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Belsky MA, Awan SN, Rothenberger SD, Fry A, Gartner-Schmidt JL. Singing In The Mask: Effects Of A Variably Occluded Face Mask On Singing. J Voice 2024; 38:435-445. [PMID: 34848103 DOI: 10.1016/j.jvoice.2021.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE A limitation of traditional semi-occluded vocal tract exercises (SOVTE) is the single sustained vowel task that precludes co-articulated singing. This study investigated immediate effects of a variably occluded face mask (VOFM) on vocal effort, acoustic, and aerodynamic measures in sung low and high pitches of healthy singers. DESIGN Single-group, pre-post intervention study. METHODS The outlet ports of disposable anesthesia facemasks were fitted with plastic caps with two drilled openings sizes (9.6 mm, 6.4 mm). Twenty-three singers with no voice complaints provided baseline vocal effort, acoustic, and aerodynamic measures in high and low pitches. Participants trained in four conditions: two VOFM sizes (9.6 mm, 6.4 mm) in combination with the 20th and 80th percentile of the singer's pitch range. Participants were trained on three phonatory tasks: repeated consonant/vowel syllables, sung sentence, and sustained vowel. Vocal effort before and after training was compared using a visual-analog scale, while standardized mean differences captured acoustic and aerodynamic changes before and after training. RESULTS Participants reported decreased vocal effort after VOFM training at all occlusion and pitch combinations. On average, consistent beneficial effect sizes were found in cepstral peak prominence (CPP) and cepstral spectral index of dysphonia (CSID) for all 4 occlusion-pitch combinations, and vocal intensity and mean estimated subglottal pressure increased for all 4 occlusion-pitch training combinations. Changes in mean phonatory airflow and resistance were less consistent. DISCUSSION There was an immediate effect of decreased vocal effort in singing after VOFM training. Acoustic and aerodynamic effects were variable and modest. Future studies should explore changes in these outcomes after VOFM in singing voice therapy.
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Affiliation(s)
- Michael A Belsky
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Shaheen N Awan
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida
| | - Scott D Rothenberger
- Division of Internal Medicine, University of Pittsburgh School of Medicine, United States, Pittsburgh, Pennsylvania
| | - Adam Fry
- Department of Communications, University of Pittsburgh, Pittsburgh, Pennsylvania
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Batista DDJ, Duarte JMDT, Siqueira LTD, Almeida AA, Lopes LW, Ribeiro VV. Volitional and Non-volitional Devices Used in Voice Therapy and Training: A Scoping Review-Part A. J Voice 2023:S0892-1997(23)00348-X. [PMID: 38155057 DOI: 10.1016/j.jvoice.2023.10.027] [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: 07/31/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To map the volitional and non-volitional devices used by speech and language pathologists (SLPs) in voice training and therapy and characterize their use in research on voice interventions. METHODS This scoping review is the first part of a larger study. The electronic search was carried out by mapping the references in PubMed/Medline, LILACS/BVS, Scopus, Web of Science, EMBASE, and the Cochrane Library, and the manual search was carried out in the grey literature. Two blind independent reviewers selected and extracted data; divergences were solved by consensus. The data extracted in this part of the study were the authorship and year of publication, country, study design, sample characteristics, intervention modality, ingredient, target, mechanism of action, dosage, and outcome measures. They were addressed with descriptive analysis. RESULTS Publications that use devices as ingredients are mostly from the last two decades, mainly carried out in the United States of America and Brazil, in adults of both sexes with behavioral dysphonia. Forty-two types of devices were used, many of them with similar approaches but different nomenclatures. Most devices were used voluntarily, focusing on vocal function, and aiming to increase source and filter interaction. Most studies used silicone tubes. The most reported technical specification to apply the ingredient was surface electrodes on the neck. Device dosage was time-controlled, and the most used outcomes were self-assessment and acoustic analysis. CONCLUSION Devices are currently used as ingredients in vocal interventions, with a greater focus on increasing the source and filter interaction, associated with silicone tubes (the most used devices in these studies), which have been dosed with performance time. Outcomes were measured with self-assessment instruments.
