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Yuen CWN, Ma EPM. Systematic Review: Singing-Based Interventions to Improve Physical Functions Related to Aging Voice in Older Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-20. [PMID: 38875480 DOI: 10.1044/2024_jslhr-23-00641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
PURPOSE This systematic review aimed to evaluate the effects of singing as an intervention for aging voice. METHOD Quantitative studies of interventions for older adults with any medical condition that involves singing as training were reviewed, measured by respiration, phonation, and posture, which are the physical functions related to the aging voice. English and Chinese studies published until April 2024 were searched using 31 electronic databases, and seven studies were included. The included articles were assessed according to the Grading of Recommendations, Assessment, Development, and Evaluations rubric. RESULTS Seven studies were included. These studies reported outcome measures that were related to respiratory functions only. For the intervention effect, statistically significant improvements were observed in five of the included studies, among which three studies had large effect sizes. The overall level of evidence of the included studies was not high, with three studies having moderate levels and the rest having lower levels. The intervention activities included trainings other than singing. These non-singing training items may have caused co-intervention bias in the study results. CONCLUSIONS This systematic review suggests that singing as an intervention for older adults with respiratory and cognitive problems could improve respiration and respiratory-phonatory control. However, none of the included studies covers the other two of the physical functions related to aging voice (phonatory and postural functions). The overall level of evidence of the included studies was not high either. There is a need for more research evidence in singing-based intervention specifically for patient with aging voice.
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Affiliation(s)
- Crystal W-N Yuen
- Voice Research Laboratory, Faculty of Education, The University of Hong Kong
| | - Estella P-M Ma
- Voice Research Laboratory, Faculty of Education, The University of Hong Kong
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Beraldo AT, Batistella J, Martins PDN, Dassie-Leite AP, Pereira EC. Immediate effect of inspiratory exercise with exerciser and respiratory encourager in women without vocal complaints. Codas 2024; 36:e20230148. [PMID: 38775526 PMCID: PMC11129852 DOI: 10.1590/2317-1782/20242023148pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/09/2023] [Indexed: 05/31/2024] Open
Abstract
PURPOSE To evaluate the immediate effect of the inspiratory exercise with a booster and a respiratory exerciser on the voice of women without vocal complaints. METHODS 25 women with no vocal complaints, between 18 and 34 years old, with a score of 1 on the Vocal Disorder Screening Index (ITDV) participated. Data collection was performed before and after performing the inspiratory exercise and consisted of recording the sustained vowel /a/, connected speech and maximum phonatory times (MPT) of vowels, fricative phonemes and counting numbers. In the auditory-perceptual judgment, the Vocal Deviation Scale (VSD) was used to verify the general degree of vocal deviation. Acoustic evaluation was performed using the PRAAT software and the parameters fundamental frequency (f0), jitter, shimmer, harmonium-to-noise ratio (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) and Acoustic Breathiness Index (ABI). To measure the aerodynamic measurements, the time of each emission was extracted in the Audacity program. Data were statistically analyzed using the Statistica for Windows software and normality was tested using the Shapiro-Wilk test. To compare the results, Student's and Wilcoxon's t tests were applied, adopting a significance level of 5%. RESULTS There were no significant differences between the results of the JPA and the acoustic measures, in the pre and post inspiratory exercise moments. As for the aerodynamic measures, it was possible to observe a significant increase in the value of the TMF /s/ (p=0.008). CONCLUSION There was no change in vocal quality after the inspiratory exercise with stimulator and respiratory exerciser, but an increase in the MPT of the phoneme /s/ was observed after the exercise.
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Affiliation(s)
- Alessandra Thais Beraldo
- Departamento de Fonoaudiologia, Universidade Estadual do Centro-Oeste – UNICENTRO - Irati (PR), Brasil.
| | - Julia Batistella
- Departamento de Fonoaudiologia, Universidade Estadual do Centro-Oeste – UNICENTRO - Irati (PR), Brasil.
| | | | - Ana Paula Dassie-Leite
- Departamento de Fonoaudiologia, Universidade Estadual do Centro-Oeste – UNICENTRO - Irati (PR), Brasil.
| | - Eliane Cristina Pereira
- Departamento de Fonoaudiologia, Universidade Estadual do Centro-Oeste – UNICENTRO - Irati (PR), Brasil.
