NSU professors research cure for the common hoarse

(Tahlequah, Okla.)--The cure for the common hoarse might be around the corner. Two professors at Northeastern State University have begun research to determine the efficacy of general vocal hygiene practices, enlisting cheerleaders at local high schools to participate in the study.

"There is a lot of literature out there about vocal hygiene programs, but nobody has studied it to see whether it works," said Dr. Ronald Schaefer, professor of speech language pathology. "I personally have some doubts as to whether some work."

Schaefer is conducting the study with Dr. Kent Hawkins, associate professor of speech language pathology. Sixty cheerleaders are participating. The half in the experimental group are presented with a vocal hygiene program and the 30 in the control group are not.

"The vocal hygiene program we've assigned to the experimental group is distilled from several others," Schaefer said. "We selected techniques that are common or universal to the others and assembled those into ours."

To preserve impartiality, the cheerleaders and their high schools are not named, but Schaefer noted all study participants are female.

"There just aren't enough male cheerleaders in the area for a representative sample," he said. "Obviously we won't be able to account for any gender differences. That is for another study."

Applications of the research may span many at-risk groups such as teachers, coaches, public speakers, singers and factory workers. Though other professions can provide adequate samples, the researchers found cheerleaders intriguing because they voluntarily stress their voices and often sustain vocal damage at young ages.

"Vocal impairment among cheerleaders is almost normal," Hawkins said. "Often when you meet a hoarse adult female, if she wasn't a smoker she was a cheerleader."

Though most people have experienced hoarseness after shouting, Hawkins said the permanent damage occurs with repeated strain.

"The vocal cords swell and develop blisters called nodules," he said. "Continue yelling and those nodules eventually burst and form granuloma. Imagine getting a blister on your heel but wearing the shoes that hurt anyway. On your foot you get a permanent scar. Scarring on your vocal cords makes you permanently hoarse. Furthermore, the cords are delicate. They are not very big and not very thick."

Data collection began in April 2011. During the study, cheerleaders are having their vocal folds and cords digitally filmed and photographed with an endoscope. Their voices are also being acoustically analyzed to check for changes. The study is ongoing until late 2011 and no determinations have been made.

Schaefer said his idea of conducting a vocal stress treatment study on cheerleaders dates back 20 years, but he found it impractical until he found a colleague with whom he could work.

"Our areas of interest complement each other perfectly and Hawkins has more experience writing grant requests," Schaefer said. "He received wonderful grant reviews and INBRE (IDeA Network of Biomedical Research Excellence) was excited for us to do this study. We got the $35,000 we requested."

All of the INBRE grant went to purchasing the endoscope. Schaefer said NSU's College of Science and Health Professions and the health professions department provided vital assistance, finding funds to cover other expenses associated with the study.

The study is being conducted in partnership with the University of Oklahoma College of Medicine, and medical assessments will be provided by Keith Clark, M.D., a specialist in otolaryngology.

"Equipment for the study was sold to us at greatly reduced costs," Hawkins said. "By regulation, Dr. Clark cannot work on this study for free, but he is charging very little. We also owe thanks to a lot of people at NSU. Susan Foster and the Office of Research and Sponsored Programs were extremely helpful, as were Dr. John de Banzie of the biology department and Dr. Ernst Bekkering of the Institutional Review Board."

Some research on cheerleading and vocal damage has been conducted on college-age women, particularly by Dr. James Case at Arizona State University. Hawkins believes identification and earlier application of vocal hygiene techniques can greatly benefit younger cheerleaders.

"Hopefully in our summation we can find something to help these young ladies not damage their cords," he said. "So many of them come out of high school with vocal cords that are not fully functional."

Schaefer said the study will yield useful information regardless of its outcome.

"I may be skeptical of some of the vocal hygiene programs out there, but if this study shows they work, that's great," he said. "We can encourage their use among cheerleaders and other at-risk groups. If it turns out they don't work, then we can begin working to identify hygiene methods that are effective."