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Boominathan P, Mahalingam S, Arunachalam R, Venkatesh L. An eclectic Voice Therapy Program for the Treatment of Hyperfunctional Voice Disorders (HFVD). J Voice 2023; 37:969.e1-969.e21. [PMID: 34261583 DOI: 10.1016/j.jvoice.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE An eclectic voice therapy program includes sequenced and structured set of exercises combining direct and indirect intervention methods. Tailor-made exercise prescription with specific cultural adaptations are needed to provide a holistic change to voice quality.1 This study detailed the construction of an exercise prescription for participants with hyperfunctional voice disorder [HFVD] in the Indian context. METHOD The exercise program was developed based on literature related to vocal therapy approaches and delivery methods. Adaptations were introduced to a selected set of exercises. Five voice experts verified the exercises and their prescription for content and feasibility of use in the Indian context. Modification suggested by the experts were included for framing the final version of the exercise program. This structured therapy program was planned for 6 weeks (30 minutes duration/session offered individually twice per week, with a gap of two days between sessions in a week) with the goals to improve voice quality, flexibility, and endurance while speaking. Five participants with HFVD partook in the study for pilot testing. Stroboscopy, perceptual voice analysis, Dysphonia Severity Index (DSI) and Vocal Fatigue Index in Tamil (VFI-T) were used to report the therapy outcomes. Participants' report on the learning process and generalization of the program were documented. Wilcoxon-signed rank test was used to test the pre-post outcome measures. RESULTS An eclectic voice therapy program, i.e., Comprehensive Voice Habilitation Program [CVHP] was constructed and it included vocal hygiene instructions, warm-up & cool-down, easy onset, resonant voice, and carry over exercises. Participants completed the program in 14-18 sessions (over 7 to 9 weeks of therapy). All participants showed significant changes in vocal fold movement patterns, reduction in ventricular hyperadduction, overall grade of voice quality, DSI and VFI-T. Participants reported that pictorial illustrations, feedback, and monitoring sheets were useful in learning the exercises. CONCLUSION CVHP showed significant change in the voice-related outcome measures and was a viable program for treating HFVD.
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Affiliation(s)
- Prakash Boominathan
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India.
| | - Shenbagavalli Mahalingam
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Ravikumar Arunachalam
- SRM Institute of Science & Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
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Kissel I, Papeleu T, Verbeke J, Van Lierde K, Meerschman I, D'haeseleer E. Immediate effects of a semi-occluded water-resistance ventilation mask on vocal outcomes in women with dysphonia. JOURNAL OF COMMUNICATION DISORDERS 2023; 103:106331. [PMID: 37098295 DOI: 10.1016/j.jcomdis.2023.106331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Semi-occluded vocal tract exercises (SOVTEs) are frequently used exercises in voice therapy. An important shortcoming to most SOVTEs is the inability to include continuous speech in these exercises. A variation of water-resistance therapy (WRT), during which a patient phonates through a resonance tube ending in water, was developed to include continuous speech: the semi-occluded water resistance ventilation mask (SOVM-WR). The current study investigated the immediate effects of this innovative technique on vocal outcomes of women with dysphonia. METHODS A pretest-posttest randomized controlled trial was performed. Twenty female participants were randomly assigned to the experimental SOVM-WR group or the WRT (control) group. A blinded multidimensional voice assessment was conducted before and after a 30-minute therapy session with the assigned technique. RESULTS No significant changes were found in acoustic or auditory-perceptual vocal outcomes in either of the groups, except for a significant increase in lowest frequency in both groups. Patient-reported outcomes (PROMs) showed significant improvements of vocal comfort, vocal effort, and voice quality in both groups, and participants indicated that they would use the techniques at home. CONCLUSIONS The similar results of the SOVM-WR to WRT and promising PROMs confirm its suitability as an alternative to the latter technique. Potential reasons for a lack of improvement of objective and auditory-perceptual vocal outcomes are vocal fatigue, tube dimensions and immersion, and the small sample size. Large-scale and longitudinal research is needed to examine whether the SOVM-WR has a higher transfer to spontaneous speech than WRT after a full therapy program.
