Effect of performance time of the high-pitched blowing vocal exercise in the voice of women

Moreira, Fabíola Santos; Gama, Ana Cristina Côrtes

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Original Articles • CoDAS 29 (1) • 2017 • https://doi.org/10.1590/2317-1782/20172016005 copy

Effect of performance time of the high-pitched blowing vocal exercise in the voice of women

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To analyze the results of the runtimes of one, three, five, and seven minutes of the high-pitched blowing vocal exercise in women without voice complaints and with dysphonia and vocal nodules.

Methods

This is an experimental study with a consecutive and convenience sample of 60 women divided into two groups: 30 participants with dysphonia caused by vocal fold nodules (study group - SG) and 30 participants without vocal complaints (control group - CG). All participants performed the high-pitched blowing vocal exercise for one, three, five, and seven minutes. Sustained vowels /a/ and counting from one to ten were recorded before and after each exercise runtime. The recordings were randomized and evaluated by comparison task by four speech-language pathologists using the parameters grade of vocal deviation, roughness, breathiness, asthenia, strain and instability (GRBASI). The acoustic parameters analyzed were fundamental frequency, jitter, shimmer, period perturbation quotient, amplitude perturbation quotient, and harmonics-to-noise ratio. After each vocal exercise runtime, the participants responded whether they had felt vocal discomfort using a visual analogue scale.

Results

Auditory-perceptual analysis in the SG showed improved overall severity of dysphonia and breathiness after three minutes and worsening of these acoustic parameters after seven minutes of exercise performance. Participants in the SG reported self-perception of vocal discomfort after seven minutes of exercise performance.

Conclusion

The ideal prescription time for the high-pitched blowing vocal exercise in dysphonic women is three minutes; worsening of voice quality and perception of vocal discomfort occurs after seven minutes.

Keywords
Speech-language Pathology; Dysphonia; Acoustics, Speech; Voice Disorders; Speech Therapy; Voice Training; Perception

SG
Vocal Condition	rt0 x rt1		rt0 x rt3		rt0 x rt5		rt0 x rt7
Vocal Condition	n	%	n	%	n	%	n	%
Better	7	23.33	11	36.67	8	26.67	4	13.33
Worse	8	26.67	3	10.00	7	23.33	11	36.67
Unchanged	15	50.00	16	53.33	15	50.00	15	50.00
Total	30	100.00	30	100.00	30	100.00	30	100.00
Significance level (p)	0.149		0.013^* * Significância (p) ≤ 0,05		0.149		0.045^* * Significância (p) ≤ 0,05
CG
Vocal Condition	rt0 x rt1		rt0 x rt3		rt0 x rt5		rt0 x rt7
Vocal Condition	n	%	n	%	n	%	n	%
Better	3	10.00	2	6.67	2	6.67	4	13.33
Worse	6	20.00	5	16.67	4	13.33	6	20.00
Unchanged	21	70.00	23	76.67	24	80.00	20	66.67
Total	30	100.00	30	100.00	30	100.00	30	100.00
Significance level (p)	9.142		2.498		3.736		0.0005^* * Significância (p) ≤ 0,05

Study and Control Groups
Runtime	Vocal Condition	SG		CG		p value
Runtime	Vocal Condition	n	%	n	%	p value
rt0 x rt1	Better	7	0.23	3	0.10	0.236
	Worse	8	0.27	6	0.20
	Unchanged	15	0.50	21	0.70
	Total	30	100.00	30	100.00
rt0 x rt3	Better	11	0.37	2	0.07	0.018^* * Significance level (p) ≤ 0.05
	Worse	3	0.10	5	0.17
	Unchanged	16	0.53	23	0.77
	Total	30	100.00	30	100.00
rt0 x rt5	Better	8	0.27	2	0.07	0.038^* * Significance level (p) ≤ 0.05
	Worse	7	0.23	4	0.13
	Unchanged	15	0.50	24	0.80
	Total	30	100.00	30	100.00
rt0 x rt7	Better	4	0.13	4	0.13	0.335
	Worse	11	0.37	6	0.20
	Unchanged	15	0.50	20	0.67
	Total	30	100.00	30	100.00

