Ideal duration of vocal techniques in dysphonia training: a scoping review

Silva, Vitória Ferreira; Penido, Fabiana Andrade; Gama, Ana Cristina Côrtes

doi:10.1590/2317-6431-2024-2995pt

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Literature Review • Audiol., Commun. Res. 30 • 2025 • https://doi.org/10.1590/2317-6431-2024-2995en linkcopy

Ideal duration of vocal techniques in dysphonia training: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose To map studies that address the ideal duration of vocal techniques in speech-language therapy training.

Research strategy This is a scoping review based on the research question: ‘What is the ideal duration of vocal techniques in speech-language therapy training?’ The search was conducted electronically in the following databases: LILACS (BVS), MEDLINE (PubMed), Cochrane, Scopus (Elsevier), Web of Science (Clarivate), and Embase.

Selection criteria The selection of studies followed the reading of titles, abstracts, and full texts, applying the established eligibility criteria. A backward search was then performed in the references of the selected articles to identify possible relevant studies to include in the results. The data extracted included information on the author and year of the study, country of publication, type of research design, sample characteristics, type of vocal exercise, exercise duration (dose), treatment duration, and the main results of the studies. These data were summarized and presented in both quantitative and descriptive formats.

Results Seven articles were selected from the 3,279 mapped studies. Most referred to semi-occluded vocal tract exercises in women and children, with an ideal duration of three to five minutes for individuals with dysphonia. There were few studies involving men and the elderly.

Conclusion Women and children showed better vocal results with a duration of three to five minutes for semi-occluded vocal tract exercises, with deterioration after seven minutes. For the male population, a longer exercise duration is necessary to achieve better vocal outcomes.

Keywords:
Dysphonia; Voice; Exercise therapy; Speech therapy; Therapeutic uses

Database	Syntax
BVS	((disfonia OR dysphonia OR disfonía OR dysphonie OR voz OR voice OR voz OR voix)) AND ((“Terapia por Exercício” OR “Exercise Therapy” OR “Terapia por Ejercicio” OR “Traitement par les exercices physiques” OR “Exercício Terapêutico” OR “Exercício de Reabilitação” OR “frequência do exercício” OR “intensidade do exercício” OR “tempo do exercício” OR fonoterapia OR “Speech Therapy” OR logopedia OR orthophonie)) AND ((“Usos Terapêuticos” OR “Therapeutic Uses” OR “Usos Terapéuticos” OR “Utilisations thérapeutiques” OR terapêutica OR therapeutics OR terapéutica OR thérapeutique OR tratamento)) AND (db:(“LILACS” OR “IBECS” OR “INDEXPSI” OR “WPRIM” OR “SES-SP” OR “BBO” OR “BDENF” OR “CUMED”))
MEDLINE	(Dysphonia OR Voice) AND (“Exercise Therapy” OR “Speech Therapy”) AND (“Therapeutic Uses” OR Therapeutics)
Cochrane	(Dysphonia OR Voice) AND (“Exercise Therapy” OR “Speech Therapy”) AND (“Therapeutic Uses” OR Therapeutics)
Scopus	(Dysphonia OR Voice) AND (“Exercise Therapy” OR “Speech Therapy”) AND (“Therapeutic Uses” OR Therapeutics)
Web of Science	(Dysphonia OR Voice) AND (“Exercise Therapy” OR “Speech Therapy”) AND (“Therapeutic Uses” OR Therapeutics)
Embase	(Dysphonia OR Voice) AND (“kinesiotherapy” OR “Speech Therapy”) AND (“drug therapy” OR Therapeutics)

Authors	Year	Country of publication	Study design
Bassetto MR, Constantini AC(¹⁷)	2021	Brazil	Experimental
Paes SM, Behlau M(¹⁸)	2017	Brazil	Experimental
Ramos LA, Gama ACC(¹⁹)	2017	Brazil	Experimental
Moreira FS, Gama ACC(²⁰)	2016	Brazil	Experimental
Menezes MHM, Ubrig-Zancanella MT, Cunha MGB, et al.(²¹)	2011	Brazil	Experimental
Azevedo LL, Passaglio KT, Rosseti MB, et al.(²²)	2010	Brazil	Experimental
Menezes MH, De Campos Duprat A, Costa HO(²³)	2005	Brazil	Experimental

