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Metabolic Mechanisms of Vocal Fatigue

  • Chayadevie Nanjundeswaran
    Correspondence
    Address correspondence and reprint requests to Chayadevie Nanjundeswaran, Department of Audiology and Speech-Language Pathology, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Lamb Hall, Box 70643, Johnson City, TN 37614.
    Affiliations
    Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, Tennessee
    Search for articles by this author
  • Jessie VanSwearingen
    Affiliations
    Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania

    School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Katherine Verdolini Abbott
    Affiliations
    Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania

    Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania

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

    Center for the Neural Basis of Cognition, Carnegie-Mellon University, Pittsburgh, Pennsylvania

    Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania
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Published:November 01, 2016DOI:https://doi.org/10.1016/j.jvoice.2016.09.014

      Summary

      Objective

      This study aimed to identify potential metabolic mechanisms including (1) neuromuscular inefficiency, (2) cardiovascular recovery deficits, or (3) both, in individuals with complaints of vocal fatigue.

      Study Design

      Within- and between-subjects group design was used in this study.

      Methods

      Three groups of women participated in the study, including (1) individuals with complaints of vocal fatigue; (2) vocally healthy sedentary individuals; and (3) vocally healthy, cardiovascularly conditioned individuals. Group assignment was based on results from the Vocal Fatigue Index, laryngeal examination, and self-report regarding exercise regimens. Metabolic profiles were obtained using gas exchange measures monitored during vocal task performance (reading) at two different loudness levels, and during recovery from reading.

      Results

      Statistical analyses did not reveal reliable group differences in metabolic cost for or recovery from vocal tasks. However, descriptive review of oxygen uptake and recovery kinetics revealed patterns indicating reliance on differential energy resources for the vocal task in individuals with vocal fatigue compared with cardiovascularly trained, vocally healthy individuals in particular. Slow oxygen uptake kinetics at task onset was a characteristic of the vocal fatigue group, indicating a general reliance on anaerobic resources to meet the demands of the vocal task, pointing to possible neuromuscular inefficiency. Individuals with vocal fatigue also demonstrated an increase in oxygen consumption following vocal task compared with cardiovascularly trained individuals, suggesting possible cardiovascular recovery deficits.

      Conclusion

      This study provides initial data relevant to possible metabolic mechanisms of vocal fatigue and the potential relevance of aerobic conditioning in individuals with such fatigue.

