Effects of isolated respiratory training on breathing and voice variables
Efectos del entrenamiento respiratorio aislado en las variables respiratorias y vocales
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Isolated breathing training in rehabilitation and voice training is a common practice in Spanish-speaking countries. Currently, there are no documents in Spanish that study the theoretical and empirical information related to respiratory training in this context. The purpose of the present review is to provide updated information regarding the current evidence of the possible effect of isolated respiratory training on voice. Respiratory strength training has been shown to have positive effects on respiratory parameters, however, the available evidence does not report significant effects on the voice, except for people with underlying neurological disorders and presbyphonia. If respiratory training using devices designed for these purposes has not been shown to positively impact vocal characteristics of subjects with dysphonia (not neurological or presbyphonia) or of healthy professional voice users, there is no reason to expect that the isolated breathing exercises that are often included in the routines of vocal trainers and speech therapists will have a positive effect on voice variables. Considering that respiratory muscle strength training seems to positively affect some vocal parameters in people with neurological disorders and presbyphonia, future research should consider exploring the possible effect on other vocal parameters not yet measured in this type of population.
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- Stemple JC. Clinical Voice Pathology: Theory and Management. San Diego, CA: Singular Publishing Inc; 2010.
- Boone D, McFarlane S, & Berg SL. The Voice and Voice Therapy. (7 th ed.). Boston USA: Allyn and Bacon; 2005.
- Thomas L, Stemple J. Voice therapy: does science support the art? Commun Disord Rev. 2007;1:49–77.
- Titze I, & Verdolini K. Vocology: The science and practice of voice habilitation. Salt Lake City, Utah: National Center for Voice and Speech; 2012.
- McKenzie DK, Butler JE, Gandevia SC. Respiratory muscle function and activation in chronic obstructive pulmonary disease. J Appl Physiol. 2009 Ago 1;107:621-629. DOI: https://doi.org/10.1152/japplphysiol.00163.2009
- Lisboa C, Munoz T, Beroiza T, et al. Inspiratory muscle training in chronic airflow limitation: comparison of two different training loads with a threshold device. Eur Respir J. 1994;7:1266–1274. DOI: https://doi.org/10.1183/09031936.94.07071266
- Weiner P, Weiner M. Inspiratory muscle training may increase peak inspiratory flow in chronic obstructive pulmonary disease. Chest. 2006;73:151–155. DOI: https://doi.org/10.1159/000088095
- Keens T, Krastins I, Wannamaker E, et al. Ventilatory muscle endurance training in normal subjects and patients with cystic fibrosis. Am Rev Respir Dis. 1977;116:853–860. DOI: https://doi.org/10.1164/arrd.1977.116.5.853
- Enright S, Chatham K, Lonescu A. Inspiratory muscle training improves lung function and exercise capacity in adults with cystic fibrosis. Chest. 2004 Ago 01;126(2):405–412. DOI: https://doi.org/10.1378/chest.126.2.405
- Billinger SA, Coughenour E, MacKay-Lyons MJ, Ivey FM. Reduced cardiorespiratory fitness after stroke: Biological consequences and exercise induced adaptations. Stroke Res Treat .2011 Ago 14;2012:1-11. DOI: https://doi.org/10.1155/2012/959120
- Hughes PD, Polkey MI, Harrus ML, Coats AJ, Moxham J, et al. Diaphragm strength in chronic heart failure. Am J Respir Crit Care Med. 1998 Oct 21;160(2):529-234. DOI: https://doi.org/10.1164/ajrccm.160.2.9810081
- Desjardins M, Halstead L, Simpson A, Flume P, & Bonilha HS. Respiratory Muscle Strength Training to Improve Vocal Function in Patients with Presbyphonia. J Voice. In Press. DOI: https://doi.org/10.1016/j.jvoice.2020.06.00
- Desjardins M, Halstead L, Simpson A, Flume P, & Bonilha HS. The Impact of Respiratory Function on Voice in Patients with Presbyphonia. J Voice. In Press
- Gartner-Schmidt JL, Roth DF, Zullo TG, et al. Quantifying component parts of indirect and direct voice therapy related to different voice disorders. J Voice. 2013;27(2):210–216. DOI: https://doi.org/10.1016/j.jvoice.2012.11.007
- Sellars C, Carding PN, Deary IJ, et al. Characterization of effective primary voice therapy for dysphonia. J Laryngol Otol. 2006;116(2):1014–1018. DOI: https://doi.org/10.1258/002221502761698757
- Desjardins M, Bonilha HS. The impact of respiratory exercises on voice outcomes: a systematic review of the literature. J Voice. 2019;34(4):648.e1–648.e39. DOI: https://doi.org/10.1016/j.jvoice.2019.01.011.