Authors/Year of publication	Gender/Age group	Exercise	Repetition/Length of exercise	Frequency/ Length of treatment	Results
Moreira FS e Gama ACC (2017)(²⁰)	Women / 18-55 years / vocal nodules	Breathing exercise, sustaining the vowel [u] in the high register	1, 3, 5, and 7 minutes	Single session	Exercise prescribed for 3 to 5 minutes, with improvement in vocal quality. Presence of vocal discomfort within 7 minutes.
Paes SM e Behlau M, (2017)(¹⁸)	Women / 20-50 years / behavioral dysphonia	SOVT: sturdy tube (rigid plastic tube 8.7 cm long and 1.5 mm in diameter); emitting [vu] at a pleasant frequency and intensity	1, 3, 5, and 7 minutes	Single session	Exercise was prescribed for 3 to 5 minutes. Positive changes were seen at 5 minutes, with better results at 3 minutes, with an increase in MPT and less effort in speech.
Ramos LA e Gama ACC (2017)(¹⁹)	Children / 5-10 years vocal nodules or epidermoid cyst	Hard plastic tube (8.7 cm long and 1.5 mm in diameter), associated with phonation exercises	1, 3, 5, and 7 minutes	Single session	Exercise prescribed for 3 to 5 minutes, with an improvement in vocal quality and a reduction in roughness and breathiness.
Menezes MHM, Ubrig-Zancanella MT, Cunha MGB, et al. (2011)(²¹)	Women / 18-48 years vocal nodules	Lip vibration	1, 3, 5, and 7 minutes	Single session	Exercise prescribed for 5 minutes with a reduction in noise, breathiness, and roughness and an increase in f^o. At 7 minutes there was an increase in tension, greater instability, and an imbalance in resonance.

Authors/Year	Gender/Age group	Exercise	Repetition/Length of exercise	Frequency/Length of treatment	Results
Bassetto MR e Constantine AC (2021)(¹⁷)	Women / average age 22 Men / average age 25 / amateur singers	Flexible latex tube (35 cm long, 9 mm in diameter, immersed 2 cm below the surface of the water, in a 500 ml bottle containing 250 ml of water) producing the vowel [u], along with breathing comfortably, at the usual frequency and intensity	1, 2, 3, 5, and 7 minutes	Single session	Exercise prescribed for 3 to 5 minutes, with improvement in vocal quality and negative effects in 7 minutes. No difference was found in males.
Moreira FS e Gama ACC (2017)(²⁰)	Women / 18-55 years / no vocal complaint	Breathing exercise, sustaining the vowel [u] in the high register	1, 3, 5, and 7 minutes	Single session	Exercise prescribed for 3 to 5 minutes, with an improvement in vocal quality.
Paes SM e Behlau M, (2017)(¹⁸)	Women / 20-50 years / no vocal complaints	SOVT: sturdy tube (rigid plastic tube 8.7 cm long and 1.5 mm in diameter; emitting [vu] at a pleasant frequency and intensity	1, 3, 5, and 7 minutes	Single session	Exercise prescribed for 1 minute, with improvement in MPT.
Azevedo LL, Passaglio KT, Rosseti MB, et al. (2010)(²²)	Women/ 18-31 years / no vocal complaint	Sonorous tongue vibration	5 minutes, with intervals between 1 and 2 minutes	Single session	Exercise prescribed for 3 minutes, with an increase in f^o and a decrease in noise.
Menezes MH, De Campos Duprat A, Costa HO (2005)(²³)	Women / 20-42 years Men / 20-42 years speech therapy students, no vocal complaints	Sounded tongue vibration	3, 5, and 7 minutes	Single session	Exercise prescribed for women for 3 minutes and for men for 7 minutes. An improvement was seen in the perceptual-auditory analysis of the women's voices. Both men and women showed a gradual increase in undesirable sensations (discomfort) as the time taken to perform the exercise increased.

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Academia Brasileira de Audiologia Rua Itapeva, 202, conjunto 61, CEP 01332-000, Tel.: (11) 3253-8711 - São Paulo - SP - Brazil
E-mail: revista@audiologiabrasil.org.br

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[1] Source: Elaborated by the authors, 2024