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Affiliation(s)
- Imke Kissel
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Tine Papeleu
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Jolien Verbeke
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Faculty of Humanities, Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Iris Meerschman
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Royal Conservatory Brussels, Musical Department, Brussels, Belgium
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Zenari MS, Cota ADR, Rodrigues DDA, Nemr K. Do Professionals Who Use the Voice in a Journalistic Context Benefit from Humming as a Semi-occluded Vocal Tract Exercise? J Voice 2021:S0892-1997(21)00100-4. [PMID: 33895007 DOI: 10.1016/j.jvoice.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Many vocal enhancement and rehabilitation programs for voice professionals define vocal exercises without analyzing their effects on that specific population in which they will be applied, in the established dose and often without considering the presence and absence of vocal alteration. Journalists have sought the voice clinic due to new professional vocal demands and a vocal program is being elaborated. OBJECTIVE To determine the immediate effect of humming in professionals with and without voice disorders who work under high vocal demand in a journalistic context. METHOD Thirty-six individuals who completed the Dysphonia Risk Screening Protocol and underwent voice recording participated in the study. Three speech therapists defined the presence and/or absence of vocal changes by consensus. Subsequently, five repetitions of humming were proposed; the exercises lasted five seconds each and were separated by five seconds of complete silence, and recordings were made before and after the exercise (vowel and phrase). For the pre and post comparison between the groups with and without vocal changes, acoustic measurements and spectrogram, including the classification of the signal type, were performed. RESULTS The sample had a similar distribution of men and women and a mean age of 39.9 years. Most of the professionals were journalists or reporters. The risk of dysphonia was high for half of the sample, and the presence of vocal changes, predominantly mild ones, was identified in 56%. After the exercise, a decrease in noise at low frequencies and an improvement in the series of harmonics and the signal type were observed in both groups; a decrease in irregularity was observed only in the participants without vocal changes. CONCLUSION The proposed humming exercise had an immediate positive effect on the voice of professionals working in a journalistic context, and the changes were particularly evident in aspects of the voice that were initially altered.
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Affiliation(s)
- Marcia Simoes Zenari
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, Brazil.
| | - Ariane Dos Reis Cota
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, Brazil
| | - Danilo de Albuquerque Rodrigues
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, Brazil
| | - Katia Nemr
- Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, Brazil
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Guzman M, Bertucci T, Pacheco C, Leiva F, Quintana F, Ansaldi R, Quezada C, Muñoz D. Effectiveness of a physiologic voice therapy program based on different semioccluded vocal tract exercises in subjects with behavioral dysphonia: A randomized controlled trial. JOURNAL OF COMMUNICATION DISORDERS 2020; 87:106023. [PMID: 32659480 DOI: 10.1016/j.jcomdis.2020.106023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The present study aimed to assess the effectiveness of a physiologic voice therapy program based on different semioccluded vocal tract exercises in subjects with behavioral dysphonia. METHODS Thirty-four participants with behavioral dysphonia were randomly assigned to one of two treatment groups: 1) voice treatment with physiologic voice therapy plus vocal hygiene program (n=20), and 2) vocal hygiene program only (n=14). Laryngoscopic assessment was performed in all subjects. Before and after voice therapy, participants underwent aerodynamic, electroglottographic, and acoustic assessment. The Voice Handicap Index (VHI), Voice symptom scale (VoiSs), Vocal tract discomfort scale (VTDS), and self-assessment of resonant voice quality were also performed. The treatment included eight voice therapy sessions. For the experimental group, the exercises consisted of a sequence of seven phonatory tasks performed with four different semioccluded vocal tract exercises (SOVTE). Comparison for all variables were performed between experimental group and control group. RESULTS Wilcoxon test showed significant improvements for experimental group for VHI, VoiSs, VTDS (decrease), and self-perception of resonant voice quality (increase). Significant decrease for experimental groups was observed on subglottic pressure, phonation threshold pressure, and glottal airflow across the implemented tasks. CONCLUSION Physiologic voice therapy based on semioccluded vocal tract exercises seems to be an effective tool to improve voice in subjects diagnosed with behavioral dysphonia. Apparently, most changes should be expected in variables related to physical and functional aspects compared to objective variables. Subglottic pressure and phonation threshold pressure seem to be the most change-sensitive parameters and they may reflect a reduction in phonatory effort reported by patients after voice therapy.
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Affiliation(s)
- Marco Guzman
- Department of Communication Sciences and Disorders, Universidad de los Andes, Chile; Department of Otolaryngology, Las Condes Clinic, Santiago, Chile.
| | - Teresa Bertucci
- Department of Communication Sciences and Disorders, University of Chile, Av. Independencia 1027, Santiago, Chile.
| | - Constanza Pacheco
- Department of Otolaryngology, Las Condes Clinic, Av. Estoril 850, Santiago, Chile.
| | - Fernando Leiva
- Department of Communication Sciences and Disorders, Universidad Pedro de Valdivia, Vicuña Mackena 44, Santiago, Chile.
| | - Felipe Quintana
- Department of Communication Sciences and Disorders, University of Chile, Av. Independencia 1027, Santiago, Chile.
| | - Romina Ansaldi
- Facultad de Ciencias de la Salud, Universidad de las Américas, Santiago, Chile.
| | - Camilo Quezada
- Department of Communication Sciences and Disorders, University of Chile, Av. Independencia 1027, Santiago, Chile.
| | - Daniel Muñoz
- Department of Otolaryngology, University of Chile, Av. Independencia 1027, Santiago, Chile.