- Baken R. Clinical measurement of speech and voice. Clifton Park, New York: Thomson. 2000.
- Sapienza C, Troche M, Pitts T, & Davenport P. Respiratory Strength Training: Concept and Intervention Outcomes. Seminars in Speech and Language. 2011;32(1):021–030. DOI: https://doi.org/10.1055/s-0031-1271972
- Sapienza C, Troche M. Respiratory Muscle Strength Training: Theory and practice. San Diego: Plural Publishing; 2012.
- Illi SK, Held U, Frank I, Spengler CM. Effect of respiratory muscle training on exercise performance in healthy individuals: A systematic review and metaanalysis. Sports Med. 2012 Dic 23;2012(42):707-724. DOI: https://doi.org/10.1007/BF03262290
- Elkins M, Dentice R. Inspiratory muscle training facilitates weaning from mechanical ventilation among patients in the intensive care unit: A systematic review. J Physiother. 2015;61(3):125-134. DOI: https://doi.org/10.1016/j.jphys.2015.05.016
- Respiratory muscle training: Theory and practice (1st edition). Edinburgh: Churchill Livingstone; 2013.
- Menezes KKP, Nascimiento LR, Avellno PR, Polese JC, Salmela LFT. A Review on Respiratory Muscle Training Devices. J Pulm Respir Med. 2018;8(2):2-7 DOI: https://doi.org/10.4172/2161-105X.1000451
- McConnell A. Respiratory muscle training: Theory and practice (1st edition). Edinburgh: Churchill Livingstone; 2013.
- McConnell AK, Romer LM. Respiratory muscle training in healthy humans: Resolving the controversy. Int J Sports Med. 2004;25(4):284-293. DOI: https://doi.org/10.1055/s-2004-815827
- Croitoru A, Bogdan MA. Respiratory muscle training in pulmonary rehabilitation. Pneumologia. 2013; 62: 166-171.
- Sapienza CM. Respiratory muscle strength training applications. Curr Opin Otolaryngol Head Neck Surg. 2008;16(3): 216-220. DOI: https://doi.org/10.1097/MOO.0b013e3282fe96bd
- EMST150 Company. Respiratory Muscle Strength Training: EMST vs IMST. Disponible en: https://tinyurl.com/y4b46cxj
- Baker S, Davenport P, Sapienza C. Examination of training and detraining effects in expiratory muscles. J Speech Lang Hear Res. 2005;48:1325–1333. DOI: https://doi.org/10.1044/1092-4388(2005/092)
- Sapienza C, Davenport P, Martin D. Expiratory muscle training increases pressure support in high school band students. J Voice. 2002;16(4):495– 501. DOI: https://doi.org/10.1016/s0892-1997(02)00125-x
- Sapienza C, Wheeler K. Respiratory muscle strength training: functional outcomes versus plasticity. Semin Speech Lang. 2006;27(4):236–244. DOI: https://doi.org/10.1055/s-2006-955114
- Anand S, El-Bashiti N, Sapienza C. Effects of training frequency on maximum expiratory pressure. Am J Speech Lang Pathol. 2012;21(4):380–386. DOI: 10.1044/1058-0360(2012/11-0048)
- Ray C, Trudeau MD, & McCoy S. Effects of Respiratory Muscle Strength Training in Classically Trained Singers. J Voice. 2018;32(5):644.e25-644.e34. DOI: https://doi.org/10.1016/j.jvoice.2017.08.005
- Nam DH, Lim JY, Ahn CM, & Choi HS. Specially Programmed Respiratory Muscle Training for Singers by Using Respiratory Muscle Training Device (Ultrabreathe®). Yonsei Medical Journal. 2004;45(5):810-817. DOI: https://doi.org/10.3349/ymj.2004.45.5.810
- Kim J, & Sapienza CM. Effects of expiratory muscle strength training with the healthy elderly on speech. Communication Sciences & Disorders. 2006;11(2):1–16.
