RESONANSRÖRSMETODEN – AKTUELL FORSKNING PÅ RÖSTTRÄNING MED RÖR NEDSÄNKTA I VATTEN

Resonansrörsmetoden, eller resonance tube phonation with the free end inwater (RTPW) är en röstträning där patienten fonerar genom ett glasrörvars fria ände är nedsänkt i en skål med vatten. Metoden har använts avtalterapeuter i Finland under lång tid, och har på senare år börjat väckaintresse även utanför Finlands gränser. Syftet med föreliggande artikel är att ge en översikt på aktuell forskning på resonansrörsmetoden, med fokus på metodens fysikaliska principer. Kunskapen om dessa principer och metodens fysiologiska påverkan är i dagsläget låg och mer forskning behövs för att man ska kunna fastställa dess effekter på röstbildningen. Vissa positiva resultat har rapporterats angående förbättringar I röstkvalitet.Nyckelord: mottryck, resonansrör, röstbehandlingResonaattoriputkiharjoitus vedessä, eli resonance tube phonation with tube end in water (RTPW), on ääniharjoitus missä potilas ääntelee lasiputkeen, jonka vapaa pää on upotettu vesiastiaan. Harjoitusta on käytetty puheterapeuttisessa äänihoidossa Suomessa jo pitkään, ja nykyään se on herättänyt huomiota myös Suomen ulkopuolella. Tämänartikkelin tarkoitus on luoda katsaus ajankohtaiseen tutkimukseen RTPW:sta, keskittyen harjoituksen fysikaalisiin periaatteisiin. Tieto näistä periaatteista sekä harjoituksen fysiologisista vaikutuksista on tällä hetkellä puutteellista, ja lisää tutkimusta tarvitaan, ennen kuin on mahdollista määritellä harjoituksen vaikutus äänentuottoon. Muutamiamyönteisiä tuloksia on raportoitu harjoituksen vaikutuksesta äänenlaatuun.Avainsanat: resonaattoriputki, vastapaine, äänihoitoKey words: back pressure, resonance tube, voice treatment

The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises

This experimental study investigated the back pressure (pback) versus flow (U) relationship for 10 different tubes commonly used for semi-occluded vocal tract exercises (SOVTE), i.e., 8 straws of different lengths and diameters, a resonance tube and a silicone tube similar to a Lax Vox tube. All tubes were assessed with the free end in air. The resonance tube and silicone tube were further assessed with the free end under water at the depths from 1 to 7 cm in steps of 1 cm. The results showed that relative changes in the diameter of straws affect pback considerably more compared to the same amount of relative change in length. Additionally, once tubes are submerged into water, pback needs to overcome the pressure generated by the water depth before flow can start. Under this condition, only a small increase in pback was observed as the flow was increased. Therefore, the wider tubes submerged into water produced an almost constant pback determined by the water depth, while the thinner straws in air produced relatively large changes to pback as flow was changed. These differences may be taken advantage of when customizing exercises for different users and diagnoses and optimizing the therapy outcome

Oral pressure and flow feedback components in semi-occluded vocal tract exercises

Vocal training with a semi-occluded vocal tract has been used for a long period of time. One way to obtain a semi-occlusion is by phonating through a straw or tube while keeping the free end of the tube in air or submerged into water. This thesis aims at investigating pressure and flow characteristics of three types of semi-occluded vocal tract exercises: (i) straw/tube phonation with the free end of the tube in air, (ii) tube phonation with the free end in water and (iii) flow ball devices, which are narrow tubes combined with a basket containing a styrofoam ball that lifts off when air is blown into the tube. Studies I, III and IV investigated pressure characteristics of these devices as functions of flow. Data were collected with a flow driven vocal tract simulator with an outlet for straw/tube/flow ball connection. Studies II and V investigated changes in oral pressure, vertical laryngeal position and fundamental frequency for vocally healthy volunteers during resonance tube phonation in water at two submersion depths. The results of study I showed that a change in tube diameter affects the pressureflow relationship more than a relative change in tube length for tube dimensions commonly used in voice exercises. When the tubes were submerged into water, the flow could not start until the pressure provided by the water depth was overcome, but as flow increased the pressure-flow relationship was similar to that of the tube in air, but with an upward shift in back pressure related to the pressure provided by the water depth. This was also confirmed in study IV. The oscillating part of the back pressure was analysed in study IV, showing that the amplitude of the oscillations increased with increasing water depth up to 3 cm depth. The amplitude of the pressure oscillations were similar at 3-7 cm water depths. Results from study IV showed that increasing the flow through a tube submerged in water affected the bubble characteristics. At low flows, the bubbles were emitted one-by-one in a periodic manner, at medium flows the bubbles were emitted in pairs of two and at high flows the bubble formation were chaotic and no clear pattern in the bubble characteristics could be identified. Bubble characteristics differed slightly between tubes with 8 and 9 mm diameter. The results of study III showed that the pressure-flow relationship for two flow ball devices were similar to those of straws. A flow of 0.2 L/s was required for ball lift off for both devices. Back pressure thresholds for ball lift off were 5 cmH2O for one of the devices, and 20 cmH2O for the other one. The results of study II and V showed that resonance tube phonation in water provides an average oral pressure slightly above the equivalent water pressure. The vertical laryngeal position, as measured by dual channel electroglottography, dropped for most participants during tube phonation in water, and a fundamental frequency modulation appeared during bubbling for the participants in study V. The results of this thesis presents new information about the physical properties involved in straw phonation with the free end in air and tube phonation with the free end in air and submerged in water. They further suggest that vocal training with phonation through tubes submerged in water can affect the phonatory system in different ways