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Oropharyngeal Geometry and the Singing Voice: Immediate Effect of Two Semi-Occluded Vocal Tract Exercises. J Voice 2020; 36:523-530. [PMID: 32712077 DOI: 10.1016/j.jvoice.2020.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of this study was to verify the immediate effect of a flexible resonance tube in water and of lip trill on oropharyngeal geometry and vocal acoustic parameters of singers without vocal symptoms. METHODS Twenty-two adult singers participated in the study. They had an average age of 27 (±4.8) years. Participants were split into two groups: a group composed of 12 singers who performed the flexible resonance tube (FRT) exercise and a group of 10 singers who performed the Lip Trill technique (LTT). Acoustic pharyngometry and acoustic analysis of the voice were used to assess oropharyngeal geometry before and after the exercises. RESULTS After performing the techniques, the vocal tract length was longer in the group that performed the FRT, compared to the one that performed the LTT. In the acoustic evaluation, there was an improvement in the glottal to noise excitation ratio and a decrease in noise in the group of singers who performed the LTT. In the analysis by sex men had a longer oral cavity compared to women and after application of the techniques greater volume of the vocal tract. CONCLUSION There was variation in the oropharyngeal geometry with the FRT, while the LTT had a positive effect on the vocal acoustic parameters related to glottal noise.
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Calvache C, Guzman M, Bobadilla M, Bortnem C. Variation on Vocal Economy After Different Semioccluded Vocal Tract Exercises in Subjects With Normal Voice and Dysphonia. J Voice 2019; 34:582-589. [PMID: 30738783 DOI: 10.1016/j.jvoice.2019.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE The present study aimed at observing the possible differential effects of eight semioccluded vocal tract exercises (SOVTE) on vocal economy measured by the Quasi Output Cost Ratio (QOCR). METHODS Thirty-six participants were included in this study. They were divided into two groups: an experimental group of subjects diagnosed with mild hyperfunctional dysphonia (n = 17) and a control group of vocally healthy subjects (n = 19). Participants were required to randomly select and produce a series of three SOVTE from a list of eight exercises. The electroglottographic based measure QOCR was used to calculate the vocal economy before and after each voice exercise. RESULTS Significant differences were found when comparing pre and poststages regardless of the vocal condition (normal voice or dysphonia) or the specific SOVTE used. Moreover, when individually comparing the effect of each SOVTE, only tube in water (10 cm) showed significant differences between pre and postconditions (QOCR values were higher after exercises). CONCLUSION In general, semioccluded vocal tract exercises tend to increase vocal economy regardless the vocal condition (normal voice or dysphonia) or the specific SOVTE used. Phonation into a tube submerged deep into water promoted the highest increase in vocal economy. An increased acoustic output, nonproportional increase in vocal folds adduction and an effortless voice production would cause this increase in vocal economy after water resistance therapy.
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Affiliation(s)
- Carlos Calvache
- Corporación Universitaria Iberoamericana, Department Communication Sciences and Disorders, Vocology Center, Bogotá, Colombia.
| | - Marco Guzman
- Universidad de los Andes, Chile, Department of Communication Sciences and Disorders, Las Condes Clinic, Department of Otolaryngology, Santiago, Chile
| | - Marcelo Bobadilla
- Universidad de los Andes, Department of Communication Sciences and Disorders, Santiago, Chile
| | - Cori Bortnem
- Corporación Universitaria Iberoamericana, Department Communication Sciences and Disorders, Vocology Center, Bogotá, Colombia
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Frisancho K, Salfate L, Lizana K, Guzman M, Leiva F, Quezada C. Immediate Effects of the Semi-Occluded Ventilation Mask on Subjects Diagnosed With Functional Dysphonia and Subjects With Normal Voices. J Voice 2018; 34:398-409. [PMID: 30424914 DOI: 10.1016/j.jvoice.2018.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The present study was designed to assess the immediate effects of the semi-occluded ventilation mask (SOVM) in subjects with functional dysphonia and subjects with normal voice. METHODS Sixty-four participants were included in this study (48 women and 16 men). Thirty-one of them were diagnosed with functional dysphonia and 33 with normal voice. All subjects were randomly assigned to one of two conditions: an experimental condition using the SOVM (n = 33) and a control condition with participants not using the SOVM (n = 31). Thus, within both conditions, participants could be either dysphonic or normal-voiced. This produced a total of four different groups: (1) subjects with normal voice with SOVM (n = 17), (2) subjects with normal voice without SOVM (n = 16), (3) dysphonic subjects with SOVM (n = 16), and (4) dysphonic subjects without SOVM (n = 15). All participants underwent aerodynamic, electroglottographic (EGG), and acoustic assessments, and were also asked to assess their own voice, before and after voice exercises. RESULTS Significant differences were found for aerodynamic, EGG, and acoustic variables when comparing SOVM conditions (dysphonic and normal) against control. Cepstral peak prominence and EGG contact quotient showed an increase among dysphonic participants with SOVM. L1-L0 showed an increase for all participants in SOVM condition (dysphonic and normal). Self-perceived resonant voice quality showed an increase for both groups in SOVM condition. Glottal airflow showed a decrease for the dysphonic participants in SOVM condition. Phonation threshold pressure and subglottic pressure showed a decrease for both groups in SOVM condition. CONCLUSION The present study suggests that immediate positive effect could be produced by connected speech phonatory tasks using the SOVM in both dysphonic subjects and subjects with normal voice, the change being greater among the former. SOVM seems to promote an easy voice production and a more efficient phonation.
