Summary
Objectives
Water resistance voice therapy applies phonation into water through a tube. This study
investigates how strenuous this therapy can be for the vocal folds in terms of impact
stress (IS). It further examines whether it is possible to estimate the IS using the contact quotient (CQ) and maximum derivative from an electroglottogram
(EGG).
Study design
Experimental study.
Methods
A male participant sustained a rounded back vowel [u:] or [o:] at a comfortable speaking
pitch and loudness, and phonated into a silicone "Lax Vox" tube submerged 2 cm in
water. High-speed videolaryngoscopy was performed with a rigid scope. Oral air pressure
(Poral) was registered in a mouthpiece through which an endoscope was inserted into the
larynx. An EGG was recorded.
Results
The CQEGG from the EGG and the closed quotient from the glottal width (CQarea) increased, while the maximum glottal amplitude and absolute value of derivative
minimum (dmin) and also the derivative maximum from the EGG decreased for phonation into water.
Normalized amplitude quotient from the glottal width variation also decreased but
the change was not significant.
Conclusions
Based on the glottal area findings, water resistance therapy does not seem to increase
vocal fold loading (in terms of increased IS) even if the increase of CQarea, and CQEGG suggest so. CQEGG may qualitatively correspond to that of area, but the reliability of CQ (from the
glottal area or the EGG) and the maximum derivative from the EGG as estimates of IS in semiocclusion exercises warrant further studies.
Key Words
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References
- Nya metoder vid behandling rostrubbningar [new methods for treating voice disorders].Nordisk Tidskrift for Tale og Stemme. 1969; 3: 121-131
- The resonance tube method in voice therapy: description and practical implementations.Logop Phoniatr Vocology. 2007; 32: 165-170
- Terve ääni. Äänen hoidon A B C [Healthy Voice. The A B C for Voice Care].Kirjapaja, Helsinki2006
- Lax Vox: Voice Therapy Technique.Ad/Zir, Turkey2007
- History of Lax Vox History of the LAX VOX®—Tube Exercise QUICK First-Aid and Vocal Self Care.LAP Lambert Academic Publishing, 2017
- Immediate effects of the Finnish resonance tube method on behavioral dysphonia.J Voice. 2013; 27: 717-722
- Efficacy of water resistance therapy in subjects diagnosed with behavioral dysphonia: A randomized controlled trial.J Voice. 2017; 31 (385.e1–385)
- Voice training and therapy with a semi-occluded vocal tract: rationale and scientific underpinnings.J Speech Lang Hear Res. 2006; 49: 448-459
- Air-pressure, vocal fold vibration and acoustic characteristics of phonation during vocal exercising. Part 1: measurement in vivo.Eng Mech. 2014; 21: 53-59
- Air pressure and contact quotient measures during different semi-occluded postures in subjects with different voice conditions.J Voice. 2015; 30: 759.e1-759.e10
Horáček J, Radolf V, Bula V, et al.Experimental investigation of air pressure and acoustic characteristics of human voice. Part 1: measurement in vivo, in J. Náprstek, C. Fischer, (Eds.) Engineering Mechanics. 2012, Prague: The Institute of Theoretical and Applied Mechanics AS CR, v.v.i., 2012, pp. 403–417. ISBN 978-80-86246-40-6 (electronic), ISSN 1805-8256 (electronic), http://engmech.cz/2012/im/im/proceedings.
- Effects on vocal fold collision and phonation threshold pressure of resonance tube phonation with tube end in water.J Speech Lang Hear Res. 2013; 56: 1530-1538
- Resonance tube phonation in water: high-speed imaging, electrographic and oral pressure observations of vocal fold vibrations—a pilot study.Logop Phoniatr Vocology. 2015; 40: 113-121
- Vertical laryngeal position and oral pressure variations during resonance tube phonation in water and in air. A pilot study.Logop Phoniatr Vocology. 2016; 41: 117-123
- The mechanisms of massage and effects on performance, muscle recovery and injury prevention.Sports Med. 2005; 35: 235-256
- Low frequency mechanical resonance of the vocal tract in vocal exercises that apply tubes.Biomed Signal Process Control. 2017; 37: 39-49
- Theoretical analysis of maximum flow declination rate versus maximum area declination rate in phonation.J Speech Lang Hear Res. 2006; 49: 439-447
- Impact stress in a self-oscillating model of human vocal folds.J Vib Eng Technols. 2016; 4: 183-190
- Mechanical stress in phonation.J Voice. 1994; 8: 99-105
- Measurement of vocal fold intraglottal pressure and impact stress.JVoice. 1994; 8: 132-144
- Comparison of acceleration and impact stress as possible loading factors in phonation. A computer modeling study.Folia Phoniatrica et Logopaedica. 2009; 61: 137-145
- Direct measurement of vocal fold medial forces.Am Speech Hear Ass Rep. 1992; 34 (A): 131
- Investigation of vocal fold impact stress in human subjects.J Voice. 1999; 13: 184-202
- Correspondence of electroglottographic closed quotient to vocal fold impact stress in excised canine larynges.J Voice. 1998; 12: 415-423
- Closed quotient as an estimate of impact stress: a computer modeling study.in: Schutte H.K. Proceedings of the 7th International Conference Advances in Quantitative Laryngology, Voice and Speech Research. Groningen, the Netherlands, Groningen Voice Research Lab., Dept. of BioMedical Engineering, Section Artificial Organs, University Medical Center Groningen2006: pp 8
- How stressful is “deep bubbling”?.J Voice. 2017; 31 (262.e1-262e6)
- Effect of water resistance therapy on vocal fold vibration: a high speed registration study.Logop Phoniatr Vocology. 2017; 42: 99-107
- Comparison of parametrization methods of electroglottographic and inverse filtered acoustic speech pressure signals in distinguishing between phonation types.J Biomed Sign Proc Contr. 2017; 36: 183-193
- Impact stress in water resistance voice therapy. A physical modeling study.J Voice. 2018; https://doi.org/10.1016/j.jvoice.2018.01.025
- Initial validation of an indirect measure of subglottal pressure during vowels.J Acoust Soc Am. 1982; 72: 633-635
- Videokymography in voice disorders: what to look for?.Ann Otol Rhinol Laryngol. 2007; 116: 172-180
- Normalized amplitude quotient for parametrization of the glottal flow.J Acoust Soc Am. 2002; 112: 701-710
- Vocal tract and glottal function during and after vocal exercising with resonance tube and straw.J Voice. 2013; 27: 523.e19-523.e34
- Resonance tube or Lax Vox.J Voice. 2017; 31: 430-437
- Laryngeal adduction in resonant voice.J Voice. 1998; 12: 315-327
- EGG and acoustic analyses of different voice samples: comparison between perceptual evaluation and voice activity and participation profile.Folia Phoniatrica et Logopaedica. 2013; 65: 98-104
- Principles of Voice Production.2nd edition. Prentice Hall (National Center for Voice and Speech), Iowa City2000
- Effects of a semioccluded vocal tract on laryngeal muscle activity and glottal adduction in a single female subject.Folia Phoniatr Logop. 2008; 60: 298-311
- High-speed digital imaging of the medial surface of the vocal folds.J Acoust Soc Am. 2001; 110: 2539-2547
Article info
Publication history
Published online: November 20, 2018
Accepted:
October 25,
2018
Footnotes
The material in this article was presented at the 12th International Conference on Advances in Quantitative Laryngology, Voice and Speech Research, which was held in Hong Kong on 17–21 October 2017.
The study was supported by a grant from the Czech Science Foundation: No. 16-01246S.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