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Garabet R, Melley LE, Sataloff RT. Noninvasive Management of Voice Disorders: An Umbrella Review. J Voice 2024:S0892-1997(24)00099-7. [PMID: 38604901 DOI: 10.1016/j.jvoice.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES The aim of this study was to assess published systematic reviews that discussed noninvasive management of voice disorders. An umbrella review was conducted to collect, organize, and summarize narratively all available pharmacologic and voice therapy interventions. STUDY DESIGN Umbrella review of systematic reviews. METHODS Pertinent systematic reviews were identified by searching Pubmed/Medline and Embase. A primary screen identified studies related to voice. The second round of screening focused on studies that involved noninvasive management of voice disorders such as pharmacologic or voice therapy interventions. Variables of interest included study design, number of studies included in the review, target population, method of intervention, and outcomes. RESULTS Forty-three systematic reviews were eligible and included in the umbrella review. Ten studies focused on pharmacologic interventions, and 33 studies focused on voice therapy. Individual studies included in the systematic reviews ranged from 2-47, with a total of 601 studies overall. CONCLUSIONS This study provides a detailed review of all available systematic reviews on noninvasive management of voice disorders. Explored medications included proton pump inhibitors, calcium channel blockers, tricyclic antidepressants, antibiotics, corticosteroids, and hormone replacement. Explored voice therapy techniques included hydration, vocal function exercises, laryngeal manual therapy, respiratory exercise, biofeedback, phonation, coping strategies, and others. This may be utilized to guide therapeutic decision-making and identify current gaps in the literature that may warrant future investigation.
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Affiliation(s)
- Razmig Garabet
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Lauren E Melley
- Department of Otolaryngology - Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
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Franzone R, Petrigna L, Signorelli D, Musumeci G. The Relationship between Posture and Muscle Tensive Dysphonia in Teachers: A Systematic Scoping Review. J Funct Morphol Kinesiol 2024; 9:60. [PMID: 38651418 PMCID: PMC11036206 DOI: 10.3390/jfmk9020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Teachers usually present work-related pain such as neck pain. Their posture could be the cause of these problems; indeed, it is often a sway-back posture. Furthermore, teachers can also experience problems with their voice such as dysphonia, specifically muscle tension dysphonia (MTD). This scoping review aims to find the correlation between teachers' posture and MTD. It also studies how a posture-based treatment can influence this disorder. Randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional studies that considered the relationship between posture and MTD and that included teachers in their sample. The search led to an initial number of 396 articles; after the screening process, a final number of eight articles were included. A total of 303 patients were analyzed and all showed altered alignment of the head around the cervical spine with hypertonus of the cricothyroid, suprahyoid, and sternocleidomastoid muscles. Although MTD is a disorder with a multifactorial etiology, the articles revealed a correlation between posture and MTD related to a forward protraction of the cervical spine with a hypertonus of the laryngeal and hyoid musculature. This study also detected that an intervention in posture could reduce vocal disorders.
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Affiliation(s)
| | | | | | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia 97, 95123 Catania, Italy; (R.F.); (L.P.); (D.S.)
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Asiaee M, Nourbakhsh M, Vahedian-Azimi A, Zare M, Jafari R, Atashi SS, Keramatfar A. The feasibility of using acoustic measures for predicting the Total Opacity Scores of chest computed tomography scans in patients with COVID-19. CLINICAL LINGUISTICS & PHONETICS 2024; 38:97-115. [PMID: 36592050 DOI: 10.1080/02699206.2022.2160659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
To study the possibility of using acoustic parameters, i.e., Acoustic Voice Quality Index (AVQI) and Maximum Phonation Time (MPT) for predicting the degree of lung involvement in COVID-19 patients. This cross-sectional case-control study was conducted on the voice samples collected from 163 healthy individuals and 181 patients with COVID-19. Each participant produced a sustained vowel/a/, and a phonetically balanced Persian text containing 36 syllables. AVQI and MPT were measured using Praat scripts. Each patient underwent a non-enhanced chest computed tomographic scan and the Total Opacity score was rated to assess the degree of lung involvement. The results revealed significant differences between patients with COVID-19 and healthy individuals in terms of AVQI and MPT. A significant difference was also observed between male and female participants in AVQI and MPT. The results from the receiver operating characteristic curve analysis and area under the curve indicated that MPT (0.909) had higher diagnostic accuracy than AVQI (0.771). A significant relationship was observed between AVQI and TO scores. In the case of MPT, however, no such relationship was observed. The findings indicated that MPT was a better classifier in differentiating patients from healthy individuals, in comparison with AVQI. The results also showed that AVQI can be used as a predictor of the degree of patients' and recovered individuals' lung involvement. A formula is suggested for calculating the degree of lung involvement using AVQI.