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Affiliation(s)
- Kharina Frisancho
- Department of EDUCATION, Universidad Nacional de San Agustin, Arequipa, Perú
| | - Lukas Salfate
- Hospital Salvador, Department of otolaryngology, Santiago, Chile
| | - Karla Lizana
- Department of Communication Sciences and Disorders, Universidad de Los Lagos, Osorno, Chile
| | - Marco Guzman
- Universidad de los Andes, CHILE; Department of Otolaryngology, Voice Center, Las Condes Clinic, Santiago, Chile.
| | - Fernando Leiva
- Department of Communication Sciences and Disorders, Universidad Pedro de Valdivia, Santiago, Chile
| | - Camilo Quezada
- Department of Communication Sciences and Disorders, Universidad de Chile, Santiago, Chile
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Nam IC, Kim SY, Joo YH, Park YH, Shim MR, Hwang YS, Sun DI. Effects of Voice Therapy Using the Lip Trill Technique in Patients With Glottal Gap. J Voice 2018; 33:949.e11-949.e19. [PMID: 30104127 DOI: 10.1016/j.jvoice.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Lip trills are widely used as a voice warm-up technique among singers. However, little is known about the effects of lip trills in cases of voice disorders. We examined the therapeutic effects of lip trills in patients with glottal gap. METHODS Patients with glottal gap were classified into three groups according to the type of gap: gap-only, gap with muscle tension dysphonia (MTD), and a sulcus vocalis group. Patients underwent perceptual, acoustic/aerodynamic analyses, stroboscopic evaluations, and subjective analyses using a questionnaire before and after lip trills. The results were analyzed before and after trills and according to and between the groups. RESULTS The results in 42 patients were analyzed. Most of the parameters were improved and glottal gap was significantly reduced after trills in all patients. In the gap-only group (n = 19), most of the parameters showed improvement and were within the respective normal ranges, and glottal gap was improved after trills. In the MTD group (n = 13), although many parameters were improved, the improvement was not as prominent as in the gap-only group. In the sulcus vocalis group (n = 10), only some of the parameters were improved and the improvement in glottal gap was limited. CONCLUSIONS Lip trills were an effective treatment for glottal gap. The therapeutic effect was prominent in the gap-only group, followed by the MTD and sulcus vocalis groups. Trills can be used as an adjuvant treatment option in voice therapy in cases of various voice disorders.
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Affiliation(s)
- Inn-Chul Nam
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Young-Hoon Joo
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Young-Hak Park
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mi-Ran Shim
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yeon-Shin Hwang
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Il Sun
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers. J Voice 2018; 32:200-208. [DOI: 10.1016/j.jvoice.2017.03.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 11/22/2022]
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Guzman M, Jara R, Olavarria C, Caceres P, Escuti G, Medina F, Medina L, Madrid S, Muñoz D, Laukkanen AM. Efficacy of Water Resistance Therapy in Subjects Diagnosed With Behavioral Dysphonia: A Randomized Controlled Trial. J Voice 2017; 31:385.e1-385.e10. [DOI: 10.1016/j.jvoice.2016.09.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
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Fantini M, Succo G, Crosetti E, Borragán Torre A, Demo R, Fussi F. Voice Quality After a Semi-Occluded Vocal Tract Exercise With a Ventilation Mask in Contemporary Commercial Singers: Acoustic Analysis and Self-Assessments. J Voice 2017; 31:336-341. [DOI: 10.1016/j.jvoice.2016.05.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 05/24/2016] [Accepted: 05/31/2016] [Indexed: 11/27/2022]
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Investigation of the Immediate Effects of Humming on Vocal Fold Vibration Irregularity Using Electroglottography and High-speed Laryngoscopy in Patients With Organic Voice Disorders. J Voice 2017; 31:48-56. [DOI: 10.1016/j.jvoice.2016.03.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/17/2016] [Indexed: 11/22/2022]
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Fabron EMG, Petrini AS, Cardoso VDM, Batista JCT, Motonaga SM, Marino VCDC. Efeitos imediatos da técnica de vibração sonorizada de língua associada à estimulação nervosa elétrica transcutânea (TENS). Codas 2017; 29:e20150311. [DOI: 10.1590/2317-1782/20172015311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Verificar variação da qualidade vocal após realização da técnica de vibração sonorizada de língua associada à estimulação nervosa elétrica transcutânea (TVSL+TENS) sobre a laringe em mulheres com função laríngea normal. Verificar, ainda, a influência do tempo de realização desta técnica na voz. Método Participaram 40 mulheres (média 23,4 anos) sem queixas ou alterações vocais. Foi realizada TVSL associada ou não à TENS por 3 minutos, descanso e realização da técnica por mais 2 minutos (total 5 min). Foram feitas gravações das vozes antes (Pré), após três minutos (Pós 3 min) e após dois minutos adicionais de técnica (Pós 5 min). Utilizou-se a corrente TENS, com dois eletrodos sobre a cartilagem tireóidea. Realizou-se autoavaliação, avaliação acústica e perceptivoauditiva. Resultados Ao comparar TVSL isolada e TVSL+TENS observou-se que a combinação das técnicas resultou em sensação de maior estabilidade na emissão vocal (autoavaliação) e melhor ganho na qualidade vocal (avaliação perceptivoauditiva). Não houve diferença estatística nos achados acústicos entre TVSL e TVSL+TENS. Ao considerar a TVSL+TENS e comparar seu tempo de realização, observou-se, na autoavaliação, sensação de menor tensão muscular (3 min) e maior conforto da emissão (5 min); na análise acústica, elevação de F0 (3 e 5 min) e intensidade (5 min), em relação ao momento Pré; e na avaliação perceptivoauditiva, melhor qualidade vocal (3 min). Conclusão Comparando TVSL isolada e TVSL+TENS, houve mudanças na sensação de conforto e tensão muscular e também, na qualidade vocal. Por outro lado, a TVSL+TENS realizada em 3 ou 5 mintuos resultou em efeitos benéficos na voz, identificados nas avaliações realizadas.
