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Vocal Exercise May Attenuate Acute Vocal Fold Inflammation

  • Katherine Verdolini Abbott
    Correspondence
    Address correspondence and reprint requests to Katherine Verdolini Abbott, Department of Communication Science and Disorders, 4033 Forbes Tower, Pittsburgh, PA 15260.
    Affiliations
    Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania

    Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Nicole Y.K. Li
    Affiliations
    Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
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  • Ryan C. Branski
    Affiliations
    Department of Otolaryngology, New York University School of Medicine, New York, New York
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  • Clark A. Rosen
    Affiliations
    Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania

    McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Elizabeth Grillo
    Affiliations
    Department of Communicative Disorders, West Chester University, West Chester, Pennsylvania
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  • Kimberly Steinhauer
    Affiliations
    Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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  • Patricia A. Hebda
    Affiliations
    Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania

    McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

    Department of Otolaryngology-Pediatric Division, Otolaryngology Wound Healing Laboratory, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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      Summary

      Objectives/Hypotheses

      The objective was to assess the utility of selected “resonant voice” (RV) exercises for the reduction of acute vocal fold inflammation. The hypothesis was that relatively large-amplitude, low-impact vocal fold exercises associated with RV would reduce inflammation more than spontaneous speech (SS) and possibly more than voice rest.

      Study Design

      The study design was prospective, randomized, and double blind.

      Methods

      Nine vocally healthy adults underwent a 1-hour vocal loading procedure, followed by randomization to a SS condition, vocal rest condition, or RV exercise condition. Treatments were monitored in clinic for 4 hours and continued extraclinically until the next morning. At baseline (BL), immediately after loading, after the 4-hour in-clinic treatment, and 24 hours post-BL, secretions were suctioned from the vocal folds bilaterally and submitted to enzyme-linked immunosorbent assay to estimate concentrations of key markers of tissue injury and inflammation: interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor α, matrix metalloproteinase (MMP)-8, and IL-10.

      Results

      Complete data sets were obtained for three markers—IL-1β, IL-6, and MMP-8—for one subject in each treatment condition. For these markers, results were poorest at 24-hour follow-up in the SS condition, sharply improved in the voice rest condition, and was the best in the RV condition. Average results for all markers and responsive subjects with normal BL mediator concentrations revealed an almost identical pattern.

      Conclusions

      Some forms of tissue mobilization may be useful to attenuate acute vocal fold inflammation.

      Key Words

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