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Affiliation(s)
- Maral Asiaee
- Department of Linguistics, Faculty of Literature, Alzahra University, Tehran, Iran
| | - Mandana Nourbakhsh
- Department of Linguistics, Faculty of Literature, Alzahra University, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Zare
- Department of Statistics, Faculty of Mathematics and Computer Science, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Ramezan Jafari
- Department of Radiology, Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Shahab Atashi
- Department of Food and Drug control, Jundishapour University of Medical Sciences, Ahvaz, Iran
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Lopes BP, Korn GP, Nunes FB, Gama ACC. Immediate effects of the incentive spirometer in women with healthy voice. Codas 2023; 36:e20220291. [PMID: 37970892 DOI: 10.1590/2317-1782/20232022291pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/16/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE To evaluate the immediate effect of the incentive spirometer on acoustic measures, aerodynamic measures and on the auditory-perceptual assessment of vocal quality in vocally healthy women. METHODS This is an experimental intra-subject comparison study with the participation of 22 women without vocal complaints. Acoustic measures, aerodynamic measures and auditory-perceptual assessment of vocal quality were obtained before and immediately after using the incentive spirometer by the participants. The device was used in the orthostatic position and the participants performed three sets of ten repetitions with a one-minute interval between sets. RESULTS After using the incentive spirometer, there was a significant reduction in jitter, shimmer and PPQ (period perturbation quotient) measurements and an increase in maximum expiratory volume, while the other acoustic and aerodynamic measurements were not significantly impacted. In addition, there was improvement in vocal quality in eight (36.4%) participants and 11 (50.0%) participants showed no changes in the auditory perceptual assessment of voice quality after using the incentive spirometer. CONCLUSION The use of the incentive spirometer is safe and, in its immediate effect, positively impacts the acoustic measures of short-term aperiodicity of frequency and intensity and increases the maximum expiratory volume in women with healthy voices.
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Affiliation(s)
- Bárbara Pereira Lopes
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | - Gustavo Polacow Korn
- Departamento de Otorrinolaringologia, Faculdade de Medicina, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil
| | - Flávio Barbosa Nunes
- Departamento de Otorrinolaringologia, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | - Ana Cristina Côrtes Gama
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
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Antonsson M, Johansson K, Bonde Dalemo A, Ivehorn Axelsson C, Burge Å, Lesueur U, Hartelius L. Effect of expiratory muscle strength training on voice and speech: An exploratory study in persons with Parkinson's disease or multiple sclerosis. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-18. [PMID: 37787640 DOI: 10.1080/17549507.2023.2243402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE This study explored how respiration, voice, and speech were affected following expiratory muscle strength training (EMST) and maintenance training in persons with Parkinson's disease (PD) or multiple sclerosis (MS). METHOD Nine participants with PD and six with MS participated in a randomised study, where the effects of EMST, sham, and maintenance treatment were investigated. Outcome measures included maximum expiratory pressure (MEP); maximum phonation time (MPT); intelligibility; verbal diadochokinesis (DDK); speech rate; a self-report form on voice, speech, and communication; and open questions about how the participants experienced the intervention. Group comparisons were performed within and between groups. RESULT The PD and the MS groups both improved significantly in MEP, and this improvement remained after 3 months of maintenance EMST. An improvement was also seen in DDK. Post-EMST, 33% of the PD group and 80% of the MS group reported a positive effect on communication. CONCLUSION The results of this study support previous evidence that EMST has positive effects on expiratory pressure in persons with PD or MS, but its effect on voice and speech remains unclear. Since subjective reports of the intervention and effects on communication were predominantly positive, further research is needed on larger groups to explore appropriate outcome measures.
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Affiliation(s)
- Malin Antonsson
- Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Johansson
- Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Bonde Dalemo
- Speech and Language Pathology Unit, Skaraborg Hospital, Gothenburg, Region Västra Götaland, Sweden, and
| | - Cornelia Ivehorn Axelsson
- Speech and Language Pathology Unit, Skaraborg Hospital, Gothenburg, Region Västra Götaland, Sweden, and
| | - Åsa Burge
- Department of Neurology, Angered Hospital, Region Västra Götaland, Sweden
| | - Ulrike Lesueur
- Department of Neurology, Angered Hospital, Region Västra Götaland, Sweden
| | - Lena Hartelius
- Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Tsai LYJ, Chan RW, Shen C, Chen Z, Zhuang P, Chiang YN, Tai SK, Xue K. A 4-Week Straw Phonation in Water Exercise Program for Aging-Related Vocal Fold Atrophy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2581-2599. [PMID: 37459605 DOI: 10.1044/2023_jslhr-23-00071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
PURPOSE This study evaluated the efficacy of a 4-week straw phonation in water (SPW) exercise program on aging-related vocal fold atrophy (VFA), with a secondary objective to examine the immediate effects of SPW exercises. METHOD Thirty-eight older adults aged 60 years and above formally diagnosed with aging-related VFA were randomly assigned into an experimental group undergoing SPW exercises with an 8-cm depth of straw submersion into water for 4 weeks plus vocal hygiene practice (n = 20), and a control group with only vocal hygiene practice (n = 18). Outcome measures included laryngeal endoscopic measures of glottal gap, auditory-perceptual ratings of voice quality, acoustic measures, aerodynamic measures, and standardized self-assessment questionnaire scores. An additional round of acoustic and aerodynamic assessment following 20 min of SPW exercises was conducted to examine the immediate effects. RESULTS Significant improvements in normalized glottal gap area, perceptual rating of breathiness, smoothed cepstral peak prominence, harmonics-to-noise ratio (HNR), mean oral airflow, subglottal pressure and laryngeal airway resistance at comfortable loudness, Voice-related Quality of Life scores, and Chinese Vocal Fatigue Index Factor 3 scores were observed in the experimental group relative to the control group. There were also significant immediate effects for HNR, mean oral airflow, subglottal pressure, and laryngeal airway resistance. CONCLUSIONS These findings suggested significant immediate improvements in vocal function following SPW exercises, with additional significant improvements in vocal function as well as significant improvements in quality of life following the 4-week SPW exercise program. Further studies with more long-term follow-up are recommended to better understand the efficacy of SPW exercises with deep levels of straw submersion into water as an effective clinical option for the management of hypofunctional dysphonia associated with aging-related VFA.
