Do Different Semi-Occluded Voice Exercises Affect Vocal Fold Adduction Differently in Subjects Diagnosed with Hyperfunctional Dysphonia?

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.

Variation on Vocal Economy After Different Semioccluded Vocal Tract Exercises in Subjects With Normal Voice and Dysphonia.

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.

Computerized Tomography Measures During and After Artificial Lengthening of the Vocal Tract in Subjects With Voice Disorders.

PURPOSE: The present study aimed to observe the effect of two types of tubes on vocal tract bidimensional and tridimensional images. METHODS: Ten participants with hyperfunctional dysphonia were included. Computerized tomography was performed during production of sustained [a:], followed by sustained phonation into a drinking straw, and then repetition of sustained [a:]. A similar procedure was performed with a stirring straw after 15 minutes of vocal rest. Anatomic distances and area measures were obtained from computerized tomography midsagittal and transversal images. Vocal tract total volume was also calculated. RESULTS: During tube phonation, increases were measured in the vertical length of the vocal tract, oropharyngeal area, hypopharyngeal area, outlet of the epilaryngeal tube, and inlet to the lower pharynx. Also, the larynx was lower, and more closure was noted between the velum and the nasal passage. CONCLUSION: Tube phonation causes an increased total vocal tract volume, mostly because of the increased cross-sectional areas in the pharyngeal region. This change is more prominent when the tube offers more airflow resistance (stirring straw) compared with less airflow resistance (drinking straw). Based on our data and previous studies, it seems that vocal tract changes are not dependent on the voice condition (vocally trained, untrained, or disordered voices), but on the exercise itself and the type of instructions given to subjects. Tube phonation is a good option to reach therapeutic goals (eg, wide pharynx and low larynx) without giving biomechanical instructions, but only asking patients to feel easy voice and vibratory sensations.

How do laryngeal and respiratory functions contribute to differentiate actors/actresses and untrained voices?

PURPOSE: The present study aimed to compare actors/actresses's voices and vocally trained subjects through aerodynamic and electroglottographic (EGG) analyses. We hypothesized that glottal and breathing functions would reflect technical and physiological differences between vocally trained and untrained subjects. METHODS: Forty participants with normal voices participated in this study (20 professional theater actors and 20 untrained participants). In each group, 10 male and 10 female subjects were assessed. All participants underwent aerodynamic and EGG assessment of voice. From the Phonatory Aerodynamic System, three protocols were used: comfortable sustained phonation with EGG, voice efficiency with EGG, and running speech. Contact quotient was calculated from EGG. All phonatory tasks were produced at three different loudness levels. Mean sound pressure level and fundamental frequency were also assessed. Univariate, multivariate, and correlation statistical analyses were performed. RESULTS: Main differences between vocally trained and untrained participants were found in the following variables: mean sound pressure level, phonatory airflow, subglottic pressure, inspiratory airflow duration, inspiratory airflow, and inspiratory volume. These variables were greater for trained participants. Mean pitch was found to be lower for trained voices. CONCLUSIONS: The glottal source seemed to have a weak contribution when differentiating the training status in speaking voice. More prominent changes between vocally trained and untrained participants are demonstrated in respiratory-related variables. These findings may be related to better management of breathing function (better breath support).

Differences in acoustic and perceptual parameters of the voice between elderly and young women at habitual and high intensity.

INTRODUCTION AND OBJECTIVES: The present study aimed to compare elderly and young female voices in habitual and high intensity. The effect of increased intensity on the acoustic and perceptual parameters was assessed. METHODS: Sound pressure level, fundamental frequency, jitter, shimmer, and harmonic to noise ratio were obtained at habitual and high intensity voice in a group of 30 elderly women and 30 young women. Perceptual assessment was also performed. RESULTS: Both groups demonstrated an increase in sound pressure level and fundamental frequency from habitual voice to high intensity voice. No differences were found between groups in any acoustic variables on samples recorded with habitual intensity level. No significant differences between groups were found in habitual intensity level for pitch, hoarseness, roughness, and breathiness. Asthenia and instability obtained significant higher values in elderly than young participants, whereas, the elderly demonstrated lower values for perceived tension and loudness than young subjects. CONCLUSIONS: Acoustic and perceptual measures do not demonstrate evident differences between elderly and young speakers in habitual intensity level. The parameters analyzed may lack the sensitivity necessary to detect differences in subjects with normal voices. Phonation with high intensity highlights differences between groups, especially in perceptual parameters. Therefore, high intensity should be included to compare elderly and young voice.

Diferencias de los parámetros acústicos y perceptuales de la voz entre sujetos ancianos y jóvenes con intensidad habitual y alta / Differences in acoustic and perceptual parameters of the voice between elderly and young women at habitual and high intensity

Introducción y objetivos: El presente estudio tiene como propósito comparar las voces de los sujetos ancianos y jóvenes durante la fonación con intensidad habitual y alta. Se evaluó el efecto del incremento de la intensidad en parámetros acústicos y perceptuales. Métodos: Se obtuvieron los siguientes parámetros: nivel de presión del sonido, frecuencia fundamental, jitter, shimmer y el ratio armónico-ruido a intensidad habitual y alta en un grupo de 30 mujeres ancianas y 30 jóvenes. También se llevó a cabo un análisis perceptual de todas las muestras grabadas. Resultados: Ambos grupos mostraron un incremento de nivel de presión del sonido y frecuencia fundamental al comparar la intensidad habitual con la alta. No se encontraron diferencias entre los grupos en ninguna variable acústica en las muestras grabadas con intensidad habitual. No se hallaron diferencias significativas entre ambos grupos con intensidad habitual para tono, ronquera, aspereza y voz soplada. La astenia e inestabilidad mostraron valores significativamente más altos en los sujetos ancianos que en los jóvenes, mientras que la percepción de tensión y sonoridad evidenció valores menores en los ancianos que en los jóvenes. Conclusiones: Ninguna de las mediciones acústicas ni perceptuales mostraron diferencias evidentes entre ancianos y jóvenes con el nivel de intensidad habitual. Los parámetros analizados podrían carecer de la sensibilidad necesaria para detectar diferencias en sujetos con voces normales. La fonación con niveles de intensidad alta acentúa las diferencias entre grupos, especialmente en los parámetros perceptuales. Por lo tanto, la evaluación vocal a alta intensidad debería incluirse al comparar voces de ancianos y jóvenes (AU)

Introduction and objectives: The present study aimed to compare elderly and young female voices in habitual and high intensity. The effect of increased intensity on the acoustic and perceptual parameters was assessed. Methods: Sound pressure level, fundamental frequency, jitter, shimmer, and harmonic to noise ratio were obtained at habitual and high intensity voice in a group of 30 elderly women and 30 young women. Perceptual assessment was also performed. Results: Both groups demonstrated an increase in sound pressure level and fundamental frequency from habitual voice to high intensity voice. No differences were found between groups in any acoustic variables on samples recorded with habitual intensity level. No significant differences between groups were found in habitual intensity level for pitch, hoarseness, roughness, and breathiness. Asthenia and instability obtained significant higher values in elderly than young participants, whereas, the elderly demonstrated lower values for perceived tension and loudness than young subjects. Conclusions: Acoustic and perceptual measures do not demonstrate evident differences between elderly and young speakers in habitual intensity level. The parameters analyzed may lack the sensitivity necessary to detect differences in subjects with normal voices. Phonation with high intensity highlights differences between groups, especially in perceptual parameters. Therefore, high intensity should be included to compare elderly and young voice (AU)