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Review
. 2020 Feb 26;63(2):509-532.
doi: 10.1044/2019_JSLHR-19-00057. Epub 2020 Feb 19.

Toward a Consensus Description of Vocal Effort, Vocal Load, Vocal Loading, and Vocal Fatigue

Eric J Hunter  1 , Lady Catherine Cantor-Cutiva  2   3 , Eva van Leer  4 , Miriam van Mersbergen  5 , Chaya Devie Nanjundeswaran  6 , Pasquale Bottalico  7 , Mary J Sandage  8 , Susanna Whitling  9
Affiliations
Review

Toward a Consensus Description of Vocal Effort, Vocal Load, Vocal Loading, and Vocal Fatigue

Eric J Hunter et al. J Speech Lang Hear Res. .

Abstract

Purpose The purpose of this document is threefold: (a) review the uses of the terms "vocal fatigue," "vocal effort," "vocal load," and "vocal loading" (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a "linguistically modeled" definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts. Method A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms ("vocal fatigue," "vocal effort," "vocal load," and "vocal loading"), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions. Results The occurrence and frequency of "vocal load," "vocal loading," "vocal effort," and "vocal fatigue" in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, "vocal demand" and "vocal demand response," in place of the terms "vocal load" and "vocal loading." We also propose standardized definitions for all four concepts. Conclusion Through a comprehensive literature search, the terms "vocal fatigue," "vocal effort," "vocal load," and "vocal loading" were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.

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Figures

Figure 1.
Figure 1.
Evolution of publications per year and topic.
Figure 2.
Figure 2.
Key word co-occurrence network.
Figure 3.
Figure 3.
Summary of the definitions.
See this image and copyright information in PMC

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