Physiologic voice rehabilitation with semi-occluded vocal tract exercises

Rehabilitación vocal fisiológica con ejercicios de tracto vocal semiocluido


Introduction. Semi-occluded vocal tract exercises (SOVTE) are tools used in physiologic voice rehabilitation. Semi-occluded vocal tract exercises are vocal exercises produced by the semi-occlusion of the vocal tract through a series of postures that seek to lengthen and/or occlude the vocal tract, generating a change in the vibratory pattern of vocal folds, degree of vocal folds adduction, and the respiratory pattern. SOVTE can be divided, according to the type of semi-occlusion, into sustained, transient and oscillatory, as well as exercises with high and low degree of airflow resistance.

Objective. To describe the different types of semi-occluded vocal tract exercises, the type of semi-occlusion, the type of resistance, and their effects on the vocal folds, respiratory pattern, and configuration of the vocal tract.

Methodology. A literature review was performed in the PubMed, Medline, and Science Direct databases, using the following terms: "Semi-occluded vocal tract postures", "Semi-occluded vocal tract" and "Semi-occluded vocal tract exercises”. Boolean operators "AND" and "OR" were used to specify the search.

Results. The benefits of these exercises positively impact aerodynamic variables, glottal function, and configuration of the vocal tract.

Conclusions. The semi-occluded vocal tract exercises are a family of vocal exercises produced by the sustained, transitory, and oscillatory semi-occlusion of the vocal tract, through a series of postures that seek to lengthen and/or occlude the vocal tract, whose benefits positively impact on vocal folds and vocal tract.


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Citado por


Carlos Manzano Aquiahuatl
Marco Guzmán


Stemple J, Lee L, D'Amico B, Pickup B. Efficacy of Vocal Function Exercises as a Method of Improving Voice Production. J Voice. 1994 Sep;8(3):271-8. Doi: https://

Guzman M, Salfate L. Efectos en la función glótica, aerodinámica y configuración del tracto vocal. Areté. 2018 Julio-Diciembre;(2):21-32. Doi:

Acevedo K, Guzman M. Efectos del entrenamiento respiratorio aislado en las variables respiratorias y vocales. Revista de Investigación e Innovación en Ciencias de la Salud. 2020;2(2):56-69. Doi:

Manzano C. Rehabilitación fisiológica de la voz: Terapia de resistencia en el agua. Artículo de revisión. Areté. 2018 Julio-Diciembre;(2):75-82. Doi:

Story B. The Vocal Tract in Singing. En: Welch G, Howard DM, Nix J, editores. The Oxford Handbook of Singing. Oxford: Oxford University Press; 2016. Doi: 10.1093/oxfordhb/9780199660773.013.012

Palaparthi A, Maxfield L, Titze I. Estimation of Source-Filter Interaction Regions Basedon Electroglottography. J Voice. 2019 May;33(3):269-276. Doi:

Aparecida C, Padilha J, Christmann K, Brum R. Semioccluded vocal tract exercises: Literature review. Rev. CEFAC. 2013 Nov-Dez;15(6):1679-1689. Doi:

Story B, Laukkanen A, Titze I. Acoustic impedance of an artificially lengthened and constricted vocal tract. J Voice. 2000 Dec;14(4):455-69. Doi: 10.1016/s0892-1997(00)80003-x

Titze, IA. Theoretical Study of F0-F1 InteractionWith Application to Resonant Speaking and Singing Voice. J Voice. 2004 Sep;18(3):292-8. Doi: https://doi. org/10.1016/j.jvoice.2003.12.010

Nix J, Simpson B. Semi-Occluded Vocal Tract Postures and Their Application in the Singing Voice Studio. Journal of Singing. January/February 2008;64(3):339–342. Doi:

Rosenberg M. Using Semi-Occluded Vocal Tract Exercises in Voice Therapy: The Clinician’s Primer. Perspectives of the ASHA Special Interest Groups: Perspectives on Voice and Voice Disorders. July 2014;24(2):71-79. Doi:

Guzmán M, Callejas C, Castro C, García P, Lavanderos D, Valladares MJ, et al. Efecto terapéutico de los ejercicios con tracto vocal semiocluido en pacientes con disfonía músculo tensional tipo I. Revista de Logopedia, Foniatría y Audiología. 2012;32:139-146. Doi:

Guzman M, Jara R, Olavarria C, Caceres P, Escuti G, Fernanda Medina LM, et al. Efficacy of Water Resistance Therapy in Subjects Diagnosed With Behavioral Dysphonia: A Randomized Controlled Trial. Journal of voice. 2017;31:385.e1–385.e10. Doi:

Denizoglu II. Doctor vox R&D in vocology. DoctorVOX; 2018. Disponible en:

Amarante P, Wood G, Ratcliffe P, Epstein R, Pijper A, Svec J. Electroglottographic Study of Seven Semi-Occluded exercises: Humming, Hand-Over-Mouth, and Tongue-Trill Combined With Hand-Over-Mouth. J Voice. 2014 Sep;28(5):589-95. Doi:

Barrichelo V, Behlau M. Perceptual Identification and Acoustic Measures of the Resonant Voice Based on ‘‘Lessac’s Y-Buzz’’A Preliminary Study With Actors. Journal of Voice. 2007;21(1):46-53. Doi:

Lessac A. The use and training of the human voice. A bio-dynamic approach to vocal life. New York: Mc Graw Hill; 1997.

