Therapeutic Singing and Semi-Occluded Vocal Tract Exercises for Individuals with Parkinson's Disease: A Randomized Controlled Trial of a Single Session Intervention.

Individuals with Parkinson's disease (PD) experience speech and voice-related symptoms that diminish communication and quality of life. Semi-occluded vocal tract (SOVT) exercises are targeted interventions that, when combined with the positive psychosocial benefits of therapeutic group singing (TGS), may affect outcomes. The purpose of this study was to explore the effectiveness of SOVT exercises, specifically straw phonation combined with TGS, to improve voice quality and mood for individuals with PD. We used a true experimental pretest-posttest between-subjects design (i.e., randomized controlled trial) facilitated by a board-certified music therapist. All participants (N = 27) were randomly assigned to one of three groups (a) straw phonation combined with TGS (SP + TGS, n = 10), (b) TGS (n = 10), and (c) speaking-only control group (n = 7). Participants completed voice recordings for acoustic measures and the Visual Analogue Mood Scale for mood analysis before and after a 30-min intervention. The results demonstrated significant improvement in voice quality evidenced by decreasing Acoustic Voice Quality Index scores following a single session for both SP + TGS and TGS intervention groups when compared to the control. Happiness scores improved in the experimental groups when compared to control. Although not statistically significant, participants in the experimental groups (SP + TGS, TGS) demonstrated better mean mood scores on happiness, anxiety, and angry when compared to control, indicating a positive psychological response to the singing interventions. Overall, this study indicated the effectiveness of SP + TGS and TGS as promising therapeutic interventions for voice quality and mood in individuals with PD.

Vocal Dose of Preservice Music Therapists, Preservice Music Teachers, and Other Undergraduate Students.

BACKGROUND: Researchers have studied various populations with high vocal doses and prevalence of related voice disorders. Teachers, singers, and university students are three such populations that have been examined extensively. No studies to date, however, have examined the voice use of music therapists and compared their voice use to these other populations. OBJECTIVE: The purpose of this investigation was to examine voice dosimeter data including phonation duration and percentage, amplitude, frequencies, and distance dose acquired over contiguous 7 day (1 week) periods by preservice music therapists, preservice music teachers, and other university students in concert with daily voice use surveys. STUDY DESIGN: This is a quantitative descriptive design. METHODS: Eight female students of varied majors (music therapy, music education, vocal performance, elementary education, and "other") in their third year of university study wore a voice dosimeter during all waking hours for 7 days. The dosimeter recorded voicing time, percentage, frequency, and estimated amplitude. Participants also completed surveys related to several parameters of vocal health, the number of hours they slept, and their voice care. RESULTS: Participants experienced relatively low vocal doses during the week. Music majors experienced more voice use than nonmusic majors. Some of the highest doses occurred during teaching demonstrations and leading of music therapy practicum sessions. CONCLUSION: Preservice music therapists and preservice music teachers may experience extreme increases in vocal load when they enter the field. Absent training protocols, these increases could be detrimental to their vocal health and long-term viability as practitioners.

Effects of a Straw Phonation Protocol on Acoustic and Perceptual Measures of an SATB Chorus.

BACKGROUND: Recent scholarship has suggested that semi-occluded vocal tract (SOVT) exercises may increase vocal economy of individuals by reducing vocal effort while maintaining or increasing acoustic output. Choral singers, however, may use different resonance techniques or change voicing behaviors in an effort to hear their own sound in relation to others. One investigation revealed significant increases in a choir's mean spectral energy after participating in a straw phonation protocol. However, that study reported only acoustic measures and did not include choristers' perceptions of the choral sound and their own voicing efficiency. OBJECTIVE: The purpose of this study was to measure the effect of a straw phonation protocol on acoustic (long-term average spectrum) and perceptual (self-report) measures of the choral sound of an intact soprano, alto, tenor, and bass (SATB) choir. STUDY DESIGN: This is a quasi-experimental, one-group, pretest-posttest design. METHODS: An SATB choir (N = 48 singers) performed a Renaissance motet, participated in a 4-minute voicing protocol with a small straw, and then sang the motet a second time. They completed the same procedure later in the rehearsal. RESULTS: Long-term average spectrum results indicated no statistically significant mean changes in spectral energy after the SOVT protocols. Most participants, however, perceived that the choir sounded better (78.26%) and that their own vocal production was more efficient or comfortable (73.91%) following the protocol. CONCLUSION: Choristers perceived less vocal effort while maintaining vocal output after straw phonation, which may feasibly align with extant solo research. More research may determine whether this result is due specifically to SOVTs.

Effects of a Straw Phonation Protocol on Acoustic Measures of an SATB Chorus Singing Two Contrasting Renaissance Works.

BACKGROUND: Researchers have found that semi-occluded vocal tract (SOVT) exercises may increase vocal economy by reducing phonation threshold pressure and effort while increasing or maintaining consistent acoustic output. This research has focused solely on individual singers. Much singing instruction, however, takes place in choral settings. Choral singers may use different resonance strategies or unconsciously adjust their singing based on the ability to hear their own sound in relation to others. Results of studies with individual singers, then, may not be directly applicable to choral settings. OBJECTIVE: The purpose of this investigation was to measure the effect of an SOVT protocol (ie, straw phonation) on acoustic changes of conglomerate, choral sound. STUDY DESIGN: This is a quasi-experimental, one-group, pretest-posttest design. METHODS: Participants in this study constituted an intact SATB choir (soprano, alto, tenor, and bass) (N = 15 singers) who performed from memory two unaccompanied pieces of varied tempos from memory, participated in a 4-minute straw phonation protocol with a small stirring straw, and then sang each piece a second time. RESULTS: The long-term average spectrum results indicated small, statistically significant increases in spectral energy for both pieces in the 0-10 kHz (.32 and .20 dB Sound Pressure Level) and 2-4 kHz regions (.46 and .25 dB SPL). CONCLUSION: These results, although not likely audible to average hearing humans, seem consistent with the assertion that singers enjoy vocal benefits with consistent or increased vocal output. SOVT exercises, therefore, may be useful as a time-efficient way to evoke more efficient and economical singing during choral warm-up and voice building procedures.