Maximum Phonation Time of School-Aged Children in Pakistan: A Normative Study : Maximum Phonation Time of School-Aged Children

Iqra Naeem; Raffa Mubeen; Syed Aftab Haider Shah; Sumaiyah Obaid; Ghulam Saqulain

doi:10.54393/pjhs.v5i02.1290

Authors

Iqra Naeem Benazir Bhutto Hospital, Rawalpindi, Pakistan
Raffa Mubeen Riphah International University, Islamabad, Pakistan
Syed Aftab Haider Shah AMF, PAC, Kamra, Attock, Pakistan
Sumaiyah Obaid Riphah International University, Islamabad, Pakistan
Ghulam Saqulain Capital Hospital, Post-Graduate Medical Institute, Islamabad, Pakistan https://orcid.org/0000-0002-6452-9339

DOI:

https://doi.org/10.54393/pjhs.v5i02.1290

Keywords:

Acoustic Measurement, Glottal Efficiency, Maximum Phonation Time

Abstract

Maximum phonation time (MPT) evaluates maximum vocal capabilities and can be used to assess the effectiveness of behavioral and medical therapy interventions. There is a literature gap regarding MPT normalcy data for Pakistani children. Objective: To determine the Maximum Phonation Time of School Aged Children in Pakistan and its association with participant variables and impact of the 6-minute walk test on participant vitals. Methods: This cross-sectional survey was conducted in Rawalpindi and Islamabad on typical healthy school-aged children from August 2021 to January 2022. The sample included both genders, aged 6-13 years having normal language. Tools used included a basic demographic sheet, token test, stopwatch, growth chart, sphygmomanometer, pulse oximeter, and 6-minute walk test. Blood Pressure, oxygen saturation, heart rate, and MPT were calculated before and after the six-minute walk test (6-MWT). Data were analyzed by using SPSS version 21.0. Results: Results show MPT of 13.11 ± 3.93 seconds. Scores were significantly (p= 0.000) higher for higher age groups. 6-MWT revealed a significantly (p=0.000) higher post walk SPO2 (99.16 ± 0.89 Vs.97.82 ± 1.45), HR (105.94 ± 14.53 vs 92.94 ± 14.79). systolic (112.46±13.40 vs. 107.25 ± 13.66) and diastolic blood pressure (79.07 ± 8.17 Vs.73.84 ± 8.50) compared to pre walk. A significantly (p<0.001) strong positive correlation was noted for age(r=.515), weight (r=.460), height (r=.491) and distance (r=.281). Conclusions: MPT of Pakistani 6-13 years children is 13.11 ± 3.93 seconds with significantly higher MPT for higher age groups. MPT has a strong positive correlation with age, weight, height and distance and increases after walking. MPT values for boys were slightly higher than for girls.

References

Tavares EL, Brasolotto AG, Rodrigues SA, Pessin AB, Martins RH. Maximum phonation time and s/z ratio in a large child cohort. Journal of Voice. 2012 Sep; 26(5): 675-e1. doi: 10.1016/j.jvoice.2012.03.001. DOI: https://doi.org/10.1016/j.jvoice.2012.03.001

Lewis K. The Maximum Duration of Phonation of /a/ in Children. [Master's thesis]. Portland State University: 1977. doi: 10.15760/etd.2471. DOI: https://doi.org/10.15760/etd.2471

Lima DC, Palmeira AC, Costa EC, Mesquita FO, Andrade FM, Correia Júnior MA. Correlation between slow vital capacity and the maximum phonation time in healthy adults. Revista CEFAC. 2014 Mar; 16: 592-7. DOI: https://doi.org/10.1590/1982-021620146912

Solomon NP, Garlitz SJ, Milbrath RL. Respiratory and laryngeal contributions to maximum phonation duration. Journal of Voice. 2000 Sep; 14(3): 331-40. doi: 10.1016/S0892-1997(00)80079-X. DOI: https://doi.org/10.1016/S0892-1997(00)80079-X

Chen Q, Ge P, Su X, Jiang J, Qiu Q, Chen S. Use maximum loudest phonation time to evaluate unilateral vocal cord paralysis voice. Lin Chuang er bi yan hou tou Jing wai ke za zhi= Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery. 2011 Aug; 25(15): 681-4.

Al-Yahya SN, Akram MH, Kumar KV, Amin SN, Malik NA, Zawawi NA, et al. Maximum phonation time normative values among malaysians and its relation to body mass index. Journal of Voice. 2022 Jul; 36(4): 457-63. doi: 10.1016/j.jvoice.2020.07.015. DOI: https://doi.org/10.1016/j.jvoice.2020.07.015

Dehqan A, Ansari H, Bakhtiar M. Objective voice analysis of Iranian speakers with normal voices. Journal of Voice. 2010 Mar; 24(2): 161-7. doi: 10.1016/j.jvoice.2008.07.005. DOI: https://doi.org/10.1016/j.jvoice.2008.07.005

