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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References
- Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment.2nd ed. Williams & Wilkins, Baltimore, MD1996
- The Voice and Voice Therapy.5th ed. Prentice-Hall, Inc, Englewood Cliffs, NJ1994
- Benign pathologic responses of the larynx.NCVS Status Prog Rep. 1997; 11: 135-148
- Modeling mechanical stresses as a factor in the etiology of benign vocal fold lesions.J Biomech. 2004; 37: 1119-1124
- Mechanical stress in phonation.J Voice. 1994; 8: 99-105
- Biomechanical signals suppress proinflammatory responses in cartilage: early events in experimental antigen-induced arthritis.J Immunol. 2006; 177: 8757-8766
- Dynamic biomechanical strain inhibits IL-1beta-induced inflammation in vocal fold fibroblasts.J Voice. 2007; 21: 651-660
- Fetal wound healing current perspectives.Clin Plast Surg. 2003; 30: 13-23
- Acute management of the performing voice.Otolaryngol Clin North Am. 2000; 33: 957-966
- Office steroid injections of the larynx.Laryngoscope. 2006; 116: 1735-1739
- Steroid injection for Reinke’s edema using fiberoptic laryngeal surgery.Acta Otolaryngol. 2003; 123: 417-420
- Steroid injection to vocal nodules using fiberoptic laryngeal surgery under topical anesthesia.Eur Arch Otorhinolaryngol. 2004; 261: 489-492
- Low magnitude of tensile strain inhibits IL-1beta-dependent induction of pro-inflammatory cytokines and induces synthesis of IL-10 in human periodontal ligament cells in vitro.J Dent Res. 2001; 80: 1416-1420
- Cyclic tensile strain suppresses catabolic effects of interleukin-1beta in fibrochondrocytes from the temporomandibular joint.Arthritis Rheum. 2001; 44: 608-617
- Signaling by mechanical strain involves transcriptional regulation of proinflammatory genes in human periodontal ligament cells in vitro.Bone. 2002; 30: 547-552
- Cyclic tensile strain acts as an antagonist of IL-1B actions in chondrocytes.J Immunol. 2000; 165: 453-460
- Role of NF-kappaB transcription factors in antiinflammatory and proinflammatory actions of mechanical signals.Arthritis Rheum. 2004; 50: 3541-3548
- Signal transduction by mechanical strain in chondrocytes.Curr Opin Clin Nutr Metab Care. 2003; 6: 289-293
- A randomized controlled trial of a passive accessory joint mobilization on acute ankle inversion sprains.Phys Ther. 2001; 81: 984-994
- The influence of immobilization versus exercise on scar formation in the rabbit patellar tendon after excision of the central third.Am J Sports Med. 1994; 22: 803-811
- Shifts in biochemical markers associated with wound healing in laryngeal secretions following phonotrauma: a preliminary study.Ann Otol Rhinol Laryngol. 2003; 112: 1021-1025
- Markers of wound healing in vocal fold secretions from patients with laryngeal pathology.Ann Otol Rhinol Laryngol. 2004; 113: 23-29
- Mucosal wound healing in a rabbit model of subglottic stenosis: biochemical analysis of secretions.Ann Otol Rhinol Laryngol. 2005; 131: 153-157
- Cytokine analysis of acute wound healing in the larynx: a rabbit model.J Voice. 2005; 19: 283-289
- Profiling the cytokines in gingival crevicular fluid using a cytokine antibody array.J Periodontol. 2006; 77: 856-864
- Local immune status and tumour marker expression in the human larynx.J Laryngol Otol Suppl. 2009; 31: 1-4
- Resonant voice therapy.in: Stemple J.C. Voice Therapy: Clinical Studies. Singular Publishing Group, San Diego, CA2000: 46-62
- Preliminary study of two methods of treatment for laryngeal nodules.J Voice. 1995; 9: 74-85
- A quantitative output-cost ration in voice production.J Speech Lang Hear Res. 2001; 44: 29-37
- Comparison of aerodynamic and electroglottographic parameters in evaluating clinically relevant voicing patterns.Ann Otol Rhinol Laryngol. 1994; 103: 335-346
- Laryngeal adduction in resonant voice.J Voice. 1998; 12: 315-327
- Exercise increases interleukin-10 levels both intraarticularly and peri-synovially in patients with knee osteoarthritis: a randomized controlled trial.Arthritis Res Ther. 2010; 12: R126