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Guzman M, Laukkanen AM, Traser L, Geneid A, Richter B, Muñoz D, Echternach M. The influence of water resistance therapy on vocal fold vibration: a high-speed digital imaging study. LOGOP PHONIATR VOCO 2016; 42:99-107. [PMID: 27484690 DOI: 10.1080/14015439.2016.1207097] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study investigated the influence of tube phonation into water on vocal fold vibration. METHOD Eight participants were analyzed via high-speed digital imaging while phonating into a silicon tube with the free end submerged into water. Two test sequences were studied: (1) phonation pre, during, and post tube submerged 5 cm into water; and (2) phonation into tube submerged 5 cm, 10 cm, and 18 cm into water. Several glottal area parameters were calculated using phonovibrograms. RESULTS The results showed individual differences. However, certain trends were possible to identify based on similar results found for the majority of participants. Amplitude-to-length ratio, harmonic-to-noise ratio, and spectral flatness (derived from glottal area) decreased for all tube immersion depths, while glottal closing quotient increased for 10 cm immersion and contact quotient for 18 cm immersion. Closed quotient decreased during phonation into the tube at 5 cm depth, and jitter decreased during and after it. CONCLUSION Results suggest that the depth of tube submersion appears to have an effect on phonation. Shallow immersion seems to promote smoother and more stable phonation, while deeper immersion may involve increased respiratory and glottal effort to compensate for the increased supraglottal resistance. This disparity, which is dependent upon the degree of flow resistance, should be considered when choosing treatment exercises for patients with various diagnoses, namely hyperfunctional or hypofunctional dysphonia.
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Affiliation(s)
- Marco Guzman
- a Department of Communication Sciences and Disorders , University of Chile , Santiago , Chile.,b Department of Otolaryngology , Las Condes Clinic , Santiago , Chile
| | - Anne-Maria Laukkanen
- c Speech and Voice Research Laboratory, School of Education , University of Tampere , Tampere , Finland
| | - Louisa Traser
- d Institute of Musicians' Medicine, Freiburg University Medical Center , Freiburg , Germany
| | - Ahmed Geneid
- e Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery , Helsinki University Central Hospital, University of Helsinki , Helsinki , Finland
| | - Bernhard Richter
- d Institute of Musicians' Medicine, Freiburg University Medical Center , Freiburg , Germany
| | - Daniel Muñoz
- f Department of Otolaryngology , University of Chile , Santiago , Chile
| | - Matthias Echternach
- d Institute of Musicians' Medicine, Freiburg University Medical Center , Freiburg , Germany
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Guzman M, Calvache C, Romero L, Muñoz D, Olavarria C, Madrid S, Leiva M, Bortnem C, Pino J. Do Different Semi-Occluded Voice Exercises Affect Vocal Fold Adduction Differently in Subjects Diagnosed with Hyperfunctional Dysphonia? Folia Phoniatr Logop 2015; 67:68-75. [PMID: 26394210 DOI: 10.1159/000437353] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To observe the possible differential effects of 8 different semi-occluded vocal tract exercises on glottal contact quotient (CQ) as a measure of vocal fold impact stress. PATIENTS AND METHODS Eighty participants were divided into two groups: an experimental group with hyperfunctional dysphonia and a control group of vocally healthy subjects. The participants were recorded before, during and after the exercises. Electroglottographic samples were analyzed to obtain CQ. RESULTS For the experimental group, all exercises, except lip trills and tongue trills, had an overall significant effect when conditions before, during and after the exercises were compared. The CQ presented differently across the 8 semi-occluded postures during exercise for both groups. For the experimental group, most exercises increased the CQ during practice. Only lip and tongue trills demonstrated lower CQ during exercise. CONCLUSIONS Different semi-occluded exercises differentially affect vocal fold adduction. Lip and tongue trills produced the lowest CQ. Therefore, they may be recommended for decreasing glottal adduction. A straw submerged 10 cm below the water surface presented the greatest CQ. A shallower depth led to a lower CQ, while deeper submersion produced a higher CQ.