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Affiliation(s)
- Lydia Yueh-Ju Tsai
- Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan
| | - Roger W Chan
- Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, China
- Department of Voice Medicine, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Cuiling Shen
- Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, China
| | - Zusen Chen
- Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, China
| | - Peiyun Zhuang
- Department of Voice Medicine, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Yu-Ning Chiang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shyh-Kuan Tai
- Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan
| | - Keying Xue
- Institute of Respiratory Diseases, Xiamen Medical College, China
- Department of Respiratory Medicine, Second Affiliated Hospital, Xiamen Medical College, Xiamen, Fujian, China
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Lin KJY, Chan RW, Wu CH, Liu SCH. A Vocal Hygiene Program for Mitigating the Effects of Occupational Vocal Demand in Primary School Teachers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1-16. [PMID: 37080241 DOI: 10.1044/2023_jslhr-22-00490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Teachers are occupational voice users with significant vocal demand. This study examined if a vocal hygiene program could mitigate the effects of occupational vocal demand in primary school teachers across 1 month. METHOD Sixty female teachers participated, with 30 in an experimental group receiving vocal hygiene education plus daily home practice for 1 month and 30 in a control group with no intervention. Their vocal changes across the month were quantified with (a) acoustic measures on fundamental frequency (fo), vocal intensity, jitter and shimmer, harmonics-to-noise ratio, and smoothed cepstral peak prominence and (b) Voice Handicap Index (VHI-10) and Vocal Fatigue Index (VFI) scores. RESULTS Analysis of covariance showed significantly larger changes (significant decreases) in conversational fo and in jitter for the experimental group relative to the control group. Post hoc pairwise comparisons following repeated-measures analysis of variance showed significant decreases in conversational fo and in jitter across the month for the experimental group. No significant differences in VHI-10 and VFI scores were found between the groups. CONCLUSIONS Vocal demand-related changes in acoustic measures could be partially mitigated with the vocal hygiene program. Future studies with a more refined intervention program and more long-term follow-up are recommended to better understand the long-term benefits of vocal hygiene programs on primary school teachers.
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Affiliation(s)
| | - Roger W Chan
- Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, China
- Department of Voice Medicine, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Chia-Hsin Wu
- Yu-Sheng Speech Language Communication Rehabilitation Center, Taipei, Taiwan
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Reis N, Gaspar L, Paiva A, Sousa P, Machado N. Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5239. [PMID: 37047855 PMCID: PMC10093871 DOI: 10.3390/ijerph20075239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
UNLABELLED This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their respiratory frequency, breathing rhythm ratio (I:E), thoracic symmetry, use of accessory muscles, dyspnea (feeling short of breath), oxygen saturation, diaphragm mobility, minute ventilation, peak flow, walking test, spirometry, Pimax/Pemax, diffusion, and respiratory muscle strength. Any variation in these markers demands the need for interventions in order to duly manage the signs and symptoms and to improve ventilation. METHOD Systematic reviews of the literature published in English, Spanish, French, and Portuguese were used, which included studies in which nonpharmacological interventions were used as a response to impaired ventilation in adults in any given context of the clinical practice. The recommendations given by the Joanna Briggs Institute (JBI) for umbrella reviews were followed. This research took place in several databases such as MEDLINE, CINAHL Complete, CINHAL, MedicLatina, ERIC, Cochrane Reviews (Embase), and PubMed. The Joanna Briggs critical analysis verification list was used for the systematic review. The data extraction was performed independently by two investigators based on the data extraction tools of the Joanna Briggs Institute, and the data were presented in a summary table alongside the support text. RESULTS Forty-four systematic reviews, thirty randomized clinical essays, and fourteen observational studies were included in this review. The number of participants varied between n = 103 and n = 13,370. Fifteen systematic revisions evaluated the effect of isolated respiratory muscular training; six systematic revisions evaluated, in isolation, breathing control (relaxed breathing, pursed-lip breathing, and diaphragmatic breathing exercises) and thoracic expansion exercises; and one systematic review evaluated, in isolation, the positions that optimize ventilation. Nineteen systematic reviews with combined interventions that reinforced the role of education and capacitation while also aiming for their success were considered. The articles analyzed isolated interventions and presented their efficacy. The interventions based on respiratory exercises and respiratory muscular training were the most common, and one article mentioned the efficacy of positioning in the compromisation of ventilation. Combined interventions in which the educational component was included were found to be effective in improving pulmonary function, diffusion, oxygenation, and functional capacity. The outcomes used in each study were variable, leading to a more difficult analysis of the data. CONCLUSIONS The interventions that were the focus of the review were duly mapped. The results suggest that nonpharmacological interventions used to optimize ventilation are effective, with a moderate to high level of evidence. There is a strong foundation for the use of the chosen interventions. The lack of studies on the intervention of "positioning to optimize ventilation" points out the need for a deeper analysis of its effects and for studies with a clear focus. This study supports the decisions and recommendations for the prescription of these interventions to patients with impaired ventilation.
