Resonance Tube or Lax Vox?

Tyrmi, Jaana; Radolf, Vojtěch; Horáček, Jaromı́r; Laukkanen, Anne-Maria

doi:10.1016/j.jvoice.2016.10.024

Cited by 46 publications

(23 citation statements)

References 12 publications

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“…Guidelines for WRT with a flexible soft‐walled tube (also called Lax Vox® tube) describe an initial 2 cm water depth which can gradually evolve to a maximum of 7 cm (Sihvo , Tyrmi et al . ). In this study, water depth was restricted to 2 cm to keep treatment conditions as strict as possible for every subject and every session.…”

Section: Discussionmentioning

confidence: 97%

Effect of three semi‐occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trill, water‐resistance therapy and straw phonation

Meerschman

Lierde

Ketels

et al. 2018

Intl J Lang & Comm Disor

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Background To date, the immediate effects of a semi‐occluded vocal tract (SOVT) configuration have been thoroughly demonstrated. However, it is not yet sufficiently confirmed whether a therapy programme (i.e. longer than one session) using SOVT exercises leads to an enhanced phonation and improved vocal quality. Aims The aim of this study was to investigate the effect of three SOVT therapy programmes: lip trill, water‐resistance therapy (WRT) and straw phonation, on the vocal quality, vocal capacities, psychosocial impact and vocal tract discomfort of patients with dysphonia. Methods & Procedures A blocked‐randomized sham‐controlled trial was used. Thirty‐five patients with dysphonia (mean age = 21 years; 33 women, two men) were assigned to either a lip trill group, a WRT group, a straw phonation group or a control group using blocked randomization. The lip trill, WRT and straw phonation groups practised their respective SOVT exercise across 3 weeks, whereas the control group received a sham treatment across the same time span. A multidimensional voice assessment consisting of both objective (multiparametric indices: Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI)) and subjective (subject's self‐report, auditory–perceptual evaluation) vocal outcomes was performed by a blinded assessor pre‐ and post‐therapy. Outcomes & Results Lip trill and straw phonation therapy led to a significant improvement in DSI. Auditory–perceptual grade and roughness significantly decreased after straw phonation. Lip trill and WRT both led to a significant decrease in Voice Handicap Index. Subjects reported a better self‐perceived vocal quality and a more comfortable voice production after WRT. No changes were found after the sham treatment in the control group. Conclusions & Implications Results suggest that SOVT therapy programmes including lip trill or straw phonation can improve the objective vocal quality in patients with dysphonia. Auditory–perceptual improvements were found after straw phonation therapy, whereas psychosocial improvements were found after lip trill and WRT. Patients seem to experience more comfort and a better self‐perceived vocal quality after WRT. This study supports the use of the three SOVT therapy programmes in clinical practice. They all had a positive impact on one or more outcomes of the multidimensional voice assessment. Strikingly, vocal quality outcomes were not in line with the subject's opinion. Larger‐scale investigation is needed to support these preliminary findings.

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Section: Discussionmentioning

confidence: 97%

Effect of three semi‐occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trill, water‐resistance therapy and straw phonation

Meerschman

Lierde

Ketels

et al. 2018

Intl J Lang & Comm Disor

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“…Most works have reported that relevant aerodynamic changes occur during and after WRT. Increase in P sub and P oral during WRT has been one of the most common outcomes [52-54, 57-59]. Amarante Andrade et al [58] suggested that P oral needs to overcome the hydrostatic pressure when the tube is submerged into the water.…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude of P oral is determined by water depth generating a higher flow resistance compared to tube phonation in air. This would increase P sub relatively more than P oral as a compensatory response to sustain phonation and overcome resistance offered by the water [54, 59]. In a recent study, Guzmán et al [54] found a strong positive correlation between P sub and P oral in subjects with different voice conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the change in CQEGG caused by a high-resistance voice exercise (8 cm water condition) could be considered to increase vocal effort by increasing vocal fold adduction (which may be desirable in patients with presbyphonia). According to Tyrmi et al [59], higher CQEGG at deeper immersion suggests that WRT may increase vocal effort. In a recent high-speed digital imaging study, CQEGG tended to increase during tube phonation into water compared to comfortable vowel production in normal-voiced subjects.…”

