Aerodynamic, Electroglottographic, and Acoustic Outcomes after Tube Phonation in Water in Elderly Subjects

Abstract

Objective: The present study aimed at observing the influence of tube phonation into water on objective voice characteristics in elderly subjects. Methods: Thirty elderly subjects with presbyphonia were randomly assigned to one of two voice exercise groups: (1) voice exercises with water resistance therapy at 4 and 8 cm of water depth (experimental group), and (2) voice exercises with vowel [a:]. Aerodynamic, electroglottographic, and acoustic voice assessments were conducted before and after exercises. Results: The experimental group showed a significant increase in contact quotient, subglottic pressure (P_sub), glottal resistance, and sound pressure level (SPL) when comparing the pre-post 8 cm and the post 4 cm-post 8 cm conditions. No significant differences were found for the control group. Moreover, significant differences for all variables (except for glottal airflow) when comparing condition post (for the control group) and condition post 8 cm (for the experimental group) were found. Conclusion: Tube phonation into water might improve vocal function in the geriatric population. This semioccluded vocal tract exercise seems to promote an increase in P_sub and vocal fold adduction immediately after exercise. This in turn might cause an increase in SPL. The effect should become manifest when a deep level of submersion (e.g., 8 cm water) is used. Shallower submersion produced negligible or no effects.

Using a Lossy Electrical Transmission Line Model for Optimizing Straw Phonation Configurations

“…Anatomical and biological changes to the vocal tract wall effect the viscous friction and heat conduction with the vocal tract wall, and thus resistance and shunt conductance, respectively. Third and finally, water resistance therapy is similar in intent to straw phonation by providing extra resistance to the patient, along with introducing nonlinear feedback to massage the vocal folds [28][29][30]. Along with the extension of the vocal tract with the aid of a straw, the end of the straw is submerged in water, requiring the phonation to push air through the water to produce bubbles.…”

Parámetros vocales para definir la severidad de una disfonía

“…En todas las deficiencias vocales se produce una alteración en los procesos aerodinámicos y en las cualidades perceptuales y acústicas del sonido [26]. Existe una correlación entre la fisiopatología de los procesos involucrados en la voz (respiración, fonación, resonancia) que hace parte de la caracterización de las diferentes disfonías [24,27]; por ello es importante comprender este tipo de correlaciones fisiológicas, a fin de establecer, para cada caso un tratamiento efectivo [8,28].…”

The Effect of Water Resistance Therapy on the Impulse Dispersion of Aerosols During Sustained Phonation

“…Water resistance therapies (WRT) and semi-occluded vocal tract exercises (SOVTE), such as LAX VOX® 19 are widely used for both voice therapy and singing warm-ups. 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 During such exercises, the patient or singer phonates into a silicone tube, one opening in the mouth and sealed by the lips, the other opening submerged several centimeters under the surface of a fluid inside a bottle, which is held by the subject. After fragmentation of the airflow by the vocal folds, the airflow has to pass a fluid medium, such as water.…”