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Affiliation(s)
- Neuza Reis
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Rehabilitation Nurse, CHULC, 1900-160 Lisbon, Portugal
| | - Luis Gaspar
- RN Centro Hospitalar Universitário S. Joao, 4200-319 Porto, Portugal
| | - Abel Paiva
- NursingOntos, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal
| | - Paula Sousa
- NursingOntos, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal
| | - Natália Machado
- NursingOntos, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal
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Andriollo DB, Frigo LF, Cielo CA. Effect of Pompage on Vocal and Respiratory Measurements from Female Teachers: A Randomized Clinical Trial. Folia Phoniatr Logop 2023; 75:295-305. [PMID: 36812904 DOI: 10.1159/000529832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Teachers stand out among occupational groups due to their contribution to modern societies, and their voice is the main form of interaction. OBJECTIVE The aim of the study was to verify the changes in vocal and respiratory measurements from teachers with vocal and musculoskeletal complaints and with normal larynx after applying a musculoskeletal manipulation protocol of myofascial release using pompage. METHODS Controlled and randomized clinical trial with 56 participants: 28 teachers in the study group and 28 teachers in the control group. Anamnesis, videolaryngoscopy, hearing screening, sound pressure and maximum phonation time measurements, and manovacuometry were performed. The musculoskeletal manipulation protocol of myofascial release using pompage consisted of a total of 24 sessions, 40 min for each session, three times a week, for 8 weeks. RESULTS There was a significant improvement in the maximum respiratory pressure in the study group after the intervention. The sound pressure level and the maximum phonation time did not change significantly. DISCUSSION AND CONCLUSION Musculoskeletal manipulation protocol of myofascial release using pompage had a direct effect on the respiratory measurements from female teachers, significantly increasing the maximum respiratory pressure but without affecting sound pressure level and the /a/ maximum phonation time.
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Affiliation(s)
- Débora Bonesso Andriollo
- Programa de Pós-graduação em Fonoaudiologia, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Universidade Federal de Santa Maria, Santa Maria, Brazil
| | | | - Carla Aparecida Cielo
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Kim SJ, Yeo MS, Kim SY. Singing Interventions in Pulmonary Rehabilitation: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1383. [PMID: 36674142 PMCID: PMC9858886 DOI: 10.3390/ijerph20021383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Individuals with pulmonary disease need intensive and consistent rehabilitation due to their high risk for serious illness and long-term complications. The purpose of this scoping review was to provide a comprehensive analysis of relevant research regarding the use of singing in pulmonary rehabilitation. (2) Methods: A systematic literature search was performed using the PsycINFO, CINAHL, PubMed, and Web of Science databases. A search for studies that employed singing in pulmonary rehabilitation for patients with pulmonary disease was conducted. (3) Results: Studies that met the selection criteria were summarized and analyzed. Twenty-seven studies were included in the final analysis. Results showed that research using singing in pulmonary rehabilitation generally employed an intervention with structured tasks and additional home practice or socialization time. However, the singing procedure in each intervention was not always specifically described and the findings were inconsistent. (4) Conclusions: Programmed singing interventions can support lung health and be an effective component of pulmonary rehabilitation. The therapeutic singing method in relation to respiratory exercises should be integrated into the main activity in the intervention. Overall, singing has physical and psychosocial effects, leading to improvements in symptoms, but more research is necessary to ensure that the respiratory needs of people with pulmonary disease are adequately met.