- Exercise accelerates cutaneous wound healing and decreases wound inflammation in aged mice.Am J Physiol. 2008; 294: R179-R184
- The anti-inflammatory effect of exercise.J Appl Physiol. 2005; 98: 1154-1162
- Simple vocal tasks for detecting vocal fold swelling.J Voice. 1990; 4: 172-183
- The s/z ratio as an indicator of laryngeal pathology.J Speech Hear Disord. 1981; 46: 147-149
- The physics of small-amplitude oscillation of the vocal folds.J Acoust Soc Am. 1988; 83: 1536-1552
- Dependence of phonatory effort on hydration level.J Speech Hear Res. 1994; 37: 1001-1007
- Prevalence of voice disorders in teachers and the general population.J Speech Lang Hear Res. 2004; 47: 281-293
- Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population.J Voice. 2001; 15: 424-440
- Glottal airflow and transglottal air pressure measurements for male and female speakers in soft, normal, and loud voice.J Acoust Soc Am. 1988; 84: 511-529
- Changes in phonation threshold pressure with induced conditions of hydration.J Voice. 1990; 4: 142-151
- The effect of viscosity changes in the vocal folds on the range of oscillation.J Voice. 1988; 1: 320-325
- Some parameters of vocal effort.J Acoust Soc Am. 1972; 51: 141
- Some relationships between vocal effort and intraoral air pressure.J Acoust Soc Am. 1973; 53: 296
- Directing attention to movement effects enhances learning: a review.Psychon Bull Rev. 2001; 8: 648-660
- Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading task: a study of vocal fatigue.J Voice. 2004; 18: 454-466
- Assessment of phonation threshold pressure: a critical review and clinical implications.Am J Speech Lang Pathol. 2011; 20: 348-366
- Oral breathing increases Pth and vocal effort by superficial drying of vocal fold mucosa.J Voice. 2002; 16: 172-181
- Vocal fold fibroblast response to mechanical stress.([doctoral dissertation]) University of Pittsburgh, Pittsburgh, PA2005
- A patient-specific in silico model of inflammation and healing tested in acute vocal fold injury.PLoS One. 2008; 3: e2789
- Biosimulation of acute phonotrauma: an extended model.Laryngoscope. 2011; 121: 2418-2428
- The basic science of wound healing.Plast Reconstr Surg. 2006; 117: 12S-34S
- Chemokines in cutaneous wound healing.J Leukoc Biol. 2001; 69: 513-521
- Inflammatory mediators in wound healing.Surg Clin North Am. 2003; 83: 483-507
- The wound healing process.Dermatol Clin. 1993; 11: 629-640
- Growth factors in skin wound healing.Eur J Cell Biol. 1995; 68: 1-7
- Genetic polymorphisms and sepsis.Shock. 2005; 24: 300-312
- Proinflammatory cytokine single nucleotide polymorphisms in nasal polyposis.Arch Otolaryngol Head Neck Surg. 2007; 133: 705-709
- Cytokine and cytokine receptor gene polymorphisms and their functionality.Cytokine Growth Factor Rev. 2009; 20: 43-59
- A quantitative output-cost ratio in voice production.J Speech Lang Hear Res. 2001; 44: 29-37
- Phonation threshold pressure measurements during phonation by airflow interruption.Laryngoscope. 1999; 109: 425-432
- Effects of Repetition on Phonation Threshold Pressure Task Performance.University of Pittsburgh, Pittsburgh, PA2011
- Phonation threshold pressure: a missing link in glottal aerodynamics.J Acoust Soc Am. 1992; 91: 2926-2935
- Phonation threshold pressure in a physical model of the vocal fold mucosa.J Acoust Soc Am. 1995; 97: 3080-3084
- Mucosal wound healing in a rabbit model of subglottic stenosis: biochemical analysis of secretions.Arch Otolaryngol Head Neck Surg. 2005; 131: 153-157
- Elucidating the role of interleukin 1beta and prostaglandin E2 in upper airway mucosal wound healing.Arch Otolaryngol Head Neck Surg. 2007; 133: 365-374
- Prostaglandin E2 is activated by airway injury and regulates fibroblast cytoskeletal dynamics.Laryngoscope. 2009; 119: 1365-1373
- Interleukin-1beta as a marker of mucosal injury and inflammation.Wound Repair Regen. 2008; 16: A49
Article info
Publication history
Accepted:
March 16,
2012
Identification
Copyright
© 2012 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
