Relations Between Creaky Voice And Vocal Symptoms Of Fatigue

Background: The use of a creaky voice in speech has become more common. Laryngeal findings relate creaky voice with strong adductive tension in the glottis, and thus it may be expected to be related to an increased risk of vocal fatigue. Methods: The present study investigated the relation of creaky voice use and vocal symptoms in 104 Finnish female university students (mean age 24.3 years, SD 6.3 years). They had no known pathology of voice or hearing. The participants were recorded while reading aloud a text of approximately 40 s in duration. They also filled in a questionnaire consisting of the Voice Handicap Index (VHI, translation in Finnish), and half of them also answered questions about the frequency and severity of symptoms of vocal fatigue. The samples were perceptually analysed for the amount of creakiness and strain by a speech therapist and a voice trainer. Results: The interrater reliability of the listeners was acceptable (Pearson's chi(2) = 100.159, p = 0.000 for creak; chi(2) = 69.199, p = 0.000 for strain). Neither creakiness nor strain correlated with vocal symptoms. Participants with a low and a high amount of creakiness or strain did not differ from each other in terms of vocal symptoms or VHI scores. Symptoms' total score correlated with VHI total score and total scores of VHI's physical subscale. Creakiness and strain correlated positively with each other (r = 0.40, p = 0.000). Conclusion: No significant relations were found between creakiness or strain and vocal symptoms in this sample of university students.