“…Because all the previously cited ambulatory studies only tracked subjects with normal voices, results may not accurately represent pathological vocal status changes but instead provide insights into solely the normative (i.e., nonpathological) aspects of vocal deterioration and recovery. In addition, study designs using vocal loading tasks artificially elicit vocal status changes in participants with normal voices (Fujiki, Chapleau, Sundarrajan, McKenna, & Sivasankar, 2016;Remacle, Finck, Roche, & Morsomme, 2012;Whitling, Rydell, & Åhlander, 2015); therefore, results cannot be assumed to accurately represent pathological vocal conditions such as VH. For example, patients with VH-who are in chronic pathological vocal states-might not fluctuate in the same manner as those with normal voices.…”