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Affiliation(s)
- Soo Ji Kim
- Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Republic of Korea
- Arts Education and Therapy Institute, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Myung Sun Yeo
- Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Republic of Korea
| | - So Yeon Kim
- Department of Music Therapy, Graduate School, Ewha Woman’s University, Seoul 03760, Republic of Korea
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13
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Rodrigues VN, Andriollo DB, Cielo CA. Respiratory and Sound Pressures, Maximum Phonation Time, Cervical Disability and Voice-Related Quality of Life of Teachers. J Voice 2022:S0892-1997(22)00365-4. [PMID: 36543607 DOI: 10.1016/j.jvoice.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Many teachers report discomfort and a decrease in the quality of aerodynamic, respiratory, and cervical vocal aspects as well as of vocal self-assessment. OBJECTIVE Characterize and correlate measurements of Sound Pressure Levels, Maximum Phonation Time of /a/, Maximum Respiratory Pressures, Voice-Related Quality of Life and cervical pain in teachers with vocal and musculoskeletal complaints and no organic vocal fold lesions, and compare with normative values. METHODS Retrospective study with 56 teachers. Anamnesis, video laryngoscopy, hearing screening, measurements of sound pressure and maximum phonation time, and manovacuometry were performed. Self-assessment protocols for Voice-Related Quality of Life and Neck Disability Index were completed. RESULTS there was significant higher Sound Pressure Levels; significant lower Maximum Phonation Time of /a/, Maximum Expiratory Pressure, and total and physical scores of Voice-Related Quality of Life; most participants had mild cervical disability; there was a negative correlation between Maximum Expiratory Pressure and Neck Disability Index, between Maximum Inspiratory Pressure and Maximum Sound Pressure Level, and between Neck Disability Index and Voice-Related Quality of Life. CONCLUSION The results showed that there are damages and inadequacies in teachers' vocal production which affect their quality of life. Therefore, it is necessary to pay attention to the conditions of use of the voice by professionals, and to their health education.
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Affiliation(s)
- Viviane Nunes Rodrigues
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Débora Bonesso Andriollo
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Carla Aparecida Cielo
- Departamento de Fonoaudiologia, Laboratório de Voz, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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14
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Liou HH, Hsieh MHC, Hung DSY, Liu HL, Lee I, Lin YC, Hsiao JR, Huang CC, Ou CY, Chang CC, Lee WT, Tsai ST, Tsai SW. The Additive Effectiveness of Inspiratory Muscle Training on Glottic Closure and Subjective Voice Outcomes of Patients With Benign Lesion After Hyaluronic Acid Laryngoplasty. J Voice 2022:S0892-1997(22)00343-5. [PMID: 36513561 DOI: 10.1016/j.jvoice.2022.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES For patients with glottic insufficiency disease, injection laryngoplasty is a rapid and efficient management option that complements voice therapy. Some studies have indicated that respiratory muscle training may also show promise in patients with voice disorders. However, the effect of respiratory muscle training in patients with glottic insufficiency was reported to be limited, and whether it provides additional benefit after standard management requires further evaluation. We aimed to investigate the effectiveness of inspiratory muscle training on glottis closure and patient-reported voice quality in glottic insufficiency patients who had been treated with hyaluronic acid injection. STUDY DESIGN Retrospective observational study. METHODS We included 46 patients with glottic insufficiency who had undergone hyaluronic acid injection. Twenty of them had undergone inspiratory muscle training during three months. We measured patients' changes in glottic status according to the normalized glottal gap area and bowing index, as well as voice quality of life according to the voice handicap index 10 and the voice outcome survey, before and after training. RESULTS Patients who underwent inspiratory muscle training had higher odds of experiencing better improvement in all scores. The range of odds ratios ranged from 2.5 to 6.3 for changes in scores, and from 3.8 to 22.2 for changes in score percentages. Of note, the effect of training on percentage changes in the normalized glottal gap area score was significant (P= 0.0127) after adjustment for the duration of vocal disease, body mass index and BMI, and history of gastroesophageal reflux disease. CONCLUSIONS Inspiratory muscle training can improve the glottal gap after injection laryngoplasty, and may be applied in clinical practice.
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Affiliation(s)
- Hsin-Hao Liou
- Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Miyuki Hsing-Chun Hsieh
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - David Shang-Yu Hung
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Hui-Ling Liu
- Respiratory treatment room,Department of internal medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ishan Lee
- Respiratory treatment room,Department of internal medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chih Lin
- Department of Otolaryngology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Jenn-Ren Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Chan-Chi Chang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Wei-Ting Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan
| | - Shu-Wei Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan,Taiwan.