Enflo L, Sundberg J, Romedahl C, McAllister A. Effects on vocal fold collision and phonation threshold pressure of resonance tube phonation with tube end in water. J Speech Lang Hear Res. 2013;56:1530–8. Doi:

Echternach M, Raschka J, Kuranova L, Köberlein M, Richter B, Döllinger M. et al. Immediate effects of water resistance therapy on patients with vocal fold mass lesions. European Archives of Oto-Rhino-Laryngology. 2020;277:1995–2003 Doi:

Fantini M, Succo G, Crosetti E, Borragán A, Demo R, Fussi F. Voice Quality After a Semi-Occluded Vocal Tract Exercise With a Ventilation Mask in Contemporary Commercial Singers: Acoustic Analysis and Self-Assessments. J Voice. 2017 May;31(3):336-341. Doi:

Frisancho K, Salfate L, Lizana K, Guzman M, Leiva F, Quezada C. Immediate Effects of the Semi-Occluded Ventilation Mask on Subjects Diagnosed With Functional Dysphonia and Subjects With Normal Voices. J Voice. 2020 May;34(3):398-409. Doi:

Lucchini E, Maccarini A, Bissoni E, Borragan M, Agudo M, González M, et al. Voice Improvement in Patients with Functional Dysphonia Treated with the Proprioceptive-Elastic (PROEL) Method. J Voice. 2018 Mar;32(2):209-215. Doi:

Gillespie A, Fanucchi A, Gartner-Schmidt J, Belsky M, Awan S. Phonation With a Variably Occluded Facemask: Effects of Task Duration. J Voice. 2020 Jun 23;S0892-1997(20):30180-6. Doi:

Mills R, Hays C, Al-Ramahi J, Jiang J. Validation and Evaluation of the Effects of Semi-Occluded Face Mask Straw Phonation Therapy Methods on Aerodynamic Parameters in Comparison to Traditional Methods. J Voice. 2017 May;31(3):323-328. Doi:

Laukkanen AM, Titze I, Hoffman H, Finnegan E. Effects of a Semioccluded Vocal Tract on Laryngeal Muscle Activity and Glottal Adduction in a Single Female Subject. Folia Phoniatr Logop. 2008;60:298–311. Doi:

Laukkanen AM. Voiced bilabial fricative /B:/ as a vocal exercise An electroglottographic and acoustic investigation. Scand J Log Phon. 1992;17:181-189. Doi:

Nix J. Lip Trills and Raspberries: "High Spit Factor" Alternatives to the Nasal Continuant Consonants. Journal of Singing. January-February 1999;55(3):15-19

Yiu E, Ho E. Short-term effect of humming on vocal quality. Asia Pacific Journal Speech, Language and Hearing. 2002;7:123-137. Doi:

Titze I. Lip and Tongue Trills—What do they do for us? The Journal of Singing. 1996; 64(3):34-41.

Ferro G, Neto A, Kátia N, Moreira MH, Hiroshi D. Comparative Analysis of the Closed Quotient for Lip and Tongue Trills in Relation to the Sustained Vowel /e/. Journal of Voice. 2012;26(1):17-22. Doi:

Vasconcelo D, Camargo A, Tavares C. Técnica de vibração sonorizada de lábios e língua: revisão de literatura. Distúrb Comun. 2016;28(3):581-593.

Hamdan A, Nassar J, Al Zaghal Z, El-Khoury E, Bsat M, Tabri D. Glottal Contact Quotient in Mediterranean Tongue Trill. Journal of Voice. 2012;26(5):669.e11-5. Doi:

Aparecida C, Keli M. Finger Kazoo: Spectrographic acoustic modifications and vocal self-assessment. Rev. CEFAC. 2014 Jul-Ago;16(4):1239-1254 Doi: 10.7162/S1809-977720120S1PF-002

Souza Z, Leite I, Valeriano N, Bandeira C, Carvalho A, Lucena J, et al. Immediate Effect of the Finger-Kazoo Technique Associated with Glissandos in the Voice of Individuals with Parkinson’s Disease. J Voice. 2020 Aug 20;S0892-1997(20):30276-9. Doi:

Behlau M, Oliveira G. Hand-over-mouth. En: Behrman A, Haskell J, editores. Exercises for Voice Therapy. San Diego, CA: Plural Publishing; 2008. p. 35–37.

