The Effects of Phonation Into Glass, Plastic, and LaxVox Tubes in Singers: A Systematic Review
Introduction
Individuals who use their voice as work instruments, such as singers, represent a population with intense voice performance. Variations in voice projection and adjustments between breathing, articulation, and resonance are common in these individuals.1, 2 Additionally, the frequency, intensity, timing, and duration of the phonation may be higher in singers than in other professionals who use their voice for working.2, 3 From a physiological point of view, the increase in voice frequency and intensity expands the amplitude of vibration in the vocal folds, decreases the amplitude of surface wave in the mucosa, increases the phonation threshold pressure, and consequently leads to the lack of energy due to the increase of friction.4
Work-related voice disorders are defined as any phonetic alteration caused by voice misuse during labor activities that hamper professional communication.5 Usually, these disorders are observed more often in singers who use their voice intensely and improperly.6, 7 High prevalence rates of self-reported voice disorders are observed among singers of classical and popular music, as well as voice coaches, during their career (46.09%). These rates become even more evident considering music students.3 In this context, preventive approaches play an important part in the prevention of voice disorders.3
Semioccluded vocal tract exercises (SOVTEs) are broadly explored in the clinical routine to promote better glottal coaptation and less activation of the laryngeal vestibule.8 Phonation into tubes emerges as an exercise to improve the proprioception of the larynx and to enhance the relation between source and filter.9, 10, 11 Consequently, an improved phonation is achieved with economic vibration of the vocal folds and efficient emission of voice.4, 10, 12 In this context, SOVTEs are valuable to support singers with intense and energetic performances.13
Phonation into tubes may be performed using plastic straws,14 Sovijärv's glass tubes,15 and LaxVox tubes.16, 17 The immersion of tubes in water may be set with different depths according to vocal and laryngeal characteristics specific for each individual. This exercise is founded on the relation between water pressure and depth—the deeper the tube, the higher the resistance to voice resonance.18
Knowing the effects of voice exercises is essential to support their application in practice. Based on that, optimal exercises could lead to optimal therapeutic outcomes, performances, and longevity for singers and their voices.19 Considering the scarce scientific lines of evidence that explore voice exercises, the present study aimed to perform a systematic literature review to assess the effects of resonance in tubes in the voice quality, glottal function, and vocal tract of singers.
Section snippets
Research protocol and registration
The present systematic review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)20 and Cochrane.21 The systematic review was registered in the PROSPERO database under the protocol CRD42017078823. (https://www.crd.york.ac.uk/PROSPERO/)
Study design and eligibility criteria
The present research aimed to answer the following question: what are the effects of phonation into tubes on the voice quality, glottal function, and vocal tract of singers?
The research question was based in the PVO
Study selection
The initial sample selection in the four electronic databases resulted in 1965 articles. After excluding duplicates, 1080 remained for title and abstract readings. Next, 960 articles were excluded. Full-text reading was performed in 120 articles and resulted in 114 exclusions. The reasons behind the exclusions were (1) studies that did not use phonation into tubes as a method of intervention (85 articles), (2) reports of case studies (2 articles), (3) reports of case series (2 articles), (4)
Discussion
Voice disorders impact the quality of life and may lead to social problems, especially for those who use their voices for working. Specifically, these disorders may hamper labor performances by limiting basic functions related to the transmission of verbal and emotional messages.28, 29 The present study assessed the effects of phonation into tubes on voice quality, glottal function, and the vocal tract of singers through a systematic literature review. According to the extracted data, positive
Conclusion
The outcomes of the articles considered eligible in the present study revealed the positive effects of voice therapy using phonation into tubes on the voice quality of singers. Specifically, these effects promoted comfortable phonation, voice projection, voice economy, and an increase in the limit for collision during the phonation into glass tubes immersed in water, straws, and LaxVox. Additionally, an enlargement of the vocal tract and a reduction in F1 were also observed. The vocal effects
References (48)
- et al.
Immediate effects of the phonation into a straw exercise
Braz J Otorhinolaryngol
(2011) - et al.
Immediate effects of the Finnish resonance tube method on behavioral dysphonia
J Voice
(2013) - et al.
Semi-occluded vocal tract exercises: aerodynamic and electroglottographic measurements in singers
J Voice
(2015) - et al.
The effect of resonance tubes on glottal contact quotient with and without task instruction: a comparison of trained and untrained voices
J Voice
(2012) - et al.
Changes in glottal contact quotient during resonance tube phonation and phonation with vibrato
J Voice
(2013) - et al.
Work-related voice disorder
Braz J Otorhinolaryngol
(2015) - et al.
The effect of phonation into a straw on the vocal tract adjustments and formant frequencies. A preliminary MRI study on a single subject completed with acoustic results
Biomed Signal Process Control
(2012) - et al.
ALSPAC Study team. The prevalence of childhood dysphonia: a cross-sectional study
J Voice
(2006) - et al.
Tempo máximo de fonação de crianças pré-escolares
Braz J Otorhinolaryngol
(2008) - et al.
A physiological and acoustic study on voiced bilabial fricative [b:] as a vocal exercise
J Voice
(1996)
Classification and analysis of speech abnormalities
ITBM-RBM
Effects of a straw phonation protocol on acoustic measures of an SATB chorus singing two contrasting renaissance works
J Voice
Inter-relações entre fonoaudiologia e canto
Música Hodie
The impact of vocal load on the vocal function of professional music theatre singers
Prevalence of voice disorders in singers: systematic review and meta-analysis
J Voice
Voice training and therapy with a semi-occluded vocal tract: rationale and scientific underpinnings
J Speech Lang Hear Res
Distúrbios da Voz Relacionados com o Trabalho
Vida Q De. Sintomas vocais de futuros profissionais da voz
Rev CEFAC
Comportamento vocal de cantores populares
Rev CEFAC
Efeitos imediatos do exercício vocal sopro e som agudo
J Soc Bras Fonoaudiol
Investigação de efeitos imediatos de dois exercícios de trato vocal semi-ocluído
Pro Fono
O corpo do cantor: alongar, relaxar ou aquecer?
Rev CEFAC
Immediate acoustic effects of straw phonation exercises in subjects with dysphonic voices
Logoped Phoniatr Vocol
The flow and pressure relationships in different tubes commonly used for semioccluded vocal tract exercises
J Voice
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This research was performed in the Postgraduation Program in Applied Health Sciences, Universidade Federal de Sergipe (UFS), Lagarto, Sergipe, Brazil.