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Affiliation(s)
- Marco Guzman
- Department of Communication Sciences, University of Chile, Santiago, Chile
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Dargin TC, DeLaunay A, Searl J. Semioccluded Vocal Tract Exercises: Changes in Laryngeal and Pharyngeal Activity During Stroboscopy. J Voice 2015; 30:377.e1-9. [PMID: 26390961 DOI: 10.1016/j.jvoice.2015.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the changes in laryngeal activity from baseline during three different semioccluded vocal tract exercises (SOVTs). STUDY DESIGN This is a prospective case-series study. METHODS Transnasal stroboscopy was performed while four singers performed three SOVTs (straw phonation, lip trill, and tongue trill) to evaluate laryngeal changes during the execution of SOVTs. Evaluations using a modified Stroboscopy Evaluation Rating Form captured the following parameters: amplitude of vocal fold movement, mucosal wave, phase closure, glottal closure, anterior-posterior vocal tract constrictions, medial-lateral vocal tract constrictions, laryngeal ascension, and pharyngeal constriction during a pitch glide. RESULTS The parameters that changed from baseline, as well as the direction and magnitude of change that occurred across SOVTs, varied within and between each subject. All the singers benefited from at least one SOVT, but no single SOVT benefited all four singers. CONCLUSIONS Although SOVTs result in endoscopic and stroboscopic changes that might be considered beneficial, the results indicate marked variability across SOVTs and singers in terms of the laryngeal and pharyngeal adjustments induced by the exercises. Singing teachers and Speech Language Pathologists (SLPs) may need to more carefully assess the impact of specific SOVTs when deciding which one(s) to prescribe as a teaching or therapeutic exercise.
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Affiliation(s)
| | - Anne DeLaunay
- University of Missouri-Kansas City Conservatory of Music, Kansas City, Missouri
| | - Jeff Searl
- University of Kansas Medical Center, Kansas City, Kansas
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Dargin TC, Searl J. Semi-Occluded Vocal Tract Exercises: Aerodynamic and Electroglottographic Measurements in Singers. J Voice 2015; 29:155-64. [DOI: 10.1016/j.jvoice.2014.05.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/21/2014] [Accepted: 05/23/2014] [Indexed: 11/29/2022]
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18
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Cordeiro GF, Montagnoli AN, Ubrig MT, Menezes MHM, Tsuji DH. Comparison of Tongue and Lip Trills with Phonation of the Sustained Vowel /<i>ε</i>/ Regarding the Periodicity of the Electroglottographic Waveform and the Amplitude of the Electroglottographic Signal. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/oja.2015.54018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Immediate Effects of Humming on Computed Electroglottographic Parameters in Patients With Muscle Tension Dysphonia. J Voice 2014; 28:733-41. [DOI: 10.1016/j.jvoice.2014.02.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 02/10/2014] [Indexed: 11/23/2022]
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20
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Cielo CA, Christmann MK. Finger Kazoo: modificações vocais acústicas espectrográficas e autoavaliação vocal. REVISTA CEFAC 2014. [DOI: 10.1590/1982-021620145513] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivo correlacionar modificações vocais acústicas espectrográficas e autoavaliação após o finger kazoo. Métodos análise de /a:/ de 46 mulheres sem queixas vocais ou afecções laríngeas pelo Real Time Spectrogram® e autoavaliação antes (Momento 1 – M1), após o finger kazoo (Momento 2 – M2) e após cinco minutos de silêncio (Momento 3 – M3). Teste Kappa, Qui-quadrado, Spearman. Resultados melhora da intensidade do escurecimento do traçado dos formantes (F) e das altas frequências, regularidade do traçado e definição dos harmônicos. Melhora na autoavaliação vocal, conforme aumento da intensidade do escurecimento do traçado de F3, da definição do traçado, do número de harmônicos e redução da substituição de harmônicos por ruídos nas médias frequências. Conclusões após o finger kazoo, aumentou a intensidade da cor do traçado, a regularidade e definição nas espectrografias e houve melhora na autoavaliação vocal.
