VOCAL RESTORATION PROGRAMS FOLLOWING ACUTE VOCAL EXERTION

Abstract

Voice disorders impede communication and diminish quality of life for over 17 million adults in the United States. Vocal exertion is a common cause of adverse laryngeal and respiratory changes that may lead to voice disorders. Despite the risks associated with vocal exertion, little is known about how its negative effects might be mitigated - both when voice production is initially affected and when an individual must continue to speak over time. Two strategies demonstrate potential for mitigating the effects of vocal exertion: (a) semi-occluded vocal tract exercises (SOVTE) with straw and (b) vocal rest. Vocal rest allows for wound healing by limiting vocal fold vibration. There is, however, growing evidence that low-level tissue mobilization through SOVTEs may more effectively reduce pathobiological changes from vocal exertion by increasing vocal fold anti-inflammatory mediators while limiting inflammatory cytokines. This study investigated whether SOVTE or vocal rest could better mitigate the negative effects of vocal exertion on voice measures and respiratory kinematics. The effectiveness of both regimens was compared in individuals reporting both low and high amounts of vocal fatigue in everyday speaking environments. Results indicated that ten minutes of vocal exertion resulted in changes in voice and respiratory measures both in individuals reporting high and low levels of vocal fatigue. Voice measures revealed similar patterns in both groups; however, individuals reporting low and high levels of vocal fatigue employed different respiratory strategies following vocal exertion. In individuals reporting low levels of vocal fatigue, laryngeal and respiratory changes were reversed by SOVTE and vocal rest. Only SOVTE protected against changes in respiratory kinematics when vocal exertion was resumed. In individuals reporting high levels of vocal fatigue, exertion-induced changes in voice measures were only partially reduced; however, both strategies had a protective effect on respiratory kinematics after vocal exertion was resumed. These findings add to our knowledge of vocal fatigue, vocal exertion, the effects of multiple exertion tasks on speech physiology, and the interaction between the respiratory and laryngeal systems.