title: Voice problems in the fitness industry: Factors associated with chronic hoarseness.
abstract: OBJECTIVE
  To determine factors associated with chronic hoarseness in Australian group fitness instructors (GFIs).
  
  
  METHODS
  A total of 361 GFIs (81 males, 280 females), aged between 18-67 years currently active in the Australian fitness industry, completed a 65-item self-completion questionnaire distributed via SurveyMonkey. Demographic, lifestyle and voice use variables thought to influence vocal health and voice production in the GFI population were examined using logistic regression analyses. GFIs' chronic hoarseness with response options "positive" and "negative" was considered as the outcome variable of interest.
  
  
  RESULTS
  Approximately 39% of the study participants reported having chronic hoarseness. Multivariable logistic regression modelling revealed a set of statistically significant factors associated with chronic hoarseness. These include: younger age, partial voice loss while instructing, partial voice loss after instructing and using vocal volume louder than normal speaking voice whilst instructing.
  
  
  CONCLUSIONS
  This study has identified factors associated with the presentation of chronic hoarseness in the Australian GFI population. Prospective studies are required to validate the findings of this study in order to better understand predictive factors of chronic hoarseness among GFIs.
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia, Brisbane , Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Rumbach
authors.forename: Asaduzzaman
authors.initials: A
authors.lastname: Khan
authors.forename: Michaela
authors.initials: M
authors.lastname: Brown
authors.forename: Karra
authors.initials: K
authors.lastname: Eloff
authors.forename: Alexandra
authors.initials: A
authors.lastname: Poetschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006685:Hoarseness / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011795:Surveys and Questionnaires; D013663:Teaching; D055815:Young Adult
keywords: Voice; dysphonia; professional issues