Parameters		SG					CG
Parameters		rt0	rt1	rt3	rt5	rt7	rt0	rt1	rt3	rt5	rt7
f0	Mean	196.14	198.70	200.61	198.81	203.83	211.07	211.1	215.3	214.71	216.1
	SD	24.26	36.35	33.04	30.09	31.66	31.64	27.56	25.05	25.45	27.79
	t Test		0.64	0.34	0.51	0.08		0.99	0.29	0.36	0.23
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 = rt7					rt0 = rt1 = rt3 = rt5 = rt7
JITTER	Mean	2.16	1.9	1.91	1.96	1.91	1.13	1.14	1.07	1.13	1.07
	SD	1.73	1.3	1.64	1.44	1.45	0.95	0.77	0.78	0.85	0.6
	t Test		0.13	0.22	0.41	0.17		0.93	0.8	0.98	0.76
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 = rt7					rt0 = rt1 = rt3 = rt5 = rt7
SHIMMER	Mean	6.99	6.02	5.9	5.68	5.7	5.18	5.51	4.91	4.79	4.57
	SD	3.99	2.09	3.38	2.47	2.44	2.12	2.33	1.93	1.57	1.76
	t Test		0.28	0.27	0.16	0.17		0.33	0.43	0.31	0.12
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 = rt7					rt0 = rt1 = rt3 = rt5 = rt7
PPQ	Mean	1.27	1.14	1.16	1.18	1.13	0.67	0.66	0.59	0.63	0.63
	SD	1	0.81	1.04	0.92	0.9	0.59	0.41	0.41	0.43	0.35
	t Test		0.14	0.36	0.5	0.18		0.85	0.55	0.66	0.65
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 = rt7					rt0 = rt1 = rt3 = rt5 = rt7
APQ	Mean	4.54	4.12	4.32	4.02	3.96	3.63	3.83	3.38	3.28	3.17
	SD	2.38	1.39	3.26	1.93	1.63	1.47	1.64	1.24	1	1.19
	t Test		0.26	0.68	0.22	0.17		0.4	0.26	0.17	0.08
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 = rt7					rt0 = rt1 = rt3 = rt5 = rt7
HNR	Mean	0.17	0.15	0.16	0.15	0.15	0.13	0.14	0.13	0.13	0.13
	SD	0.07	0.05	0.09	0.07	0.04	0.03	0.04	0.03	0.03	0.03
	t Test		0.21	0.37	0.16	0.05^* * Significance level (p) ≤ 0.05		0.16	0.38	0.32	0.91
	Tukey M. C.	rt0 = rt1 = rt3 = rt5 > rt7					rt0 = rt1 = rt3 = rt5 = rt7

Independent comparison of the groups
	Group	Cat.		rt1 x rt3		(p) value	R	rt1 x rt5		(p) value	R	rt1 x rt7		(p) value	R
	SG	N-L		18	14	0.43	rt1 = rt3	18	13	0.3	rt1 = rt5	18	11	0.12	rt1 = rt7
	SG	M-I		12	16			12	17			12	19
	CG	N-L		24	20	0.38	rt1 = rt3	24	18	0.15	rt1 = rt5	24	20	0.38	rt1 = rt7
	CG	M-I		6	10			6	12			6	10
Comparison between the Study (SG) and Control (CG) groups
Group	Cat.	rt1		(p) value	R	rt3		(p) value	R	m5		(p) value	R	rt7		(p) value	R
SG x CG	N-L	18	24	0.15	SG = CG	14	20	0.19	SG = CG	13	18	0.3	SG = CG	11	20	0.03^* * Significance level (p) ≤ 0.05	SG>CG
SG x CG	M-I	12	6	0.15	SG = CG	16	10	0.19	SG = CG	17	12	0.3	SG = CG	19	10	0.03^* * Significance level (p) ≤ 0.05	SG>CG

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[1] Conflict of interests: nothing to declare.