Summary
Introduction
Vibratory positive expiratory pressure (PEP) devices are now commonly used as a resource
for voice therapy. PEP devices promote improved vocal economy with the added benefit
of producing a massage effect in the vocal tract. Although the benefits of PEP devices
for voice have already been demonstrated, their impact on the vocal source is still
not very clear. This study assesses the impact of phonation into the Acapella Choice
(a type of PEP device) on the voice.
Methods
Three normophonic subjects underwent high-speed videoendoscopy assessment while pressure,
flow and electroglottographic data was collected.
Results
Phonation into the Acapella device produces large changes in the pressure and flow
profiles consequently affecting the voice source. In specific, when intraoral pressure
increases as a consequence of the downward movement of the rocker arm in the Acapella
device (reduction of the airflow outlet), phonation is hindered, demonstrated by the
lower amplitude of vibration of the vocal folds and weaker modulation of the pressure
and flow values by the glottal cycle. When the rocker arm in the Acapella device opens
(increasing the airflow outlet), the opposite trend is observed where vocal fold vibration
is aided and the modulation of pressure and flow by the vocal cycle increases. Based
on the pressure and flow signals, we can assume that the impedance of the vocal tract
alternates between two dominant regimes: increased inertive reactance (aided vibration)
and increased resistance (hindered vibration).
Conclusions
PEP devices, such as the Acapella device, are efficient in modulating the pressure
and flow profiles in the vocal tract leading to the alternation of glottal vibration
from aided to hindered. These changes in the glottal vibration can be considered an
additional consequence of the massage effect caused by the Acapella device.
Key Words
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Article info
Publication history
Published online: March 10, 2022
Accepted:
February 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
