Commanding the Crew, Damaging the Voice? Self-Reported Vocal Health and Care Among Coxswains

The primary objective of this cross-sectional survey study was to describe the frequency, characteristics, and consequences of voice problems among coxswains. Additionally, we sought to identify factors that predict the presence of perceived voice problems among these athletes, and evaluate the nature and extent of participants' knowledge, use, and perceived benefit of interventions to prevent voice problems.

Eighty-five participants (54 females and 31 males) completed the survey. The majority (62.4%) were between 18 and 24 years of age. Participants completed an electronic survey posted to a Reddit community ("r/rowing") to assess demographics; voice use, voice care practices, and prior vocal education; nature of vocal symptoms; and perception and use of voice treatment. Participants also completed the Voice Handicap Index (VHI-10). Data were analyzed using descriptive statistics and binary logistic regression.

Half (56%) of the participants self-reported voice problems after coxing. Fifteen (17.6%) participants reported a significant voice handicap (VHI > 11), 21 (24.7%) missed practice due to voice problems, and nine (10.6%) sought treatment for their voice problems. Amplification was used by most coxswains (90.2%). Participants who reported a greater number of days per week of coxing were more likely to report voice problems. Conversely, the use of optimal voice was associated with a lower risk for voice disorders. Almost one-third of respondents (31.8%) reported receiving training on optimal voice use, and 55.3% reported anticipated benefit from training.

Voice complaints were prevalent among coxswains, yet the majority of participants reported receiving no training in voice care strategies. Given the need for frequent, precise, and timely verbal communication by coxswains, in challenging acoustic environments, as well as the relatively high prevalence of voice problems among these athletes, findings of this study highlight the need for future studies to develop targeted education programs to support vocal health among coxswains.