The Impact of Double Source of Vibration Semioccluded Voice Exercises on Objective and Subjective Outcomes in Subjects with Voice Complaints

Guzmán, Marco; Acuña, Gabriela; Pacheco, Fernanda; Peralta, Francisca; Romero, Constanza; Vergara, Cecilia; Quezada, Camilo

doi:10.1016/j.jvoice.2017.08.021

Cited by 34 publications

(16 citation statements)

References 23 publications

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“…Guzman et al . (2017b), on the other hand, did find a decreased VTDS after both lip trill and WRT. These contradictory finding may be due to differences in inclusion criteria.…”

Section: Discussionmentioning

confidence: 69%

“…, Guzman et al . ). This effect might balance the potential uncomfortable feeling associated with the increased supraglottal pressure.…”

Section: Discussionmentioning

confidence: 97%

“…, Guzman et al . ). Straw phonation has a single source of vibration (i.e., vocal folds only), whereas lip trill and WRT have a secondary source of vibration (i.e., lip trilling and water bubbling).…”

Section: Introductionmentioning

confidence: 97%

“…, Guzman et al . ). Changes in psychosocial impact and auditory–perceptual vocal quality were not yet expected after 3 weeks of practice.…”

Section: Introductionmentioning

confidence: 97%

“…In a later study, Guzman et al . (2017b) showed that one session (30 min) of lip trills or WRT (drinking straw), followed by a 1‐week home‐practice programme, led to improvements in self‐perceived muscle relaxation, vocal tract discomfort and resonant voice quality ( n = 21 per group). None of the above studies included objective multiparametric vocal quality indices or control groups receiving sham (placebo) treatment.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Guzman et al . (2017b), on the other hand, did find a decreased VTDS after both lip trill and WRT. These contradictory finding may be due to differences in inclusion criteria.…”

Section: Discussionmentioning

confidence: 69%

“…, Guzman et al . ). This effect might balance the potential uncomfortable feeling associated with the increased supraglottal pressure.…”

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

“…, Guzman et al . ). Changes in psychosocial impact and auditory–perceptual vocal quality were not yet expected after 3 weeks of practice.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Immediate effects of water resistance therapy on patients with vocal fold mass lesions

Echternach

Raschka

Kuranova

et al. 2020

Eur Arch Otorhinolaryngol

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Introduction Semi-occluded vocal tract exercises, such as water resistance therapy (WRT), are widely used in voice therapy. However, the potential positive effects of such a therapy on vocal fold oscillation patterns in patients indicating a need for phonomicrosurgery have not yet been explored. The presented study aims to analyze the effect of WRT in patients suffering from vocal fold mass lesions. Materials and methods Eight participants with vocal fold mass lesions were asked to sustain a phonation on the vowel /i/ at a comfortable loudness and a fundamental frequency of 250 Hz (females) or 125 Hz (males). During phonation the subjects were simultaneously recorded with transnasal high-speed videoendoscopy (HSV, 20.000 fps), electroglottography, and audio signals. These subjects then performed a WRT (phonation in a silicone tube of 30 cm length, 5 cm below the water surface) for 10 min. Repeated measurements of sustained phonation were performed 0, 10, and 30 min after exercising. From the HSV data the glottal area waveform (GAW) was segmented and GAW parameters were computed. Results During WRT there was an increase of the GAW related open quotient and closing quotient. Immediately after WRT, there was a drop of both values followed by a rise of these parameters up to 30 min after the intervention. Furthermore, there was no correlation between GAW and electroglottographical open quotients. Conclusions The effects observed after a single session of WRT on participants with vocal fold mass lesions showed a similar pattern to vocal fatigue.

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Update on the pediatric adverse vocal behavior voice disorders: a clinical practice review

Yang

2023

Eur J Pediatr

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The Impact of Double Source of Vibration Semioccluded Voice Exercises on Objective and Subjective Outcomes in Subjects with Voice Complaints

Cited by 34 publications

References 23 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

Immediate effects of water resistance therapy on patients with vocal fold mass lesions

Update on the pediatric adverse vocal behavior voice disorders: a clinical practice review

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