Section: Discussionmentioning

confidence: 99%

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Aerodynamic, Electroglottographic, and Acoustic Outcomes after Tube Phonation in Water in Elderly Subjects

Guzmán

Saldívar

Pérez

et al. 2018

Folia Phoniatr Logop

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Objective: The present study aimed at observing the influence of tube phonation into water on objective voice characteristics in elderly subjects. Methods: Thirty elderly subjects with presbyphonia were randomly assigned to one of two voice exercise groups: (1) voice exercises with water resistance therapy at 4 and 8 cm of water depth (experimental group), and (2) voice exercises with vowel [a:]. Aerodynamic, electroglottographic, and acoustic voice assessments were conducted before and after exercises. Results: The experimental group showed a significant increase in contact quotient, subglottic pressure (P_sub), glottal resistance, and sound pressure level (SPL) when comparing the pre-post 8 cm and the post 4 cm-post 8 cm conditions. No significant differences were found for the control group. Moreover, significant differences for all variables (except for glottal airflow) when comparing condition post (for the control group) and condition post 8 cm (for the experimental group) were found. Conclusion: Tube phonation into water might improve vocal function in the geriatric population. This semioccluded vocal tract exercise seems to promote an increase in P_sub and vocal fold adduction immediately after exercise. This in turn might cause an increase in SPL. The effect should become manifest when a deep level of submersion (e.g., 8 cm water) is used. Shallower submersion produced negligible or no effects.

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“…When performing a SOVTE, the anterior region of the vocal tract becomes partially occluded. This increases the source-filter interaction, increases the glottic and supraglottic pressure and, therefore, decreases the collision between the vocal folds, producing a massage effect (10) , which favors a more efficient and economical vocal production due to retroflex resonance (11) . A study with 33 healthy elderly, observed positive immediate effects on the vocal quality after one minute of the SOVTE with sounded blowing exercise added to no self-perceived vocal changes (7) .…”

Section: Introductionmentioning

confidence: 99%

Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis

Piragibe

Silvério

Dassiê-Leite

et al. 2020

CoDAS

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RESUMO Objetivo Verificar e comparar os efeitos imediatos da técnica de oscilação oral de alta frequência sonorizada (OOAFS) e sopro sonorizado com tubo de ressonância na autopercepção de sintomas vocais/laríngeos e na qualidade vocal de idosas. Método Participaram 14 mulheres idosas que realizaram as técnicas OOAFS e sopro sonorizado com tubo de ressonância de silicone, com wash-out de uma semana. Todas responderam questões sobre frequência e intensidade dos sintomas vocais/laríngeos; foram submetidas à gravação da vogal sustentada /a/ e contagem de números, para análise perceptivo-auditiva e acústica vocal. Foram extraídos os tempos máximos de fonação (TMF). Em seguida, sorteou-se a técnica a ser realizada: OOAFS ou tubo de ressonância, por três minutos em tom habitual. Após exercício, os mesmos procedimentos da avaliação inicial foram repetidos e as idosas responderam a um questionário de autoavaliação sobre os efeitos das técnicas. Os dados foram comparados antes e após aplicação das técnicas por meio dos testes ANOVA, Wilcoxon e Mann-Whitney; para as sensações vocais após técnicas, aplicou-se teste Quiquadrado(p<0,05). Resultados Ao comparar as técnicas, verificou-se diminuição da rugosidade e melhora da ressonância na contagem dos números após tubo de ressonância e manutenção dos resultados após OOAFS. Não houve mais diferenças significantes para as demais variáveis estudadas entre os grupos. Conclusão O sopro sonorizado com tubo de ressonância melhora a qualidade vocal de mulheres idosas. Além disso, ambos os exercícios apresentaram semelhanças na autopercepção dos sintomas vocais/laríngeos e sensações, sugerindo que a OOAFS é segura e pode ser empregada na terapia de voz nesta população.

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Resonance Tube or Lax Vox?

Cited by 46 publications

References 12 publications

Effect of three semi‐occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trill, water‐resistance therapy and straw phonation

Effect of three semi‐occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trill, water‐resistance therapy and straw phonation

Aerodynamic, Electroglottographic, and Acoustic Outcomes after Tube Phonation in Water in Elderly Subjects

Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis

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