The influence of water resistance therapy on vocal fold vibration: a high-speed digital imaging study

Guzmán, Marco; Laukkanen, Anne María; Traser, Louisa; Geneid, Ahmed; Richter, Bernhard; Muñoz, Daniel; Echternach, Matthias

doi:10.1080/14015439.2016.1207097

Cited by 45 publications

(38 citation statements)

References 39 publications

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“…In addition, in the present study, the jitter parameter significantly decreased (P < 0.001), and this finding is consistent with studies conducted on semi-occluded vocal tract exercises (17)(18)(19). In particular, it is consistent with Guzman et al's study (2016), where they studied the impact of depth of immersion of tube in the water on perturbation measures and concluded that immersion to a depth of 5 cm reduces jitter (19).…”

Section: Discussionsupporting

confidence: 82%

“…In particular, it is consistent with Guzman et al's study (2016), where they studied the impact of depth of immersion of tube in the water on perturbation measures and concluded that immersion to a depth of 5 cm reduces jitter (19). According to previous studies, after vocal fatigue, jitter increases (20)(21)(22), which may be associated with a reduction in sensory-motor control (23).…”

Section: Discussionsupporting

confidence: 77%

“…According to previous studies, after vocal fatigue, jitter increases (20)(21)(22), which may be associated with a reduction in sensory-motor control (23). Thus, reducing jitter can be associated with improved sensorimotor control and reduced vocal fatigue (19,23). Reduced jitter was not observed in Van Lierde et al's study (2011) because in their study, jitter significantly increased, and the authors argued that this difference may have been due to different methods of assessment, difference in time and content of warm-up exercises, and difference in the number of the participants in the study and their vocal background (4).…”

Section: Discussionmentioning

confidence: 99%

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Immediate Effects of Phonation into the Tube Protocol on the Dysphonia Severity Index (DSI) and Perceptual Self-Evaluation in Future Speech-Language Pathologists

et al. 2018

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Objectives: The aim of this study was to investigate the immediate effects of the protocol of phonation into tube on DSI as an objective multi-parametric approach for measuring voice quality and perceptual self-evaluation in senior students participating in clinical training to become speech language pathologists (SLPs). Methods:Eleven future SLPs (7 females and 4 males) with an average age of 22.5 ± 1 performed the protocol of phonation into tube.The immediate effects of phonation into tube exercise program were evaluated by dysphonia severity index (DSI) and self-evaluation of perceived phonatory comfort.Results: After phonation in the tube exercise program, DSI and all its parameters significantly improved. Results of the paired t-test showed that MPT (P = 0.02), F-high (P = 0.001), i-low (P < 0.001), jitter (P < 0.001), and DSI (P < 0.001) before and after phonation in the tube program significantly changed, respectively. Self-evaluation after phonation in tube exercise program showed that most participants, i.e. 7 individuals (64%), reported improved phonatory comfort. Conclusions:The results of this study suggest that phonation in tube exercise program may lead to an improvement of vocal quality and voice fatigue in future SLPs.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Immediate Effects of Phonation into the Tube Protocol on the Dysphonia Severity Index (DSI) and Perceptual Self-Evaluation in Future Speech-Language Pathologists

et al. 2018

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“…In a recent high-speed digital imaging study, CQEGG tended to increase during tube phonation into water compared to comfortable vowel production in normal-voiced subjects. Higher values were found at 10 and 18 cm of immersion compared to 5 cm [65]. …”

Section: Discussionmentioning

confidence: 99%

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

Guzmán

Saldívar

Pérez

et al. 2018

Folia Phoniatr Logop

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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.

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“…The latter are referred to as water resistance therapies (WRT) where LaxVox© and DoctorVox© are the commercially available products [10]. For WRT, the depth to which the tube is submerged under water defines the intraoral pressure and therefore influences the transglottic pressure difference [11]. Furthermore, the popping bubbles produced in the water cause a fluctuating intraoral pressure during phonation.…”

Section: Introductionmentioning

confidence: 99%

Immediate effects of water resistance therapy on patients with vocal fold mass lesions

Echternach

Raschka

Kuranova

et al. 2020

Eur Arch Otorhinolaryngol

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Introduction Semi-occluded vocal tract exercises, such as water resistance therapy (WRT), are widely used in voice therapy. However, the potential positive effects of such a therapy on vocal fold oscillation patterns in patients indicating a need for phonomicrosurgery have not yet been explored. The presented study aims to analyze the effect of WRT in patients suffering from vocal fold mass lesions. Materials and methods Eight participants with vocal fold mass lesions were asked to sustain a phonation on the vowel /i/ at a comfortable loudness and a fundamental frequency of 250 Hz (females) or 125 Hz (males). During phonation the subjects were simultaneously recorded with transnasal high-speed videoendoscopy (HSV, 20.000 fps), electroglottography, and audio signals. These subjects then performed a WRT (phonation in a silicone tube of 30 cm length, 5 cm below the water surface) for 10 min. Repeated measurements of sustained phonation were performed 0, 10, and 30 min after exercising. From the HSV data the glottal area waveform (GAW) was segmented and GAW parameters were computed. Results During WRT there was an increase of the GAW related open quotient and closing quotient. Immediately after WRT, there was a drop of both values followed by a rise of these parameters up to 30 min after the intervention. Furthermore, there was no correlation between GAW and electroglottographical open quotients. Conclusions The effects observed after a single session of WRT on participants with vocal fold mass lesions showed a similar pattern to vocal fatigue.

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The influence of water resistance therapy on vocal fold vibration: a high-speed digital imaging study

Cited by 45 publications

References 39 publications

Immediate Effects of Phonation into the Tube Protocol on the Dysphonia Severity Index (DSI) and Perceptual Self-Evaluation in Future Speech-Language Pathologists

Immediate Effects of Phonation into the Tube Protocol on the Dysphonia Severity Index (DSI) and Perceptual Self-Evaluation in Future Speech-Language Pathologists

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

Immediate effects of water resistance therapy on patients with vocal fold mass lesions

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