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A Four-Part Study of the Aging Voice

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University of Kentucky UKnowledge Theses and Dissertations--Rehabilitation Sciences Rehabilitation Sciences 2019 GROWING OLD AS A ROCK STAR: A FOUR-PART STUDY OF THE AGING VOICE JoAnna Sloggy University of Kentucky, [email protected] Author ORCID Identifier: https://orcid.org/0000-0002-8042-131X Digital Object Identifier: https://doi.org/10.13023/etd.2020.023 Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Sloggy, JoAnna, "GROWING OLD AS A ROCK STAR: A FOUR-PART STUDY OF THE AGING VOICE" (2019). Theses and Dissertations--Rehabilitation Sciences. 59. https://uknowledge.uky.edu/rehabsci_etds/59 This Doctoral Dissertation is brought to you for free and open access by the Rehabilitation Sciences at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Rehabilitation Sciences by an authorized administrator of UKnowledge. For more information, please contact [email protected]. STUDENT AGREEMENT: I represent that my thesis or dissertation and abstract are my original work. Proper attribution has been given to all outside sources. I understand that I am solely responsible for obtaining any needed copyright permissions. I have obtained needed written permission statement(s) from the owner(s) of each third-party copyrighted matter to be included in my work, allowing electronic distribution (if such use is not permitted by the fair use doctrine) which will be submitted to UKnowledge as Additional File. I hereby grant to The University of Kentucky and its agents the irrevocable, non-exclusive, and royalty-free license to archive and make accessible my work in whole or in part in all forms of media, now or hereafter known. I agree that the document mentioned above may be made available immediately for worldwide access unless an embargo applies. I retain all other ownership rights to the copyright of my work. I also retain the right to use in future works (such as articles or books) all or part of my work. I understand that I am free to register the copyright to my work. REVIEW, APPROVAL AND ACCEPTANCE The document mentioned above has been reviewed and accepted by the student’s advisor, on behalf of the advisory committee, and by the Director of Graduate Studies (DGS), on behalf of the program; we verify that this is the final, approved version of the student’s thesis including all changes required by the advisory committee. The undersigned agree to abide by the statements above. JoAnna Sloggy, Student Dr. Joseph Stemple, Major Professor Dr. Esther Dupont-Versteegden, Director of Graduate Studies GROWING OLD AS A ROCK STAR: A FOUR-PART STUDY OF THE AGING VOICE ________________________________________ DISSERTATION ________________________________________ A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Health Sciences at the University of Kentucky By JoAnna Sloggy Lexington, Kentucky Co-Directors: Dr. Joseph Stemple, Professor of Communication Sciences & Disorders and Dr. Dana Howell, Professor of Occupational Science & Occupational Therapy Lexington, Kentucky Copyright © JoAnna Sloggy 2019 https://orcid.org/0000-0002-8042-131X ABSTRACT OF DISSERTATION GROWING OLD AS A ROCK STAR – A FOUR-PART STUDY OF THE AGING VOICE This dissertation focuses on the aging voice - specifically the aging elite vocal athlete. It is comprised of four components; a series of research studies and a viewpoint piece designed to explore the awareness, struggles, and vocal compensations of aging singers dealing with age related vocal and performance problems. The overarching goal of these studies is to inform the development of a voice care protocol for the aging rock star to guide customized intervention for these elite vocal athletes that is focused on optimizing both vocal output and performance. First, the dissertation introduces and identifies characteristics of the exceptional voice. This involves a new vocal continuum that includes the normal voice, the trained voice, and the exceptional voice. The second component is a qualitative study of older contemporary commercial music (CCM) singers adjustments and accommodations associated with their aging. From this, four overarching themes are identified: modest self-perception of their vocal prowess and its relationship to performance, acute sensitivity to changes in vocal quality, recognition of the critical association of voice quality with their identity as a performer, and an array of accommodations to aging- related vocal changes. The third component of the dissertation is a randomized control trial examining the efficacy of Vocal Function Exercises as a treatment modality for presbyphonia. Analysis revealed that the experimental group improved in select outcome measures including decreased glottic gap, increased upper range, and maximum phonation time at the 6-week post-treatment re-evaluation with no such changes in the control group. The final study investigated the vocal and performing trajectories of six CCM male singers through analysis of video performances across their career. Singers were shown to make accommodations consistent with the reported findings from component two. Such accommodations include decreased total time singing for some singers, accommodations for range changes, and changes to performance. From this study, the Exceptional Voice Protocol was created to provide a customized vocal and performance blueprint for each artist that meets their unique needs for their exceptional voices. Overall, this research indicates that aging CCM singers appear to be experiencing age and performance related vocal changes and are making detectable accommodations to their performance. Additional findings show that Vocal Function Exercises appear to be an efficacious treatment modality for aging voice. Findings from these studies confirm the need for continued research on age-related vocal and performance changes for these performers and guidelines for appropriate habilitation and rehabilitation so these rock stars can continue performing for as long as they desire. KEYWORDS: presbyphonia, presbylaryngeus, aging elite vocal athlete, Vocal Function Exercises, voice therapy, exceptional voice JoAnna Sloggy (Name of Student) 12/16/2019 Date GROWING OLD AS A ROCK STAR: A FOUR-PART STUDY OF THE AGING VOICE By JoAnna Sloggy Joseph Stemple, PhD, CCC-SLP Co-Director of Dissertation Dana Howell, PhD, OTD, OTR/L, FAOTA Co-Director of Dissertation Esther Dupont-Versteegden, PhD Director of Graduate Studies 12/16/2019 Date TABLE OF CONTENTS LIST OF TABLES ............................................................................................................. ix LIST OF FIGURES .......................................................................................................... xii PROLOGUE ....................................................................................................................... 1 CHAPTER 1: INTRODUCTION ....................................................................................... 3 Dissertation Stages .......................................................................................................... 4 Component I Primary Objective – Defining the Exceptional Voice .......................... 4 Component I Rationale: .......................................................................................... 5 Component II Primary Objective – The Aging Exceptional Voice: In Their Own Words .......................................................................................................................... 5 Component II Rationale: ......................................................................................... 5 Component III Primary Objective – Treatment of the Aging Voice .......................... 6 Component III Rationale: ....................................................................................... 6 Component IV Primary Objective – Crafting the Stage Show Across the Continuum ..................................................................................................................................... 8 Component IV Rationale: ....................................................................................... 8 Summary ......................................................................................................................... 9 CHAPTER 2: REVIEW OF THE LITERATURE ........................................................... 10 The Aging Voice – An Overview ................................................................................. 10 Voice Producing Mechanisms: Respiration, Phonation, and Resonance ................. 10 Effects of Aging on the Respiratory System............................................................. 12 Respiration ............................................................................................................ 12 Respiratory Changes ............................................................................................. 14 Effects of Aging on the Laryngeal Mechanism ........................................................ 15 Phonation .............................................................................................................. 15 Aerodynamic-Myoelastic Theory ..................................................................... 16 Hirano’s Body Cover Theory............................................................................ 17 Titze’s Self-Oscillation Theory........................................................................
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