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Balata PMM, Silva HJ, Pernambuco LA, Amorim GO, Braga RSM, Fernandes da Silva EG, Lima LMD, Moraes SRA. Electrical activity of extrinsic laryngeal muscles in subjects with and without dysphonia. J Voice 2014; 29:129.e9-17. [PMID: 24962232 DOI: 10.1016/j.jvoice.2014.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 03/18/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare dysphonic individuals to nondysphonic with regards to electrical activity of extrinsic laryngeal muscles related to perceptual and acoustic vocal parameters. HYPOTHESIS Dysphonic individuals have higher electrical activity in the supra and infrahyoid muscles than those nondysphonic. STUDY DESIGN Prospective, cross-sectional, case series study. METHODS Forty-one subjects, divided into two groups according to the presence of dysphonia, underwent evaluation of surface electromyography, auditory-perceptual, and acoustic evaluations of voice during the vocal rest and sustained emissions of the vowel /ε/ and count of 20 to 30 at usual and strong intensities. RESULTS The dysphonic group differed significantly from the nondysphonic by (1) lower electrical activity normalized by the maximum sustained voluntary activity evaluated in all tasks of phonation in the suprahyoid group; (2) lower recruitment of electrical activity in emissions of strong intensity compared with those of usual intensity in the suprahyoid muscles to emit the vowel /ε/ (13.66 ± 5.17 in dysphonic group and 35.20 ± 7.60 in the nondysphonic group, P = 0.029) and in the infrahyoid muscles in the count of 20 to 30 (14.90 ± 4.69 vs. 42.01 ± 6.15; P < 0.001) and to emit the vowel /ε/ (11.47 ± 6.52 vs. 22.66 ± 9.05, P < 0.001); (3) lower vocal intensity to produce the vowel /ε/ in usual and strong intensities and count in strong intensity. The electrical activities of the maximum sustained voluntary activity were reduced with increasing degree of dysphonia. CONCLUSIONS There was lower electrical activity of the extrinsic laryngeal muscles in dysphonic individuals compared with nondysphonic, and related to the degree of dysphonia.
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Affiliation(s)
| | - Hilton Justino Silva
- Speech and Language Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Leandro Araújo Pernambuco
- Speech and Language Department, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Geová Oliveira Amorim
- Institute of Human Sciences, Communication and Arts, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | | | | | - Leilane Maria de Lima
- Speech and Language Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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22
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Andrade PA, Wood G, Ratcliffe P, Epstein R, Pijper A, Svec JG. Electroglottographic study of seven semi-occluded exercises: LaxVox, straw, lip-trill, tongue-trill, humming, hand-over-mouth, and tongue-trill combined with hand-over-mouth. J Voice 2014; 28:589-95. [PMID: 24560003 DOI: 10.1016/j.jvoice.2013.11.004] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Semi-occluded vocal tract exercises (SOVTE) are often used in voice clinics. SOVTE change the acoustic vocal tract impedance in relation to the glottis impedance, improving voice quality. However, differences among SOVTE, such as the number of vibration sources into the vocal tract, are often disregarded by clinicians. Some SOVTE present single, whereas others double source. This study aims at investigating changes in voice production pattern for a series of SOVTE. A combined exercise (tongue-trill coupled with hand-over-mouth) was implemented to illustrate the effect of a secondary source of vibration in the vocal tract. METHOD Twenty-three healthy volunteers performed a series of SOVTE: LaxVox, straw, lip-trill, tongue-trill, hand-over-mouth, humming, and tongue-trill combined with hand-over-mouth. Comfortable phonation served as control exercise. The dependent variables were electroglottography contact quotient (CQ), contact quotient range (CQr), fundamental frequency (F0), fundamental frequency range, and difference between the first formant frequency and F0 (F1 - F0). RESULTS A significant difference for CQr scores compared with comfortable phonation was found for the combined tongue-trill with hand-over-mouth, lip-trill, LaxVox, and tongue-trill exercises. The F1 - F0 acoustic analysis showed significant differences in scores for exercises with one versus two sources of vibration. DISCUSSION AND CONCLUSION The results indicate that SOVTE should be divided into two groups, as follows: (a) steady (single sourced) with lower CQr and F1 - F0 difference (hand-over-mouth, humming, and straw) and (b) fluctuating (dual source) with larger CQr and F1 - F0 difference (tongue-trill, lip-trill, and LaxVox). Because of these differences, also different therapeutic effects can be expected. Tongue-trill combined with hand-over-mouth exhibited mixed effects of both the exercise groups.
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Affiliation(s)
- Pedro Amarante Andrade
- Department of Biophysics, Faculty of Science, Palacky University, Olomouc, Czech Republic; Department of Speech and Language Therapy, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
| | - Gary Wood
- Department of Speech and Language Therapy, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Philippa Ratcliffe
- Department of Speech and Language Therapy, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Ruth Epstein
- Department of Speech and Language Therapy, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Anne Pijper
- Department of Speech and Language Therapy, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Jan G Svec
- Department of Biophysics, Faculty of Science, Palacky University, Olomouc, Czech Republic
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23
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Enflo L, Sundberg J, Romedahl C, McAllister A. Effects on vocal fold collision and phonation threshold pressure of resonance tube phonation with tube end in water. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:1530-1538. [PMID: 23838993 DOI: 10.1044/1092-4388(2013/12-0040)] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively. METHOD Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography, and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel, who also rated the subjects' singing experience. RESULTS Resonance tube phonation significantly increased CTP and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced. CONCLUSION Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP did not reach significance.
