Comparison of the immediate effect of voiced oral high-frequency oscillation and flow phonation with resonance tube in vocally-healthy elderly women
Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis
Paloma Cristine Piragibe; Kelly Cristina Alves Silverio; Ana Paula Dassie-Leite; Daniela Hencke; Lorena Falbot; Kariane Santos; Yasmin Batista; Larissa Thaís Donalonso Siqueira
Abstract
Purpose: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. Methods: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). Results: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. Conclusion: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.
Keywords
Resumo
Objetivo: Verificar e comparar os efeitos imediatos da técnica de oscilação oral de alta frequência sonorizada (OOAFS) e sopro sonorizado com tubo de ressonância na autopercepção de sintomas vocais/laríngeos e na qualidade vocal de idosas. Método: Participaram 14 mulheres idosas que realizaram as técnicas OOAFS e sopro sonorizado com tubo de ressonância de silicone, com wash-out de uma semana. Todas responderam questões sobre frequência e intensidade dos sintomas vocais/laríngeos; foram submetidas à gravação da vogal sustentada /a/ e contagem de números, para análise perceptivo-auditiva e acústica vocal. Foram extraídos os tempos máximos de fonação (TMF). Em seguida, sorteou-se a técnica a ser realizada: OOAFS ou tubo de ressonância, por três minutos em tom habitual. Após exercício, os mesmos procedimentos da avaliação inicial foram repetidos e as idosas responderam a um questionário de autoavaliação sobre os efeitos das técnicas. Os dados foram comparados antes e após aplicação das técnicas por meio dos testes ANOVA, Wilcoxon e Mann-Whitney; para as sensações vocais após técnicas, aplicou-se teste Quiquadrado(p<0,05). Resultados:Ao comparar as técnicas, verificou-se diminuição da rugosidade e melhora da ressonância na contagem dos números após tubo de ressonância e manutenção dos resultados após OOAFS. Não houve mais diferenças significantes para as demais variáveis estudadas entre os grupos. Conclusão: O sopro sonorizado com tubo de ressonância melhora a qualidade vocal de mulheres idosas. Além disso, ambos os exercícios apresentaram semelhanças na autopercepção dos sintomas vocais/laríngeos e sensações, sugerindo que a OOAFS é segura e pode ser empregada na terapia de voz nesta população.
Palavras-chave
References
1 Markson EW, Hollis-Sawyer LA. Intersections of aging: readings in social gerontology. Los Angeles: Roxbury Publishing Company; 2000. 512 p. [ Links ]
2 Gorham-Rowan MM, Laures-Gore J. Acoustic-perceptual correlates of voice quality in elderly men and women. J Commun Disord. 2006;39(3):171-84. http://dx.doi.org/10.1016/j.jcomdis.2005.11.005. PMid:16360669. [ Links ]
3 Pontes P, Yamasaki R, Behlau M. Morphological and functional aspects of the senile larynx. Folia Phoniatr Logop. 2006;58(3):151-8. http://dx.doi.org/10.1159/000091729. PMid:16636563. [ Links ]
4 Verdonck-de Leeuw IM, Mahieu HF. Vocal aging and the impact on daily life: a longitudinal study. J Voice. 2004;18(2):193-202. http://dx.doi.org/10.1016/j.jvoice.2003.10.002. PMid:15193652. [ Links ]
5 Sataloff RT, Caputo Rosen D, Hawkshaw M, Spiegel JR. The aging adult voice. J Voice. 1997;11(2):156-60. http://dx.doi.org/10.1016/S0892-1997(97)80072-0. PMid:9181537. [ Links ]
6 Ramig LO, Gray S, Baker K, Corbin-Lewis K, Buder E, Luschei E, et al. The aging voice: a review, treatment data and familial and genetic perspectives. Folia Phoniatr Logop. 2001;53(5):252-65. http://dx.doi.org/10.1159/000052680. PMid:11464067. [ Links ]
7 Siracusa MGP, Oliveira G, Madazio G, Behlau M. Immediate effect of sounded blowing exercise in the elderly voice. J Soc Bras Fonoaudiol. 2011;23(1):27-31. http://dx.doi.org/10.1590/S2179-64912011000100008. PMid:21552729. [ Links ]
8 Santos SB, Rodrigues SR, Gadenz CD, Anhaia TC, Spagnol PE, Cassol M. Verifying the effectiveness of using resonance tubes in voice therapy with elderly people. Audiol Commun Res. 2014;19(1):81-7. http://dx.doi.org/10.1590/S2317-64312014000100014. [ Links ]
9 Fadel CBX, Dassie-Leite AP, Santos RS, Santos Junior CG, Dias CAS, Sartori DJ. Efeitos imediatos do exercício de trato vocal semiocluído com Tubo LaxVox® em cantores. CoDAS. 2016;28(5):618-24. http://dx.doi.org/10.1590/2317-1782/20162015168. PMid:27849247. [ Links ]