      Key Words

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      References

        • Gotaas C.
        • Starr C.D.
        Vocal fatigue among teachers.
        Folia Phoniatr (Basel). 1993; 45: 120-129
        • McCabe D.J.
        • Titze I.R.
        Chant therapy for treating vocal fatigue among public school teachers: a preliminary study.
        Am J Speech Lang Pathol. 2002; 11: 356-369
        • Smith E.
        • Gray S.D.
        • Dove H.
        • et al.
        Frequency and effects of teachers' voice problems.
        J Voice. 1997; 11: 81-87
        • Buekers R.
        Are voice endurance tests able to assess vocal fatigue?.
        Clin Otolaryngol Allied Sci. 1998; 23: 533-538
        • Eustace C.S.
        • Stemple J.C.
        • Lee L.
        Objective measures of voice production in patients complaining of laryngeal fatigue.
        J Voice. 1996; 10: 146-154
        • Laukkanen A.M.
        • Ilomaki I.
        • Leppanen K.
        • et al.
        Acoustic measures and self-reports of vocal fatigue by female teachers.
        J Voice. 2006; 22: 283-289
        • Boucher V.J.
        • Ahmarani C.
        • Ayad T.
        Physiologic features of vocal fatigue: electromyographic spectral-compression in laryngeal muscles.
        Laryngoscope. 2006; 116: 959-965
        • Boucher V.J.
        • Ayad T.
        Physiological attributes of vocal fatigue and their acoustic effects: a synthesis of findings for a criterion-based prevention of acquired voice disorders.
        J Voice. 2009; 24: 324-336
        • Chang A.
        • Karnell M.P.
        Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading task: a study of vocal fatigue.
        J Voice. 2004; 18: 454-466
        • Vintturi J.
        • Alku P.
        • Sala E.
        • et al.
        Loading-related subjective symptoms during a vocal loading test with special reference to gender and some ergonomic factors.
        Folia Phoniatr Logop. 2003; 55: 55-69
        • Welham N.V.
        • Maclagan M.A.
        Vocal fatigue in young trained singers across a solo performance: a preliminary study.
        Logoped Phoniatr Vocol. 2004; 29: 3-12
        • Milbrath R.L.
        • Solomon N.P.
        Do vocal warm-up exercises alleviate vocal fatigue?.
        J Speech Lang Hear Res. 2003; 46: 422-436
        • Solomon N.P.
        • DiMattia M.S.
        Effects of a vocally fatiguing task and systemic hydration on phonation threshold pressure.
        J Voice. 2000; 14: 341-362
        • Solomon N.P.
        • Glaze L.E.
        • Arnold R.R.
        • et al.
        Effects of a vocally fatiguing task and systemic hydration on men's voices.
        J Voice. 2003; 17: 31-46
        • Hunter E.J.
        • Titze I.R.
        Quantifying vocal fatigue recovery: dynamic vocal recovery trajectories after a vocal loading exercise.
        Ann Otol Rhinol Laryngol. 2009; 118: 449-460
        • Solomon N.P.
        Vocal fatigue and its relation to vocal hyperfunction.
        Int J Speech Lang Pathol. 2007; 10: 1-13
        • Allen D.G.
        • Lamb G.D.
        • Westerblad H.
        Skeletal muscle fatigue: cellular mechanisms.
        Physiol Rev. 2008; 88: 287-332
        • Amann M.
        • Calbet J.A.
        Convective oxygen transport and fatigue.
        J Appl Physiol. 2008; 104: 861-870
        • Astrand P.O.
        • Rodahl K.
        • Dahl H.A.
        • et al.
        Textbook of Work Physiology: Physiological Bases of Exercise.
        4th ed. Human Kinetics, Champaign, IL2003
        • Bigland-Ritchie B.
        • Cafarelli E.
        • Vollestad N.K.
        Fatigue of submaximal static contractions.
        Acta Physiol Scand Suppl. 1986; 556: 137-148
        • Enoka R.M.
        • Stuart D.G.
        Neurobiology of muscle fatigue.
        J Appl Physiol. 1992; 72: 1631-1648
        • Fitts R.H.
        Cellular mechanisms of muscle fatigue.
        Physiol Rev. 1994; 74: 49-94
        • Gandevia S.C.
        • Enoka R.M.
        • McComas A.J.
        • et al.
        Neurobiology of muscle fatigue. Advances and issues.
        Adv Exp Med Biol. 1995; 384: 515-525
        • Noakes T.D.
        • St Clair Gibson A.
        • Lambert E.V.
        From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans.
        Br J Sports Med. 2004; 38: 511-514
        • Davis M.P.
        • Walsh D.
        Mechanisms of fatigue.
        J Support Oncol. 2010; 8: 164-174
        • Gandevia S.C.
        Spinal and supraspinal factors in human muscle fatigue.
        Physiol Rev. 2001; 81: 1725-1789
        • Amann M.
        • Eldridge M.W.
        • Lovering A.T.
        • et al.
        Arterial oxygenation influences central motor output and exercise performance via effects on peripheral locomotor muscle fatigue in humans.
        J Physiol. 2006; 575: 937-952
        • Amann M.
        • Dempsey J.A.
        The concept of peripheral locomotor muscle fatigue as a regulated variable.
        J Physiol. 2008; 586.7: 2029-2030
        • Brooks G.A.
        • Fahey T.D.
        • Baldwin K.M.
        Exercise Physiology: Human Bioenergetics and its Applications.
        4th ed. McGraw Hill, New York, NY2005