Real-Time Visual Feedback of Airflow in Voice Training: Aerodynamic Properties of Two Flow Ball Devices

Objectives: Flow ball devices have been used as teaching tools to provide visual real-time feedback of airflow during singing. This study aims at exploring static back pressure and ball height as function of flow for two devices, marketed as flow ball and floating ball game. Study Design: This is a comparative descriptive study. Methods: A flow-driven vocal tract simulator was used to investigate the aerodynamic properties of these two devices, testing them for four different ball sizes. The flow range investigated was between 0 and 0.5 L/s. Audio, flow, pressure, and ball height were recorded. Results: The flow pressure profiles for both tested devices were similar to those observed in previous studies on narrow tubes. For lifting the ball, both devices had a flow and a pressure threshold. The tested floating ball game required considerably higher back pressure for a given flow as compared with the flow ball. Conclusions: Both tested devices have similar effects on back pressure as straws of 3.7 and 3.0 mm in diameter for the flow ball and the floating ball game, respectively. One might argue that both devices could be used as tools for practicing semi-occluded vocal tract exercises, with the additional benefit of providing real-time visual feedback of airflow during phonation. The flow threshold, combined with the flow feedback, would increase awareness of flow, rather than of pressure, during exercises using a flow ball device

How older adults relate to their own voices : a qualitative study of subjective experiences of the aging voice

Aim: The aim of this study was to investigate how otherwise healthy older adults with self-assessed voice problems relate to their voice and voice changes. Method: Focus groups were conducted at an activity center to identify how older adults reflect on their own voice and the aging voice in general. The interviews were audio recorded and transcribed. The analysis was done using thematic content analysis. Results: The analysis resulted in three main themes: “communicational aspects of the aging voice,” “consequences of deteriorating vocal and communicative capacity,” and “attitudes, strategies, and ideas”. The participants considered voice to be an important communication tool and presented what could be interpreted as awareness regarding their voice. Voice changes were considered a natural part of aging. This attitude was also an important reason why the participants had not sought medical care for their voice problems. The participants discussed ideas concerning extended voice use to maintain a functioning voice when aging. Simultaneously, voice changes due to aging were considered to have a negative effect on communication and social participation. Conclusions: The voice is important for older adults, and an insufficient voice can affect communication and social participation. Information about aging voice and voice exercises, for example from speech language pathologists, could be of interest among older adults. Further studies on the voice of older adults are needed regarding how they experience their voice and the general aspects of a healthy aging voice

Sex differences in vocal behavior in virtual rooms compared to real rooms

This study investigates speech production under various room acoustic conditions in virtual environments, by comparing vocal behavior and the subjective experience of speaking in four real rooms and their audio-visual virtual replicas. Sex differences were explored. Males and females (N = 13) adjusted their voice levels similarly to room acoustic changes in the real rooms, but only males did so in the virtual rooms. Females, however, rated the visual virtual environment as more realistic compared to males. This suggests a discrepancy between sexes regarding the experience of realism in a virtual environment and changes in objective behavioral measures such as voice level.</p

Resonance tube phonation in water – the effect of tube diameter and water depth on back pressure and bubble characteristics at different airflows

Objectives: Resonance tube phonation with tube end in water is a voice therapy method in which the patient phonates through a glass tube, keeping the free end of the tube submerged in water, creating bubbles. The purpose of this experimental study was to determine flow-pressure relationship, flow thresholds between bubble types, and bubble frequency as a function of flow and back volume. Methods: A flow-driven vocal tract simulator was used for recording the back pressure produced by resonance tubes with inner diameters of 8 and 9 mm submerged at water depths of 0–7 cm. Visual inspection of bubble types through video recording was also performed. Results: The static back pressure was largely determined by the water depth. The narrower tube provided a slightly higher back pressure for a given flow and depth. The amplitude of the pressure oscillations increased with flow and depth. Depending on flow, the bubbles were emitted from the tube in three distinct types with increasing flow: one by one, pairwise, and in a chaotic manner. The bubble frequency was slightly higher for the narrower tube. An increase in back volume led to a decrease in bubble frequency. Conclusions: This study provides data on the physical properties of resonance tube phonation with the tube end in water. This information will be useful in future research when looking into the possible effects of this type of voice training