10 Tyrmi J, Radolf V, Horacek J, Laukkanen AM. Resonance tube or LaxVox? J Voice. 2017;31(4):430-7. http://dx.doi.org/10.1016/j.jvoice.2016.10.024. PMid:28062093. [ Links ]
11 Titze IR. Voice training and therapy with a semi-occluded vocal tract: rationale and scientific underpinnings. J Speech Lang Hear Res. 2006;49(2):448-59. http://dx.doi.org/10.1044/1092-4388(2006/035). [ Links ]
12 Saters T, Maroti BD, Ribeiro VV, Siqueira LTD, Brasolotto AG, Silverio KCA. The Voiced Oral High-Frequency Oscillation technique’s immediate effect in individuals with dysphonic and normal voices. J Voice. 2018;32(4):449-58. PMid:28844805. [ Links ]
13 Antonetti AEMS, Ribeiro VV, Moreira PAM, Brasolotto AG, Silverio KCA. Voiced High Frequency Oscillation and LaxVox: immediate effects analysis in subjects with healthy voice. J Voice. 2019;33(5):808.e7-14. PMid:29861293. [ Links ]
14 Gava MV, Ortenzi L. Estudo analítico dos efeitos fisiológicos e da utilização do aparelho Flutter VRP 1®. Fisioter Mov. 1998;11(1):37-48. [ Links ]
15 Gava MV, Picanço PSA. Fisioterapia pneumológica. São Paulo: Manole; 2007. [ Links ]
16 Ghirardi ACA, Ferreira LP, Giannini SPP, Latorre MRDO. Screening index for voice disorder (SIVD): development and validation. Development and Validation. J. Voice. 2013;27(2):195-200. http://dx.doi.org/10.1016/j.jvoice.2012.11.004. PMid:23280383. [ Links ]
17 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74. http://dx.doi.org/10.2307/2529310. PMid:843571. [ Links ]
18 Soyama CK, Espassatempo CDL, Gregio FN, Camargo ZA. Qualidade vocal na terceira idade: parâmetros acústicos de longo termo de vozes masculinas e femininas. Rev CEFAC. 2005;7(2):267-79. [ Links ]
19 Sato K, Hirano M, Nakashima T. Age-related changes of collagenous fibers in the human vocal fold mucosa. Ann Otol Rhinol Laryngol. 2002;111(1):15-20. http://dx.doi.org/10.1177/000348940211100103. PMid:11800365. [ Links ]
20 Gorman S, Weinrich B, Lee L, Stemple JC. Aerodynamic changes as a result of vocal function exercises in elderly men. Laryngoscope. 2008;118(10):1900-3. http://dx.doi.org/10.1097/MLG.0b013e31817f9822. PMid:18622308. [ Links ]
21 Oyarzún P, Sepúlveda A, Valdivia M, Roa I, Cantín M, Trujillo G, et al. Variations of the vocal fold epithelium in a menopause induced model. Int J Morphol. 2011;29(2):377-81. http://dx.doi.org/10.4067/S0717-95022011000200011. [ Links ]
22 Sihvo M. Lax Vox tube. In: 7th Pan European Voice Conference (PEVOC); 2007; Copenhagem, Dinamarca. Proceedings. Groningen: PEVOC; 2007. [ Links ]
23 Ogawa M, Hosokawa K, Yoshida M, Yoshii T, Shiromoto O, Inohara H. Immediate effectiveness of humming on the supraglottic compression in subjects with muscle tension dysphonia. Folia Phoniatr Logop. 2013;65(3):123-8. http://dx.doi.org/10.1159/000353539. PMid:24296412. [ Links ]
24 Nemr K, Souza GVS, Simões-Zenari M, Tsuji DH, Hachiya A, Cordeiro GF, et al. Cognitive Vocal Program applied to individuals with signals presbylarynx: preliminary results. CoDAS. 2014;26(6):503-8. http://dx.doi.org/10.1590/2317-1782/20142014108. PMid:25590914. [ Links ]
25 Sauder C, Roy N, Tanner K, Houtz DR, Smith ME. Vocal function exercises for presbylaryngis: a multidimensional assessment of treatment outcomes. Ann Otol Rhinol Laryngol. 2010;119(7):460-7. http://dx.doi.org/10.1177/000348941011900706. PMid:20734967. [ Links ]
26 Titze IR. Acoustic Interpretation of Resonant. J Voice. 2001;15(4):519-28. http://dx.doi.org/10.1016/S0892-1997(01)00052-2. PMid:11792028. [ Links ]
27 Lagorio LA, Carnaby-Mann GD, Crary MA. Treatment of vocal fold bowing using neuromuscular electrical stimulation. Arch Otolaryngol Head Neck Surg. 2010;136(4):398-403. http://dx.doi.org/10.1001/archoto.2010.33. PMid:20403858. [ Links ]
28 Ziegler A, Hapner E. The behavioral voice-Lift. ASHA Lead. 2013;18(3). http://dx.doi.org/10.1044/leader.FTR4.18032013.np. [ Links ]
29 Lu FL, Presley S, Lammers B. Efficacy of intensive phonatory-respiratory treatment (LSVT) for presbyphonia: two case reports. J Voice. 2013;27(6):786.e11-23. http://dx.doi.org/10.1016/j.jvoice.2013.06.006. PMid:24119640. [ Links ]
30 Story BH, Laukkanen A, Titze I. Acoustic impedance of an artificially lengthened and constricted vocal tract. J Voice. 2000;14(4):455-69. http://dx.doi.org/10.1016/S0892-1997(00)80003-X. PMid:11130104. [ Links ]
Submitted date:
03/14/2019
Accepted date:
08/19/2019