title: Voice problems of group fitness instructors: diagnosis, treatment, perceived and experienced attitudes and expectations of the industry.
abstract: OBJECTIVE
  To determine the anatomical and physiological nature of voice problems and their treatment in those group fitness instructors (GFIs) who have sought a medical diagnosis; the impact of voice disorders on quality of life and their contribution to activity limitations and participation restrictions; and the perceived attitudes and level of support from the industry at large in response to instructor's voice disorders and need for treatment.
  
  
  METHODS
  Prospective self-completion questionnaire design.
  
  
  METHODS
  Thirty-eight individuals (3 males and 35 females) currently active in the Australian fitness industry who had been diagnosed with a voice disorder completed an online self-completion questionnaire administered via SurveyMonkey.
  
  
  RESULTS
  Laryngeal pathology included vocal fold nodules (N = 24), vocal fold cysts (N = 2), vocal fold hemorrhage (N = 1), and recurrent chronic laryngitis (N = 3). Eight individuals reported vocal strain and muscle tension dysphonia without concurrent vocal fold pathology. Treatment methods were variable, with 73.68% (N = 28) receiving voice therapy alone, 7.89% (N = 3) having voice therapy in combination with surgery, and 10.53% (N = 4) having voice therapy in conjunction with medication. Three individuals (7.89%) received no treatment for their voice disorder. During treatment, 82% of the cohort altered their teaching practices. Half of the cohort reported that their voice problems led to social withdrawal, decreased job satisfaction, and emotional distress. Greater than 65% also reported being dissatisfied with the level of industry and coworker support during the period of voice recovery.
  
  
  CONCLUSIONS
  This study identifies that GFIs are susceptible to a number of voice disorders that impact their social and professional lives, and there is a need for more proactive training and advice on voice care for instructors, as well as those in management positions within the industry to address mixed approaches and opinions regarding the importance of voice care.
authors.affiliation: Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. Electronic address: a.rumbach@uq.edu.au.
authors.forename: Anna F
authors.initials: AF
authors.lastname: Rumbach
mesh_terms: D000328:Adult; D005260:Female; D020446:Fitness Centers; D006801:Humans; D008297:Male; D008875:Middle Aged; D013663:Teaching; D014832:Voice Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D055815:Young Adult
keywords: Aerobics instructor; Education; Group fitness instructor; Professional voice use; Training; Treatment; Vocal hygiene; Voice disorder