        • Westerblad H.
        • Bruton J.D.
        • Katz A.
        Skeletal muscle: energy metabolism, fiber types, fatigue and adaptability.
        Exp Cell Res. 2010; 316: 3093-3099
        • Dresen M.H.
        • de Groot G.
        • Mesa Menor J.R.
        • et al.
        Aerobic energy expenditure of handicapped children after training.
        Arch Phys Med Rehabil. 1985; 66: 302-306
        • Woo J.S.
        • Derleth C.
        • Stratton J.R.
        • et al.
        The influence of age, gender, and training on exercise efficiency.
        J Am Coll Cardiol. 2006; 47: 1049-1057
        • McCardle W.D.
        • Katch F.I.
        • Katch V.L.
        Exercise Physiology: Energy, Nutrition, and Human Performance.
        Lippincott Williams & Wilkins, Philadelphia, PA2007
        • Kemps H.M.
        • Schep G.
        • Zonderland M.L.
        • et al.
        Are oxygen uptake kinetics in chronic heart failure limited by oxygen delivery or oxygen utilization?.
        Int J Cardiol. 2010; 142: 138-144
        • Short K.R.
        • Sedlock D.A.
        Excess postexercise oxygen consumption and recovery rate in trained and untrained subjects.
        J Appl Physiol. 1997; 83: 153-159
        • Jones A.M.
        • Carter H.
        The effect of endurance training on parameters of aerobic fitness.
        Sports Med. 2000; 29: 373-386
        • Tomlin D.L.
        • Wenger H.A.
        The relationship between aerobic fitness and recovery from high intensity intermittent exercise.
        Sports Med. 2001; 31: 1-11
        • Bahr R.
        • Sejersted O.M.
        Effect of intensity of exercise on excess postexercise O2 consumption.
        Metabolism. 1991; 40: 836-841
        • Gaesser G.A.
        • Brooks G.A.
        Metabolic bases of excess post-exercise oxygen consumption: a review.
        Med Sci Sports Exerc. 1984; 16: 29-43
        • McCardle W.D.
        • Katch F.I.
        • Katch V.L.
        Exercise Physiology: Energy, Nutrition, and Human Performance.
        Lippincott Williams & Wilkins, Philadelphia, PA2001
        • Poole D.C.
        • Schaffartzik W.
        • Knight D.R.
        • et al.
        Contribution of exercising legs to the slow component of oxygen uptake kinetics in humans.
        J Appl Physiol. 1991; 71: 1245-1260
        • Ratkevicius A.
        • Stasiulis A.
        • Dubininkaite L.
        • et al.
        Muscle fatigue increases metabolic costs of ergometer cycling without changing VO2 slow component.
        J Sports Sci Med. 2006; 5: 440-448
        • Reybrouck T.
        • Vangesselen S.
        • Mertens L.
        • et al.
        Efficiency of oxygen cost during exercise in patients with symptoms of fatigue during physical activities.
        Acta Paediatr. 2007; 96: 1311-1314
        • Nanjundeswaran C.
        • Jacobson B.H.
        • Gartner-Schmidt J.
        • et al.
        Vocal Fatigue Index (VFI): development and validation.
        J Voice. 2015; 29: 433-440
        • Russell B.A.
        • Cerny F.J.
        • Stathopoulos E.T.
        Effects of varied vocal intensity on ventilation and energy expenditure in women and men.
        J Speech Lang Hear Res. 1998; 41: 239-248
        • Smith E.
        • Kirchner H.L.
        • Taylor M.
        • et al.
        Voice problems among teachers: differences by gender and teaching characteristics.
        J Voice. 1998; 12: 328-334
        • Borg G.A.
        Psychophysical bases of perceived exertion.
        Med Sci Sports Exerc. 1982; 14: 377-381
        • Waters D.D.
        • Szlachcic J.
        • Bonan R.
        • et al.
        Comparative sensitivity of exercise, cold pressor and ergonovine testing in provoking attacks of variant angina in patients with active disease.
        Circulation. 1983; 67: 310-315
        • Holmberg E.B.
        • Hillman R.E.
        • Perkell J.S.
        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
        • Van den Berg J.
        Myoelastic-aerodynamic theory of voice production.
        J Speech Hear Res. 1958; 1: 227-244
        • Grillo E.U.
        • Verdolini K.
        Evidence for distinguishing pressed, normal, resonant, and breathy voice qualities by laryngeal resistance and vocal efficiency in vocally, trained subjects.
        J Voice. 2007; 22: 546-552
        • Kasch F.W.
        • Boyer J.L.
        Adult Fitness Principles and Practice.
        San Diego State College, San Diego1968
        • Jacks D.
        • Moore J.B.
        • Topp R.
        • et al.
        Prediction of VO2 peak using a sub-maximal Bench Step Test in children: 2268: board #48 May 30 3:30 PM–5:00 PM.
        MSSE. 2008; 40: S418https://doi.org/10.1249/1201.mss.0000322780.0000329703.0000322713
        • Scott C.
        Misconceptions about aerobic and anaerobic energy expenditure.
        J Int Soc Sports Nutr. 2005; 2: 32-37
        • Julius L.M.
        • Brach J.S.
        • Wert D.M.
        • et al.
        Perceived effort of walking: relationship with gait, physical function and activity, fear of falling, and confidence in walking in older adults with mobility limitations.
        Phys Ther. 2012; 92: 1268-1277