Summary
Purpose
The present study was designed to assess the efficacy of a six-session physiologic
voice therapy program with the semioccluded ventilation mask (SOVM) in a group of
subjects with voice complaints (vocal effort and fatigue).
Methods
Thirty-four participants with functional dysphonia were randomly assigned to one of
two treatment groups: (1) voice treatment with physiologic voice therapy plus vocal
hygiene program (n = 17), and (2) vocal hygiene program only (n = 17). Laryngoscopic
assessment was performed in all subjects to confirm laryngeal diagnosis. Before and
after voice therapy, participants underwent aerodynamic assessment. The Voice Handicap
Index (VHI), Vocal Tract Discomfort Scale (VTDS), and self-assessment of resonant
voice were also performed. The treatment included six voice therapy sessions. For
the experimental group, the exercises consisted of a sequence of seven phonatory tasks
performed with the SOVM. Comparison for all variables was performed between experimental
group and control group.
Results
Statistical analysis showed significant improvements for experimental group for VHI
(decrease), VTDS (decrease), and self-perception of resonant voice quality (increase).
Significant decrease for experimental group was observed in subglottic pressure and
phonation threshold pressure.
Conclusion
Physiologic voice therapy based on the SOVM with connected speech exercises seems
to be an effective tool to improve voice in subjects diagnosed with voice complaints.
Apparently, improvements are reflected in both subjective and objective outcomes.
A reduction in phonatory effort and perceptual aspects of vocal fatigue are the main
subjective improvements. A decrease in air pressure-related variables seems to be
the most important objective change after voice therapy.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Toward a consensus description of vocal effort, vocal load, vocal loading, and vocal fatigue.J Speech Lang Hear Res. 2020; 63: 509-532
- Vocal fatigue: current knowledge and future directions.J Voice. 2003; 17: 21-30
- Vocal fatigue and its relation to vocal hyperfunction.Int J Speech Lang Pathol. 2008; 10: 254-266
- Effect of hydration and vocal rest on the vocal fatigue in amateur karaoke singers.J Voice. 2003; 17: 216-227
- Laryngeal airway resistance in teachers with vocal fatigue: a preliminary study.J Voice. 1998; 12: 287-299
- Vocal fatigue index (VFI): development and validation.J Voice. 2015; 29: 433-440
- Acoustic measures and self-reports of vocal fatigue by female teachers.J Voice. 2008; 22: 283-289https://doi.org/10.1016/j.jvoice.2006.10.001
- The effect of sustained phonation at high and low pitch on vocal jitter and shimmer.Folia Phoniatr (Basel). 1993; 45: 223-228
- Vocal performance of group fitness instructors before and after instruction: changes in acoustic measures and self-ratings.J Voice. 2016; 30: 127.e1-127.e8https://doi.org/10.1016/j.jvoice.2015.02.007
- Vocal impact of a prolonged reading task in dysphonic versus normophonic female teachers.J Voice. 2012; 26 (e1-13): 820https://doi.org/10.1016/j.jvoice.2012.06.002
- Objective measures of voice production in normal subjects following prolonged voice use.J Voice. 1995; 9: 127-133
- Quantifying vocal fatigue recovery dynamic vocalrecovery.Ann Otol Rhinol Laryngol. 2009; 118: 449-460
- Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading task: a study of vocal fatigue.J Voice. 2004; 18: 454-466https://doi.org/10.1016/j.jvoice.2004.01.004
- Vocal loading and environmental humidity effects in older adults.J Voice. 2017; 31: 707-713https://doi.org/10.1016/j.jvoice.2017.02.002
- Dynamically monitoring vocal fatigue and recovery using aerodynamic, acoustic, and subjective self-rating measurements.J Voice. 2019; 33: 809.e11-809.e18
- Can vocal economy in phonation be increased with an artificially lengthened vocal tract? A computer modeling study.Logoped Phoniatr Vocol. 2007; 32: 147-156