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Affiliation(s)
- Denis de Jesus Batista
- Center for Exact and Natural Sciences, Postgraduate program in Decision Models and Health of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil
| | - João M da Trindade Duarte
- Center for Human Sciences, Letters and Arts, Postgraduate program in Linguistics of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Larissa T D Siqueira
- Department of Speech-Language Pathology and Audiology of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Anna A Almeida
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Leonardo W Lopes
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Vanessa V Ribeiro
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Faculty of Medicine, Speech-Language Pathology and Audiology course and the Postgraduate Program in Medical Sciences of the Universidade de Brasília, Brasília, Distrito Federal, Brazil.
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Batista DDJ, da Silva RC, Ostolin TLVDP, Behlau M, Ribeiro VV. Mapping of the Execution of Resonance Tubes Phonation Immersed in Water Exercise in Adults: A Scoping Review. J Voice 2022:S0892-1997(22)00162-X. [PMID: 35835649 DOI: 10.1016/j.jvoice.2022.06.010] [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: 02/18/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To map the execution of resonance tubes phonation immersed in water exercise in adults with healthy or altered voices. METHODS This study was a scoping review. An electronic search was performed using the following databases: MEDLINE, LILACS, SCOPUS, Web of Science, EMBASE, Cochrane Library, gray literature, and a manual search. A blinded review was performed by two authors to determine the selection and extraction procedures. Studies with adult participants with dysphonic or healthy voices who underwent intervention with phonation in a resonance tube immersed in water in the context of the vocal clinic, with an experimental intervention, quasi-experimental, or before and after the intervention were included. Data from the publication, sample, execution, and results obtained from the exercises were extracted by two blinded reviewers. Disagreements were resolved through consensus. The analysis was performed quantitatively. RESULTS A total of 44 publications were analyzed. Among these, Brazilian studies were the most frequent, with a publication peak in 2020. The characterization of the sample was variable, with a higher frequency of participants of both sexes who were not voice professionals. The most frequent studies were before and after exercise with a resonance tube immersed in water, in one session, with an exercise execution time of 3 minutes; in cases of more than one series of executions, the 30-sseconds rest time was more frequent. The most used resonance tube was a flexible silicone tube, with a wall thickness of 0.1 mm, immersion container in a 500-, 510-, or 600-mL bottle, 2/3 filled with water, and the resonance tube immersed 2 cm from the water surface. The most used phonatory task was flow phonation with rounded lips similar to the articulation of the vowel /u/. Acoustic analysis and vocal self-assessment are the most commonly used outcome measures. The best results were obtained in the self-assessment. CONCLUSION There is significant variability in the information on the execution of resonance tubes phonation immersed in water exercise influenced by vocal diagnosis and experience with previous vocal training. Studies on the effects of this exercise have been concentrated over the last decade and are of the vocal training and therapy. Acoustic and self-assessment measures were used to verify the results, with self-assessment being the outcome that most frequently indicated positive results.
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Affiliation(s)
- Denis de Jesus Batista
- Associate Program in Speech-Language Pathology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Specialization Course in Exercise Physiology Applied to Clinics, Universidade Federal de São Paulo, Santos, São Paulo, Brazil.
| | - Rebeca Cardoso da Silva
- Speech-Language Pathology Department, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | | | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Centro de Estudos da Voz, São Paulo, São Paulo, Brazil
| | - Vanessa Veis Ribeiro
- Associate Program in Speech-Language Pathology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Speech-Language Pathology Course, Universidade de Brasília, Brasília, Distrito Federal, Brazil
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Horáček J, Radolf V, Bula V, Laukkanen AM. Experimental modelling and human data of glottal area declination rate for vowel and semi-occluded vocal tract phonation. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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