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15
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Chukwu SC, Egbumike CJ, Ojukwu CP, Uchenwoke C, Igwe ES, Ativie NR, Okemmuo AJ, Chukwu NP, Ezeugwu UA, Ikele CN, Uduonu EM. Effects of Diaphragmatic Breathing Exercise on Respiratory Functions and Vocal Sustenance in Apparently Healthy Vocalists. J Voice 2022:S0892-1997(22)00303-4. [PMID: 36333216 DOI: 10.1016/j.jvoice.2022.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Effective vocalization is dependent on breathing efficiency. Previous studies have reported the efficacy of Diaphragmatic Breathing Exercise (DBE) on the respiratory muscles and breath control of vocalists. There is a paucity of data on the effects of DBE on their vocal sustenance (VS), which is determined as Maximum Phonation Time (MPT). No known published study has considered physiotherapy as influencing voice dynamics amongst vocalists; evaluated the relationship between respiratory functions (Forced Vital Capacity - FVC, Forced Expiratory Volume in one second - FEV1, FEV1/FVC, and Peak Expiratory Flow - PEF) and VS in apparently healthy vocalists. Moreover, literature on the benefits of DBE to vocalists has not considered explicitly this aspect of vocalization skill, VS. METHODS This is a pre-test - post-test experimental study involving a total of 37 participants (17 males and 20 females) selected by purposive and convenience sampling techniques. The subjects were grouped into DBE and control groups. Spirobank MIR spirometer was used to assess the respiratory function of the singers, while a stopwatch and keyboard were used in assessing the MPT. Statistical analysis was done with SPSS version 21.0. Alpha level set at 0.05. RESULTS Significant improvement was found in respiratory functions (FVC, FEV1, FEV1/FVC, PEF) of the DBE group when pre- and post-test results were compared. The DBE and control groups differed significantly. Respiratory values correlated significantly with the MPT values (FVC - r[p] - 0.416[0.011]; FEV1 - r[p] - 0.416[0.010]; PEF - r[p] - 0.566[0.000]), except for FEV1/FVC - r(p) - 0.248(0.138). Voice category did not correlate with respiratory parameters or MPT. While male singers showed more changes in respiratory function the female singers showed more improvement in MPT. CONCLUSION AND RECOMMENDATION DBE can improve respiration and VS (increased MPT). Therefore, it can be recommended for vocalists, and Physiotherapy can be relevant in trainings to improve vocal dynamics.
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Affiliation(s)
| | - Chukwuenyegom Joseph Egbumike
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria; Department of Physiotherapy, Evangel University, Akaeze, Ebonyi State, Nigeria.
| | - Chidiebele P Ojukwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chigozie Uchenwoke
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emeka S Igwe
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nkechi R Ativie
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Adaora J Okemmuo
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nkem P Chukwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Uchechukwu A Ezeugwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chioma N Ikele
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ekezie M Uduonu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Enugu State, Nigeria
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16
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Abstract
The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.
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Affiliation(s)
- Aaron M Johnson
- Department of Otolaryngology - Head and Neck Surgery, New York University Voice Center, New York University School of Medicine, New York, New York.
| | - Mary J Sandage
- Department of Communication Disorders, Auburn University, Auburn, Alabama
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17
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Respiratory Muscle Strength Training to Improve Vocal Function in Patients with Presbyphonia. J Voice 2020; 36:344-360. [PMID: 32680804 DOI: 10.1016/j.jvoice.2020.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The effects of presbyphonia are compounded by the decline in respiratory function that occurs with age. Commonly recommended exercises to optimize the use of respiratory muscles during speech, such as diaphragmatic breathing, are unlikely to be intensive enough to induce respiratory changes and impact vocal function. The objective of this study was to assess the effect of adding a targeted intervention, respiratory muscle strength training, to voice exercises in a sample of patients with presbyphonia. METHODS/DESIGN In this prospective, randomized-controlled trial, 12 participants received either (1) vocal function exercises (VFE), (2) VFE combined with inspiratory muscle strength training (IMST), or (3) VFE combined with expiratory muscle strength training (EMST). Data collected prior to and following 4 weekly intervention sessions included respiratory measures (pulmonary function and respiratory muscle strength) and voice measures (videostroboscopy, acoustic, auditory-perceptual, aerodynamic, and self-assessment measures). RESULTS Participants who received IMST improved their voice quality during connected speech (smoothed cepstral peak prominence and ratings of overall voice quality) and their scores on the three self-assessment questionnaires with large to very large within-group effect sizes (|d| = 0.82-1.61). In addition, participants in the IMST group reduced their subglottal pressure with a large effect size (d = -0.92). Participants who received EMST improved their maximum expiratory strength and smoothed cepstral peak prominence with large effect sizes (d = 0.80 and 0.99, respectively) but had limited improvements in other outcomes. Participants who received only VFE decreased their amount of vocal fold bowing, improved their voice quality on a sustained vowel (amplitude perturbation quotient), and improved their Glottal Function Index score with large effect sizes (|d| = 0.74-1.00). CONCLUSION Preliminary data indicate that adding IMST to voice exercises may lead to the greatest benefits in patients with presbyphonia by promoting improved subglottal pressure control as well as increasing air available for phonation, resulting in improved self-assessment outcomes.