Pascotini FD, Haeffner LS, Cielo CA. Forced vital capacity and maximum phonation time compared to waist circumference and nutritional status of children. Revista CEFAC. 2016 Jul; 18: 915-22. doi: 10.1590/1982-0216201618419315. DOI: https://doi.org/10.1590/1982-0216201618419315

Finger LS, Hoffmann CF, Cielo CA. Maximum phonation time and body mass index in nondysphonic eutrophic children. Journal of Voice. 2021 May; 35(3): 500-e1. DOI: https://doi.org/10.1016/j.jvoice.2019.09.018

Coelho AR, Siqueira LT, Fadel CB, Rosa MD, Dassie-Leite AP. Influence of the speech-language pathologist’s orientation on maximum phonation times. Revista CEFAC. 2018 Mar; 20: 201-8. doi: 10.1590/1982-021620182028717. DOI: https://doi.org/10.1590/1982-021620182028717

Lewis K, Casteel R, McMahon J. Duration of sustained/a/related to the number of trials. Folia Phoniatrica et Logopaedica. 1982; 34(1): 41-8. doi: 10.1159/000265626. DOI: https://doi.org/10.1159/000265626

Harden JR and Looney NA. Duration of sustained phonation in kindergarten children. International Journal of Pediatric Otorhinolaryngology. 1984 Mar; 7(1): 11-9. doi: 10.1016/S0165-5876(84)80049-X. DOI: https://doi.org/10.1016/S0165-5876(84)80049-X

Cielo CA, Pascotini FD, Haeffner LS, Ribeiro VV, Christmann MK. Maximum phonation time of/e/and voiceless/ė/and their relationship with body mass index and gender in children. Revista CEFAC. 2016 Mar; 18: 491-7. doi: 10.1590/1982-021620161825915. DOI: https://doi.org/10.1590/1982-021620161825915

Geiger R, Strasak A, Treml B, Gasser K, Kleinsasser A, Fischer V, et al. Six-minute walk test in children and adolescents. The Journal of Pediatrics. 2007 Apr; 150(4): 395-9. doi: 10.1016/j.jpeds.2006.12.052 DOI: https://doi.org/10.1016/j.jpeds.2006.12.052

Whitaker HA and Noll JD. Some linguistic parameters of the Token Test. Neuropsychologia. 1972 Dec; 10(4): 395-404. doi: 10.1016/0028-3932(72)90002-4. DOI: https://doi.org/10.1016/0028-3932(72)90002-4

Alkhamra RA and Al‐Jazi AB. Validity and reliability of the Arabic Token Test for children. International Journal of Language & Communication Disorders. 2016 Mar; 51(2): 183-91. doi: 10.1111/1460-6984.12198. DOI: https://doi.org/10.1111/1460-6984.12198

Cielo CA and Cappellari VM. Maximum phonation time in pre-school children. Brazilian Journal of Otorhinolaryngology. 2008 Jul; 74(4): 552-60. doi: 10.1016/S1808-8694(15)30602-9. DOI: https://doi.org/10.1016/S1808-8694(15)30602-9

Pribuisiene R, Uloza V, Kardisiene V. Voice characteristics of children aged between 6 and 13 years: Impact of age, gender, and vocal training. Logopedics Phoniatrics Vocology. 2011 Dec; 36(4): 150-5. doi: 10.3109/14015439.2011.569756. DOI: https://doi.org/10.3109/14015439.2011.569756

Prater RJ and Swift RW. Manual of voice therapy: Little Brown and Company; 1984.

Fabron EM, Santos GR, Omote S, Perdoná GC. Respiratory dynamics measurements in children with four to ten years of age. Pró-Fono Revista de Atualização Científica. 2006; 18: 313-22. doi: 10.1590/S0104-56872006000300011. DOI: https://doi.org/10.1590/S0104-56872006000300011

De Souza LB and Santos MM. Body mass index and acoustic voice parameters: is there a relationship?. Brazilian journal of otorhinolaryngology. 2018 Jul; 84: 410-5. doi: 10.1016/j.bjorl.2017.04.003. DOI: https://doi.org/10.1016/j.bjorl.2017.04.003

de Souza LB, Dos Santos MM, Pernambuco LA, de Almeida Godoy CM, da Silva Lima DM. Effects of weight loss on acoustic parameters after bariatric surgery. Obesity Surgery. 2018 May; 28: 1372-6. doi: 10.1007/s11695-017-3018-6. DOI: https://doi.org/10.1007/s11695-017-3018-6

Isshiki N, Okamura H, Morimoto M. LXXXIII Maximum phonation time and air flow rate during phonation: simple clinical tests for vocal function. Annals of Otology, Rhinology & Laryngology. 1967 Dec; 76(5): 998-1007. doi: 10.1177/000348946707600510. DOI: https://doi.org/10.1177/000348946707600510

Cunha LJ, Pereira EC, Ribeiro VV, Dassie-Leite AP. Influence of the body position and emission number in the results of the maximum phonation times of adults without vocal complaints. Journal of Voice. 2019 Nov; 33(6): 831-7. doi: 10.1016/j.jvoice.2018.05.010. DOI: https://doi.org/10.1016/j.jvoice.2018.05.010