Effects of Humidification of the Vocal Tract and Respiratory Muscle Training in Women With Voice Symptoms—A Pilot Study

Abstract

Objective: The aim of this study was to determine the efficacy of a four-week breathing exercise intervention in participants with voice symptoms. Methods: Six non-smoking women (mean age 49) experiencing voice symptoms used a novel device WellO2 TM for respiratory exercises that provides counter pressure during both inspiration and expiration and warms and humidifies the breathing air. Speech samples were acoustically (Acoustic Voice Quality Index [AVQI]) and perceptually (grade, roughness, breathiness, asthenia and strain scale, [GRBAS]) analysed, and perceived voice symptoms and self-reported effort in breathing and phonation were obtained. Respiratory measurements included breathing frequency and pattern, peak expiratory flow (PEF), forced vital capacity (FVC) and forced expiratory volume in one minute (FEV1). Results: The total scores of AVQI and some of its subcomponents (shimmer and harmonic-to-noise ratio), and the grade, roughness and strain of the GRBAS scale indicated significantly improved voice quality. However, neither the nature or frequency of the experienced voice symptoms nor the perceived phonatory effort changed as the function of intervention. According to the participants, their breathing was significantly less effortful after the intervention, although no significant changes were observed in the objective respiratory measurements with a spirometer. Conclusion: Training with the WellO2 device has the potential to improve voice quality. The combination of inspiratory and expiratory training and warmed, humidified air is a multifaceted entity influencing several parts in the physiology of voice production. The effects of using WellO2 need to be confirmed by further studies with a larger number of participants.

The Efficacy of the NHS Waterpipe in Superficial Hydration for People With Healthy Voices: Effects on Acoustic Voice Quality, Phonation Threshold Pressure and Subjective Sensations

“…The HNR values in the last measurement were higher in the group that used the waterpipe without heating rather than in those with heated fluid. In previous studies, the HNR values have either increased 20,27 or remained unchanged. 26,56 An explanation for this discrepancy could be that the baseline status of the participants affect how they benefit from the hydrating treatment.…”

“…18,20,25 Treatments have also exhibited promising results in treating patients with dysphonia. 27 However, the results have been somewhat different among healthy participants. For example, Vermeulen and colleagues 28 investigated how surface hydration treatment affects voice quality with or without systemic hydration, such as fluid ingestion.…”

“…Similarly, perturbation has been shown to decrease after treatment. 20,27 However, in a study by Zou and colleagues, 21 the acoustically measured quality of voice was reported to decrease when the hydration treatment was continued after reaching the optimal hydration status. Similarly, Vermeulen and colleagues 28 observed increasing perturbation values when superficial hydration was added to the systemic hydration treatment in healthy subjects.…”

“…The observed trends in the means of the AVQI, CPPs, and shimmer were also somewhat unexpected. The AVQI has typically decreased after hydration treatment, 27 indicating improved overall voice quality. Similarly, perturbation has been shown to decrease after treatment.…”

Efectos del entrenamiento respiratorio aislado en las variables respiratorias y vocales

“…Entre estas se incluyó a niños hipotónicos [40], pacientes con esclerosis múltiple [41,42] y otros con enfermedad de Parkinson [36,37]. Además, se contó con problemas de voz auto-reportados [43], cáncer laríngeo con estado de post laringectomía parcial [44], quejas de profesores [45], trabajadores de la medicina con fatiga vocal [46] y lo que se denominó profesionales de la voz con disfonía [47,48]. En el grupo de habilitación o entrenamiento vocal solo 2 artículos pudieron ser considerados.…”