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Cielo CA, Frigo LF, Christmann MK. Pressão sonora e tempo máximo de fonação após a técnica de finger kazoo. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013000400029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: verificar o nível de pressão sonora (NPS) modal e o tempo máximo de fonação (TMF) de /a/ de mulheres adultas, sem queixas vocais ou afecções laríngeas, antes, imediatamente após e cinco minutos após a execução da técnica de finger kazoo (FK). MÉTODO: coleta do TMF/a/, medida da frequência fundamental (f0) e seu desvio-padrão e do NPS modal, de 32 mulheres entre 18 e 40 anos de idade sem queixas vocais ou afecções laríngeas antes (M1), imediatamente após três séries de 15 repetições do FK (M2), e cinco minutos após silêncio (M3). Testes Spearman, Tukey e Friedman. RESULTADOS: aumento do NPS modal em M2 (com significância) e em M3; aumento de TMF/a/ em M2 e M3. CONCLUSÃO: no grupo pesquisado de mulheres adultas sem queixas vocais ou afecções laríngeas, houve aumento do NPS modal imediatamente após três séries de 15 repetições da técnica de FK, mostrando que a técnica pode influenciar a pressão sonora, a loudness e a projeção vocal.
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Affiliation(s)
| | - Letícia Fernandez Frigo
- Centro Universitário Franciscano, Brasil; Universidade Federal de Santa Maria, Brasil; Colégio Brasileiro de Estudos Sistêmicos
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Guzman M, Laukkanen AM, Krupa P, Horáček J, Švec JG, Geneid A. Vocal Tract and Glottal Function During and After Vocal Exercising With Resonance Tube and Straw. J Voice 2013; 27:523.e19-34. [DOI: 10.1016/j.jvoice.2013.02.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 02/19/2013] [Indexed: 10/26/2022]
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26
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Guzman M, Rubin A, Muñoz D, Jackson-Menaldi C. Changes in glottal contact quotient during resonance tube phonation and phonation with vibrato. J Voice 2013; 27:305-11. [PMID: 23490123 DOI: 10.1016/j.jvoice.2013.01.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/24/2013] [Indexed: 11/19/2022]
Abstract
Phonating into narrow hard-walled tubes of varying diameters and length as an extension of the vocal tract is considered a semioccluded vocal tract exercise. Semioccluded vocal tract postures have been postulated to have a therapeutic effect during the treatment of the dysphonic patient. They appear to affect at least two components of the voice source (1) glottal flow pulse and (2) vibrational characteristics of the vocal folds. Vibrato also has been described as a possible therapeutic tool and may decrease phonatory hyperfunction. The aim of this study was to determine the influence of resonance tubes and phonation with vibrato on the closed quotient. Thirty-six adult classical singers were recruited for this study. Subjects were asked to produce four phonatory tasks at comfortable pitch and loudness: sustained vowel [a:] without vibrato, sustained vowel [a:] with vibrato, sustained phonation into a straw without vibrato, and sustained phonation into a straw with vibrato. Computer analysis of the contact quotient (CQ) was performed for each type of phonation in every participant. An increase in CQ variability was observed during tube phonation when compared with vowel phonation. Although there was a decrease in the mean CQ values when comparing vowel phonation without vibrato with the other three phonatory tasks, the difference was not statistically significant. Intrasubject analysis demonstrated a decrease in the CQ during tube and vibrato phonation in most of the participants. Although a causal relationship is not proven, this finding suggests that the use of straws and vibrato during phonation may have potential therapeutic value in the treatment of patients with hyperfunctional voice disorders.
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Affiliation(s)
- Marco Guzman
- Lakeshore Professional Voice Center, Lakeshore Ear, Nose and Throat Center, St. Clair Shores, Michigan, USA.
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Pimenta RA, Dájer ME, Hachiya A, Tsuji DH, Montagnoli AN. Parameters acoustic and high-speed kymography identified effects of voiced vibration and vocal fry exercises. Codas 2013; 25:577-83. [PMID: 24626983 DOI: 10.1590/s2317-17822014000100010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 11/08/2013] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.
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Affiliation(s)
- Regina Aparecida Pimenta
- Universidade de São Paulo, Engineering School of São Carlos, São CarlosSP, Brazil, Engineering School of São Carlos, Universidade de São Paulo - USP - São Carlos (SP), Brazil
| | - María Eugenia Dájer
- Universidade de São Paulo, School of Medicine, São PauloSP, Brazil, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil
| | - Adriana Hachiya
- Universidade de São Paulo, School of Medicine, São PauloSP, Brazil, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil
| | - Domingos Hiroshi Tsuji
- Universidade de São Paulo, School of Medicine, São PauloSP, Brazil, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil
| | - Arlindo Neto Montagnoli
- Universidade de São Paulo, Engineering School of São Carlos, São CarlosSP, Brazil, Engineering School of São Carlos, Universidade de São Paulo - USP - São Carlos (SP), Brazil
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