Vocal restoration programs after acute vocal exertion

Purdue University, West Lafayette IN

Investigators

Linked publications & trials

Abstract

Proposal Summary/Abstract Even short episodes of vocal exertion can cause loss of speaking efficiency. Adverse changes to vocal physiology associated with vocal exertion may place individuals at increased risk for numerous laryngeal pathologies, which affect over 17 million adults in the United States. It is unknown, however, how the negative effects of vocal exertion can be mitigated immediately when they occur, and after individuals continue phonation. Two programs demonstrate potential for mitigating the effects of vocal exertion: (1) controlled phonation through semi-occluded vocal tract exercises with straw and (2) vocal rest. Vocal rest is often recommended clinically and the limited vocal fold vibration allows for wound healing. However, there is growing evidence that low-level tissue mobilization may be more effective than vocal rest in reducing pathobiological changes from vocal exertion. Controlled phonation takes advantage of source-tract interaction which can lead to more efficient phonation, improve voice measures, and cause phonation to feel less effortful. These exercises may also produce large-amplitude, low-impact patterns of vocal fold oscillation, which may cause increased vocal fold anti-inflammatory mediators while limiting inflammatory cytokines. Therefore, it is possible that controlled phonation, which creates low-level mobilization of the vocal folds, might better promote vocal fold healing than vocal rest. The proposed research will seek to determine if controlled phonation can better mitigate the negative effects of vocal exertion than vocal rest. Because it is unknown whether the detrimental effects of vocal exertion are the result of changes on the laryngeal level, the respiratory level, or a combination of the two, this study will examine the effects of vocal exertion and these restorative programs on both laryngeal and respiratory function. Aim 1 investigates whether controlled phonation is more effective than vocal rest in returning laryngeal function to pre-exertion (baseline) levels following an initial vocal exertion task. We also seek to understand if controlled phonation can better enable efficient performance of a second vocal exertion task. Aim 2 investigates whether controlled phonation is more effective than vocal rest in returning respiratory function to pre-exertion (baseline) levels following vocal exertion. Outcome measures will reflect laryngeal and respiratory physiology. This study will broaden our understanding of the role of respiratory and laryngeal subsystems in vocal exertion so that we can develop effective strategies to target these systems in therapy. Further, these data will lay the groundwork to inform our clinical recommendation on mitigating vocal exertion prior to, and immediately after vocal exertion occurs, to reduce the likelihood of maladaptive vocal behaviors that can result in vocal pathology.