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18
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Desjardins M, Halstead L, Simpson A, Flume P, Bonilha HS. The Impact of Respiratory Function on Voice in Patients with Presbyphonia. J Voice 2020; 36:256-271. [PMID: 32641221 DOI: 10.1016/j.jvoice.2020.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Presbyphonia is an age-related voice disorder characterized by vocal fold atrophy and incomplete glottal closure during phonation. The extent to which the effects of presbyphonia may be compounded by age-related declines in the respiratory system and further impact communication and quality of life remains unknown. Therefore, the objective of this study was to determine how variations in respiratory function impacts voice measures in a sample of participants with presbyphonia. METHODS In this pilot study, 21 participants with presbyphonia underwent respiratory assessments (spirometry and respiratory muscle strength testing) and voice assessments (videostroboscopy, acoustic analysis, auditory-perceptual ratings, aerodynamic assessment, and self-assessments). Factor and cluster analyses were conducted to extract voice and respiratory constructs and to identify groups of participants with similar profiles. Correlations and regression analyses were conducted to better describe the relationships between voice and respiratory function. RESULTS Respiratory function was found to impact voice via two main pathways: through its physiological effect on voice and through its impact on general health and impairment. A lower respiratory function was associated with a lower vocal fold pliability and regularity of vibration and with an elevated aerodynamic resistance accompanied by laryngeal hyperfunction. Standardized measures of respiratory function were associated with perceived voice-related handicap. Respiratory function did not associate with voice quality, which was mostly influenced by the severity of vocal fold atrophy. CONCLUSION Poor respiratory health exacerbates the burden of vocal fold atrophy and, therefore, implementation of respiratory screening prior to starting voice therapy may significantly affect the treatment plan and consequently the outcomes of voice therapy in this patient population.
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Affiliation(s)
- Maude Desjardins
- Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.
| | - Lucinda Halstead
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Annie Simpson
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina
| | - Patrick Flume
- Pulmonary and Critical Care Division, Medical University of Soutch Carolina, Charleston, South Carolina
| | - Heather Shaw Bonilha
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina
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19
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Yilmaz C, Bostancı Ö, Bulut S. Effect of Respiratory Muscle Training on Pitch Range and Sound Duration in Brass Instrument Players and Singers. J Voice 2020; 36:76-82. [PMID: 32451252 DOI: 10.1016/j.jvoice.2020.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Effective use of respiratory organs is important for musicians. Therefore, the impact of Respiratory Muscle Training (RMT) on phonation is open to research. The aim of this study was to investigate the measurable effects of RMT on blowing in brass instrumental and on voice performance in singers. METHODS Thirty musicians were recruited and separated into a four groups. The brass instrumental and singers groups were further subdivided into control and RMT groups for a 4 week RMT intervention giving a total four groups: singers experimental (SE; n:10), singers control (SC; n:10), brass instrument players experimental (BIPE; n:5), and BIPC (n:5). The groups selected from the musicians of Samsun State Opera and Ballet Directorate and Samsun Metropolitan Municipality Band Team participated in the study. RESULTS After 4 weeks of RMT application in the study groups, significant increase in all parameters except Forced vital capacity/Forced expiratory volume in 1 second was observed in the values of pulmonary function tests and respiratory muscle strength in subjects with SE and BIPE (P < 0.05). The most significant results of this study are that in addition to changes in the duration of phonation (SE 36%), high-pitch (SE 79%, BIPE 27%) and low-pitch sounds (BIPE 61% and SE 42%), the SE (15%) and BIPE (3%) groups reached higher pitches in the high-pitch notes. CONCLUSIONS It was determined that performance of the highest and lowest pitch sounds within a vocal register in a single breath and phonation times can be improved by RMT.
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Affiliation(s)
- Coşkun Yilmaz
- Ondokuz Mayıs University, Graduate School of Health Sciences, Samsun, Turkey.
| | - Özgür Bostancı
- Ondokuz Mayıs University, Yasar Dogu Sport Science Faculty, Department of Physical Education and Sports, Samsun, Turkey
| | - Seyhan Bulut
- Ondokuz Mayıs University, State Conservatory, Department of Music, Samsun, Turkey
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20
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Exercise Science and the Vocalist. J Voice 2019; 35:376-385. [PMID: 31628045 DOI: 10.1016/j.jvoice.2019.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/11/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023]
Abstract
The application of exercise science training knowledge has been of growing interest to voice professionals. This tutorial, derived from the authors' invited presentations from the "Exercise and the Voice" Special Session at the 2018 Voice Foundation Symposium, proposes a foundational theoretical structure based in exercise science, clarifies the wide range of variables that may influence voice training, and summarizes our present understanding of voice physiology from the perspective of muscle training. The body of literature on voice exercise was then analyzed from the perspective of this framework, identifying what we currently know and what we still have yet to learn.
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