The Therapeutic Effects of Straw Phonation on Vocal Fatigue

Abstract

Objectives: Straw phonation has been investigated for its vocal warm-up effects on healthy populations and therapeutic effects on voice patients. The purpose of this article was to determine whether it is beneficial for vocal fatigue. Study Design: Prospective cohort study Methods: Twenty-five healthy participants were recruited into 1-hour vocal loading tasks followed by 10-minute vocal rest or straw phonation on 2 different days. Various parameters including phonation threshold pressure (PTP), mean airflow, closed quotient (CQ), current speaking effort level (EFFT), and laryngeal discomfort (DISC) were acquired at baseline, after vocal load, and after the intervention. Results: Increased PTP, EFFT, and DISC were observed after vocal load. Decreased PTP, EFFT, and DISC were then acquired after both vocal rest or straw phonation. More significant improvements were obtained in straw phonation when compared with vocal rest. Additionally, significantly increased mean flow and decreased CQ were obtained after straw phonation when compared to vocal rest. Conclusions: Straw phonation has the potential to adjust aerodynamics within the vocal tract leading to improved vocal efficiency, optimized vibration mode, and attenuated vocal fatigue. This study provided a promising treatment for vocal fatigue that could have wide clinical relevance to voice users with high voice demands.

Mitigating the Effects of Acute Vocal Exertion in Individuals With Vocal Fatigue

“…This finding differs from a previous report. 32 The fact that both strategies worked similarly may reflect the short-duration exertion task. 17,19 It is also noteworthy that although both strategies produced improvements in PTP and maximum F0, these measures did not return to baseline levels.…”

“…10,17,19,27 Clinically, however, vocal rest may be impractical, [28][29][30] and the efficacy of short periods of vocal rest as frequently recommended in vocal hygiene protocols 31 is relatively unexplored. 32 Emerging evidence suggests that semi-occluded vocal tract exercises (SOVTEs) may better mitigate the effects of vocal fatigue than vocal rest. Low-resistance SOVTEs allow for mobilization of laryngeal tissue, which ameliorates healing trajectory through attenuation of inflammatory response 33,34 and extracellular matrix synthesis.…”

“…straw phonation) can return measures such as phonation threshold pressure (PTP) and selfperceived vocal effort to baseline levels in healthy individuals. 32 In addition, SOVTEs capitalize on source-tract interaction by promoting increased efficiency in airflow [36][37][38] and also reducing vocal effort. 39,40 Although there is evidence that both SOVTEs and vocal rest are beneficial, 19,26,27,32 it is unclear if these recovery strategies mitigate the effects of vocal exertion in individuals experiencing frequent vocal fatigue.…”

“…Vocal rest is used to mitigate the effects of vocal exertion 24 as it may promote wound healing on a molecular level 25,26 and return aerodynamic and self‐reported voice measures to near baseline levels 10,17,19,27 . Clinically, however, vocal rest may be impractical, 28–30 and the efficacy of short periods of vocal rest as frequently recommended in vocal hygiene protocols 31 is relatively unexplored 32 …”

“…Functionally, SOVTEs (e.g. straw phonation) can return measures such as phonation threshold pressure (PTP) and self‐perceived vocal effort to baseline levels in healthy individuals 32 . In addition, SOVTEs capitalize on source‐tract interaction by promoting increased efficiency in airflow 36–38 and also reducing vocal effort 39,40 .…”