found for low intensity and strain (R = 0/025) in the connected speech in the control group.

Conclusion: This study found a significant relationship between the target objective and subjective voice assessment scales in most parameters. Furthermore, the findings of the current study show that the DSI scale, as an objective tool, can predict some auditory-perceptual parameters.
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http://dx.doi.org/10.1016/j.jvoice.2020.06.030DOI Listing
August 2020

Use of formant centralization ratio for vowel impairment detection in normal hearing and different degrees of hearing impairment.

Logoped Phoniatr Vocol 2019 Dec 15;44(4):159-165. Epub 2019 Jan 15.

Department of Epidemiology and Biostatistics, Faculty of Health, Health promotion research center, Zahedan University of Medical Sciences , Zahedan , Iran.

Hearing-impaired (HI) speakers show changes in vowel production and formant frequencies, as well as more cases of overlapping between vowels and more restricted formant space, than hearing speakers. This study was intended to explore whether the use of different acoustic parameters (Formant Centralization Ratio (FCR), Vowel Space Area (VSA), F2i/F2u ratio (second formant of/i,u/)) was suitable or not for characterizing impairments in the articulation of vowels in the speech of HL speakers. In fact, correlated acoustic parameters are used to determine the limits of tongue movements in vowel production in different severity degrees of hearing impairment. Speech recordings of 40 speakers with HL and 40 healthy controls were acoustically analyzed. The vowels (/a/,/i/,/u/) were extracted from the word context and, then, the first and second formants were calculated. The same vowel-formant elements were used to construct the FCR, expressed as (F2u + F2a + F1i + F1u)/(F2i + F1a), the F2i/F2u ratio, and the vowel space area (VSA), expressed as ABS((F1i*(F2a-F2u)+F1a*(F2u-F2i)+F1u*(F2i-F2a))/2). The FCR differentiated HL groups from the control group and the discrimination was not gender-sensitive. All parameters were found to be strongly correlated with each other. The findings of this study showed that FCR was a more sensitive acoustic parameter than F2i/F2u ratio and VSA to distinguish speech of the HL groups from that of the normal group. Thus, FCR is considered to be applicable as an early objective measure of impaired vowel articulation in HL speakers.
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http://dx.doi.org/10.1080/14015439.2018.1545867DOI Listing
December 2019

Dysphonia Characteristics and Vowel Impairment in Relation to Neurological Status in Patients with Multiple Sclerosis.

J Voice 2020 May 19;34(3):364-370. Epub 2018 Oct 19.

Air Pollution and Respiratory Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Purpose: In this study, we attempted to assess the phonation and articulation subsystem changes in patients with multiple sclerosis compared to healthy individuals using Dysphonia Severity Index and Formant Centralization Ratio with the aim of evaluating the correlation between these two indexes with neurological status.

Materials And Methods: A sample of 47 patients with multiple sclerosis and 20 healthy speakers were evaluated. Patients' disease duration and disability were monitored by a neurologist. Dysphonia Severity Index and Formant Centralization Ratio scores were computed for each individual. Acoustic analysis was performed by Praat software; the statistical analysis was run using SPSS 21. To compare multiple sclerosis patients with the control group, Mann-Whitney U test was used for non-normal data and independent-samples t test for normal data. Also a logistic regression was used to compare the data. Correlation between acoustic characteristics and neurological status was verified using Spearman correlation coefficient and linear regression was performed to evaluate the simultaneous effects of neurological data.

Results: Statistical analysis revealed that a significant difference existed between multiple sclerosis and healthy participants. Formant Centralization Ratio had a significant correlation with disease severity.

Conclusion: Multiple sclerosis patients would be differentiated from healthy individuals by their phonation and articulatory features. Scores of these two indexes can be considered as appropriate criteria for onset of the speech problems in multiple sclerosis. Also, articulation subsystem changes might be useful signs for the progression of the disease.
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http://dx.doi.org/10.1016/j.jvoice.2018.09.018DOI Listing
May 2020

Cross-Cultural Adaptation and Validation of the Vocal Fatigue Index into Persian.

J Voice 2019 Nov 30;33(6):947.e35-947.e41. Epub 2018 Aug 30.

Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, Tennessee.

Introduction: The aim of the present study was the cross-cultural adaptation and validation of the Vocal Fatigue Index (VFI) in Persian.

Methods: The English version of the VFI was translated to Persian using the guidelines of International Quality of Life Assessment. Eighty participants with voice disorders and 50 healthy controls without any voice disorders completed the Persian version of the VFI. The 80 participants with voice disorders completed the VFI a second time a week from the initial completion to evaluate test-retest reliability.

Results: The VFI measure demonstrated a strong internal consistency. Cronbach alpha coefficient was 0.95 for tiredness and avoidance of voice use, 0.86 for physical discomfort and 0.83 for improvement or lack thereof of symptoms with voice rest. VFI also showed a high test-retest reliability (r = 0.75-0.89).

Conclusions: The Persian version of the VFI is considered to be a valid and reliable questionnaire for identifying individuals with probable vocal fatigue. The VFI can be utilized in clinics across Iran in the assessment and treatment of individuals with vocal fatigue.
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http://dx.doi.org/10.1016/j.jvoice.2018.07.024DOI Listing
November 2019

Voice Handicap Index in Persian Speakers with Various Severities of Hearing Loss.

Folia Phoniatr Logop 2016 17;68(5):211-215. Epub 2017 Jun 17.

Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: The purpose of this study was to assess and compare the total score and subscale scores of the Voice Handicap Index (VHI) in speakers with and without hearing loss. A further aim was to determine if a correlation exists between severities of hearing loss with total scores and VHI subscale scores.

Patients And Methods: In this cross-sectional, descriptive analytical study, 100 participants, divided in 2 groups of participants with and without hearing loss, were studied. Background information was gathered by interview, and VHI questionnaires were filled in by all participants.

Results: For all variables, including mean total score and VHI subscale scores, there was a considerable difference in speakers with and without hearing loss (p < 0.05). The correlation between severity of hearing loss with total score and VHI subscale scores was significant.

Conclusion: Speakers with hearing loss were found to have higher mean VHI scores than speakers with normal hearing. This indicates a high voice handicap related to voice in speakers with hearing loss. In addition, increased severity of hearing loss leads to more severe voice handicap. This finding emphasizes the need for a multilateral assessment and treatment of voice disorders in speakers with hearing loss.
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http://dx.doi.org/10.1159/000455230DOI Listing
June 2017

Voice-related disability of Iranian patients with temporomandibular disorders.

J Voice 2014 Nov 28;28(6):841.e17-20. Epub 2014 Aug 28.

University of Tehran, Tehran, Iran.

Introduction: The relationship between handicaps because of voice disorders and temporomandibular disorders (TMDs) severity was examined.

Method: Fifty-two Persian women with temporomandibular disorder (TMD) were examined by two dentists in separate sessions and the assessment protocol of the Dentistry Clinic of Tehran University of Medical Sciences was filled by both dentists and finally they gave their opinion separately about the existence of TMD and categorized the severity of TMD as mild, moderate, and severe. To assess perceived disability resulting from voice disorders in TMD patients, the voice handicap index (VHI) questionnaire was used.

Results: The total score of VHI in 80.8% of patients with TMD was equal to or more than 14.5. A significant positive relationship was found between the severity of TMD and the total score of VHI (P = 0.000, r = 0.79).

Conclusions: It seems that a comprehensive voice assessment should be included in the evaluation of TMD, and considering different effects of voice disorders on patients' lives, a complete voice evaluation including voice-related disability is necessary to understand the nature of pathophysiology of TMD.
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http://dx.doi.org/10.1016/j.jvoice.2014.04.001DOI Listing
November 2014

Cross-cultural adaptation and validation of the voice-related quality of life into Persian.

J Voice 2014 Nov 5;28(6):842.e1-9. Epub 2014 Jul 5.

Department of Speech Therapy, University of Social Welfare and Rehabilitation Science, Tehran, Iran.

The purpose of this study was to adapt and determine reliability, validity, and responsiveness of voice-related quality of life (V-RQOL) for Persian. A total of 300 patients with voice disorders participated in the study. Also, 116 people without any voice disorders volunteered to participate in the study as a control group. All participants filled in the Persian version of V-RQOL. The reliability, validity, and responsiveness were studied. Results demonstrated that the discrimination coefficient is significant for all items. The V-RQOL measure showed a strong internal consistency (Cronbach alpha coefficient = 0.88-0.91) and a good test-retest reliability (r = 0.93-0.95). Pre- and post-treatment results showed a significant responsiveness (functioning, 0.000; social-emotional, 0.001; and total, 0.000). Effect size range of 1.26-1.59 and the standardized response mean range of 1.07-1.41 were obtained for V-RQOL. It seems that the Persian version of V-RQOL is valid, reliable, and responsive to change, and this questionnaire can be used for completing voice evaluation for patients with dysphonia.
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http://dx.doi.org/10.1016/j.jvoice.2014.03.013DOI Listing
November 2014

Intrarater and interrater reliability of sagittal head posture: a novel technique performed by a physiotherapist and a speech and language pathologist.

J Voice 2014 Nov 18;28(6):842.e11-6. Epub 2014 Jun 18.

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Introduction: Different professionals such as speech and language pathologists and voice scientists are involved in the evaluation of head and neck posture. Therefore, a reliable, time-efficient, and precise method of posture assessment is essential for use in clinical and research settings. Photogrammetry is one of the most commonly used methods to assess head and neck posture. The objectives of this study were to evaluate the intrarater reliability of the method with a large sample size and the interrater reliability by two different specialists (a physiotherapist and a speech and language pathologist).

Method: A total of three hundred four subjects (144 males and 160 females) aged between 18 and 28 years participated in the study. During the test session, a photograph was taken of the left-side profile of each subject in their ordinary and comfortable position. The head posture angle of each picture was calculated by two raters. The whole procedure was repeated in a retest session, 24 hours later. A total number of eight analyses were performed for each subject. The reliability was evaluated at several stages hierarchically and after confirming the reliability in each step, the next step was investigated. Paired t tests on the differences of scores obtained at all the aforementioned stages were used to ensure the absence of any systematic bias. To assess the reliability, intraclass correlation coefficients (ICCs) and the standard error of measurements (SEMs) were calculated.

Results: There was no significant difference between the mean values of the test and the retest angles at any stage of calculating the head posture angle in both pictures by both examiners (P > 0.05). The ICC and SEM values calculated for all stages were between 0.86-0.97 and 0.52-1.53, respectively.

Conclusion: Systematic bias has not occurred at any stage. The ICC and SEM values calculated have demonstrated that there were appropriate relative and absolute reliabilities in all stages. This method is suggested to be used simply in research and clinical areas by different specialists.
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http://dx.doi.org/10.1016/j.jvoice.2014.02.014DOI Listing
November 2014