Van Lierde K, D’haeseleer E, Baudonck N, Claeys S, De Bodt M, Behlau M. The Impact of Vocal Warm-Up Exercises on the Objective Vocal Quality in Female Students Training to be Speech Language Pathologists. Journal of Voice. 2011;25(3):e115-121. Doi:

Laukkanen M, Titze I, Hoffman H, Finnegan E. Effects of a Semioccluded Vocal Tract on Laryngeal Muscle Activity and Glottal Adduction in a Single Female Subject. Folia Phoniatr Logop. 2008;60(6):298–311. Doi:

Roll C. The Evolution of the Female Broadway Belt Voice: Implications for Teachers and Singers. Journal of voice. September 2016;30(5):639.e1-639.e9. Doi:

Titze I, Finnegan E, Laukkanen A, Jaiswal S. Raising Lung Pressure and Pitch In Vocal Warm-Ups: The Use of Flow-Resistant Straws. Journal of Singing. March/April 2002;58(4):329-338.

Laukkanen, A.-M., PhD, Pulakka, H., Alku, P., Vilkman, E., Hertegård, S., Wredmark, T. High-speed registration of phonation-related glottal area variation during artificial lengthening of the vocal tract. Logopedics Phoniatrics Vocology, 2007 32, 157-164. Doi:

Radolf V, Laukkanen A-M, Horacek J, Liu D. Air-pressure, vocal fold vibration and acoustic characteristics of phonation during vocal exercising. Part 1: Measurement in vivo. Engineering Mechanics. 2014;21:53–59.

Guzmán M, Castro C, Madrid S, Olavarria C, Leiva M, Muñoz D, et al.. Air Pressure and Contact Quotient Measures During Different Semioccluded Postures in Subjects With Different Voice Conditions. Journal of voice. 2016;30:759.e1–759.e10. Doi:

Guzman M, Laukkanen A-M, Krupa P, Horáček J, Švec J, Geneid A. Vocal Tract and Glottal Function During and After Vocal Exercising With Resonance Tube and Straw. Journal of voice. 2013;27:523.e19–523.e34. Doi:

Portillo MP, Rojas S, Guzman M, Quezada C. Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers. Journal of voice. 2018;32:200–208. Doi:

Salfate L, Guzmán M. Physiological approach of voice rehabilitation in vocal nodules:a single case study. Revista digital EOS Peru. 2016;7:28-41. Disponible en:

Conroy E, Hennick T, Awan S, Hoffman M, Smith B, Jiang J. Effect of Variations to a Simulated System of Straw Phonation Therapy on Aerodynamic Parameters Using Excised Canine Larynges. Journal of Voice. 2014;28:1–6. Doi:

Davidson L, Amick EH. Formation of gas bubbles at horizontal orifices. American Institute of Chemical Engineers Journal. 1956;2(3):337-342.

Gaskill C, Erickson M. The Effect of a Voiced Lip Trill on Estimated Glottal Closed Quotient. Journal of voice. 2008;22:634–643. Doi:

Guzman M, Castro C, Acevedo K, Moran C, Espinoza V, Quezada C. How Do Tube Diameter and Vocal Tract Configuration Affect Oral Pressure Oscillation Characteristics Caused by Bubbling During Water Resistance Therapy? J Voice. 2020 Apr 30;S0892-1997(20):30096-5. Doi:

Guzman M, Laukkanen A-M, Traser L, Geneid A, Richter B, Muñoz D, et al. The influence of water resistance therapy on vocal fold vibration: a high-speed digital imaging study. Logopedics Phoniatrics Vocology. 2017;42:99-107. Doi:

guzman M, Higueras D, Fincheira C, Guajardo C. Immediate effects of a vocal exercise sequence with resonance tubes. Revista CEFAC. 2012;14(3):471-480.

Laukkanen A-M, Horácek J, Krupa P, Svec J. The effect of phonation into a straw on the vocal tract adjustments and formant frequencies. A preliminary MRI study on a single subject completed with acoustic results. Biomedical Signal Processing and Control. 2010;7(1)50-57. Doi:

Vampola T, Laukkanen AM, Horácek J, Svec JG. Vocal tract changes caused by phonation into a tube: a case study using computer tomography and finite-element modeling. J Acoust Soc Am. 2011 Jan;129(1):310-5. doi: 10.1121/1.3506347

Guzman M, Miranda G, Olavarria C, Madrid S, Muñoz D, Leiva M, et al. Computerized tomography measures during and after artificial lengthening of the vocal tract in subjects with voice disorders. Journal of Voice. 2017;31:124.e1-124.e10. Doi:

Guzman M, Castro C, Testart A, Muñoz D, Gerhard J. Laryngeal and Pharyngeal Activity During Semi-occluded Vocal Tract Postures in Subjects Diagnosed With Hyperfunctional Dysphonia. Journal of Voice. 2013;27:709-716. Doi:

Laukkanen A-M, Horáček J, Havlík R. Case-study magnetic resonance imaging and acoustic investigation of the effects of vocal warm-up on two voice professionals. Logopedics Phoniatrics Vocology 2012;37:75-82. Doi:


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