- Revisión sistemática de la literatura sobre medidas aerodinámicas de la fonación.Revista de Logopedia Foniatría Audiología. 2018; 38: 130-137
- Efficacy of water resistance therapy in subjects diagnosed with behavioral dysphonia: a randomized-controlled trial.J Voice. 2017; 31: 385.e1-385.e10
- Effectiveness of a physiologic voice therapy program based on different semioccluded vocal tract exercises in subjects with behavioral dysphonia: a randomized controlled trial.J Comm Dis. 2020; 87: 106023
- Vocal function exercises for presbylaryngis: a multidimensional assessment of treatment outcomes.Ann Otol Rhinol Laryngol. 2010; 119: 460-467
- A randomized controlled trial of two semi-occluded vocal tract voice therapy protocols.J Speech Lang Hear Res. 2015; 58: 535-549
- El juego Vocal Para Prevenir Problemas De La Voz.Aljibe, Archidona, Malaga1999
- Validation and evaluation of the effects of semi-occluded face mask straw phonation therapy methods on aerodynamic parameters in comparison to traditional methods.J Voice. 2017; 31: 323-328
- Voice quality after a semioccluded vocal tract exercise with a ventilation mask in contemporary commercial singers: acoustic analysis and self-assessments.J Voice. 2017; 31: 336-341
- Immediate effects of the semi-occluded ventilation mask on subjects diagnosed with functional dysphonia and subjects with normal voices.J Voice. 2020; 34: 398-409
- Effects of a variably occluded face mask on the aerodynamic and acoustic characteristics of connected speech in patients with and without voice disorders.J Voice. 2019; 33: 809.e1-809.e10
- Immediate effects of a semi-occluded water resistance ventilation mask on objective and subjective vocal outcomes in musical theater students.J Speech Lang Hear Res. 2020; 63: 661-673
- The Voice Handicap Index (VHI): development and validation.Am J Speech Lang Pathol. 1997; 6: 66-70
- Adaptation and validation to the Spanish of the Voice Handicap Index (VHI-30) and its shortened version (VHI-10).Acta Otorrinolaringol Esp. 2007; 58: 386-392
- Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia.J Voice. 2009; 23: 353-366
- Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia.J Voice. 2009; 23: 353-366
- Applicability of the vocal tract discomfort (VTD) scale in evaluating the effects of voice therapy of occupational voice disorders.Med Pr. 2012; 63: 141-152
- Vocal tract discomfort symptoms in patients with different voice disorders.J Voice. 2015; 29: 317-323
- An evaluation of the effects of two treatment approaches for teachers with voice disorders: a prospective randomized clinical trial.J Speech Lang Hear Res. 2001; 44: 286-296
- The effectiveness of the comprehensive voice rehabilitation program compared with the vocal function exercises method in behavioral dysphonia: a randomized clinical trial.J Voice. 2016; 30 (377, e11-e19)
- Multidimensional analysis on the effect of vocal function exercises on aged vocal fold atrophy.J Voice. 2015; 29: 638-644
- Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements.J Voice. 2007; 21: 415-425
- Acoustic impedance of an artificially lengthened and constricted vocal tract.J Voice. 2000; 14: 455-469
- The physics of small-amplitude oscillation of the vocal folds.J Acoust Soc Am. 1988; 83: 1536-1552
- Role of ratings of perceived exertion during self-paced exercise: what are we actually measuring?.Sports Med. 2015; 45: 1235-1243
- Perception of effort in exercise science: definition, measurement and perspectives.Eur J Sport Sci. 2016; 16: 885-894
- A preliminary study of two methods of treatment for laryngeal nodules.J Voice. 1995; 9: 74-85
Article info
Publication history
Published online: October 21, 2020
Accepted:
October 13,
2020
Footnotes
Funding: This research was supported by grants from CONICYT (grant FONDECYT 11180291).
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