- Darling-White M, & Huber JE. The impact of expiratory muscle strength training on speech breathing in individuals with Parkinson’s disease: A preliminary study. Am J of Speech-Language Patho. 2017;26(4):1159–1166. DOI: https://doi.org/10.1044/2017_AJSLP-16-0132
- Reyes A, Castillo A, Castillo J, Cornejo I, & Cruickshank T. The effects of respiratory muscle training on phonatory measures in individuals with Parkinson’s disease. J Voice. 2019; 34(6):894-902. DOI: https://doi.org/10.1016/j.jvoice.2019.05.001
- Yilmaz C, Bostanc O, Bulut S. Effect of Respiratory Muscle Training on Pitch Range and Sound Duration in Brass Instrument Players and Singers. J voice. In press. DOI: https://doi.org/10.1016/j.jvoice.2020.04.012
- Lloyd A, Diaz J, Bret M. Expiratory muscle strength training in voice habilitation and rehabilitation: A systematic review. Ponencia presentada en PAVA Symposium; 2020 agosto 14-16 (online).
- Cerny FJ, Panzarella KJ, & Stathopoulos E. Expiratory muscle conditioning in hypotonic children with low vocal intensity levels. Journal of Medical Speech-Language Pathology. 1997 5, 141–152. DOI: https://doi.org/10.1177%2F1545968306294737
- Chiara T, Martin D, & Sapienza C. Expiratory muscle strength training: Speech production outcomes in patients with multiple sclerosis. Neurorehabilitation and Neural Repair. 2007;21: 239–249. DOI: https://doi.org/10.1177/1545968306294737
- Johansson KM, KJellmer L, Schalling E, Hartelius L, & Fredrikson S. “I can walk briskly and talk at the same time”: Effects of expiratory muscle strength training on respiration and speech in multiple sclerosis. J Medical Speech-Language Patho. 2012;20:70–76.
- Huttunen K, & Rantala L. Effects of humidification of the vocal tract and respiratory muscle training in women with voice symptoms-A pilot study. J Voice. 2019 In press. DOI: https://doi.org/10.1016/j.jvoice.2019.07.019
- Palmer AD, Bolognone RK, Thomsen S, Britton D, Schindler J. & Graville DJ. The safety and efficacy of expiratory muscle strength training for rehabilitation after supracricoid partial laryngectomy: A pilot investigation. Annals of Otology, Rhinology and Laryngology. 2019;128(3):169–176. DOI: https://doi.org/10.1177%2F0003489418812901
- Roy N, Weinrich B, Gray SD, Tanner K, Stemple JC, & Sapienza CM. Three treatments for teachers with voice disorders: A randomized clinical trial. J Speech, Language, and Hearing Research. 2003;46(3):670–688. DOI: https://doi.org/10.1044/1092-4388(2003/053)
- Tsai YC, Huang S, Che WC, Huang YC, Liou TH, & Kuo, YC. The effects of expiratory muscle strength training on voice and associated factors in medical professionals with voice disorders. J Voice. 2016;30(6):759.e21-759.e27. DOI: https://doi.org/10.1016/j.jvoice.2015.09.012
- Wingate JM, Brown WS, Shrivastav R, Davenport P, & Sapienza CM. Treatment outcomes for professional voice users. J Voice. 2017;21(4):433–449. DOI: https://doi.org/10.1016/j.jvoice.2006.01.001
- Ruddy BH. Expiratory pressure threshold training in high-risk performers [Dissertation]. Gainesville, FL: Communication and Speech Disorders, University of Florida; 2001.