Immediate effect of two semi-occluded vocal tract exercises in glottal contact of occupational voice users

Efecto inmediato de dos ejercicios con tracto vocal semiocluido en el contacto glótico de usuarios ocupacionales de la voz


Introduction. Teachers are occupational voice users with high risk of developing vocal pathologies due to their work. To face this situation, it is common the use of semi-occluded vocal tract (SOVT) exercises, a strategy of voice education/rehabilitation implemented to induce a change in the vibration pattern of the vocal folds, mitigating, therefore, the risk of vocal lesion by reducing the collision stress applied to tissues. A variety of reports have indicated that this treatment has effects in the closed quotient (CQ), an indirect measure of collision stress.

Aim. The purpose of this study was to examine the physiological effect of two different SOVT exercises in larynx activity of teachers with constant vocal effort but without vocal pathology.

Methods. 43 samples of teachers were recorded before, during and after executing two SOVT exercises (tongue trill and tube phonation). Electroglottographic samples were analyzed in order to obtain CQ.

Results and conclusion. Both exercises had a significant difference of CQ scores when before and during conditions were compared. Any difference was found on this parameter after executing the activity. These findings agree with previous reports where CQ tends to increase during phonation through resonance tubes; on the contrary, execution of tongue trill tends to decrease CQ values. This behavior might be because of the particular biomechanical mechanisms of each exercise.


Download data is not yet available.

Citado por


Fernando Delprado-Aguirre
Luisa Fernanda Ángel Gordillo
Carlos Alberto Calvache-Mora


Vintturi J, Alku P, Lauri E-R, Sala E, Sihvo M, Vilkman E. Objective Analysis of Vocal Warm-Up with Special Reference to Ergonomic Factors. J Voice [Internet]. 2001;15:36-53.doi:

Vilkman E. Voice problems at work: A challenge for occupational safety and health arrangement. Folia Phoniatr Logop [Internet]. 2000;52:120-5. doi:

Cantor Cutiva LC, Vogel I, Burdorf A. Voice disorders in teachers and their associations with work-related factors: A systematic review. J. Commun. Disord [Internet]. 2013;143-55. doi:

Munier C, Farrell R. Working Conditions and Workplace Barriers to Vocal Health in Primary School Teachers. J Voice [Internet]. 2016;30:127.e31-127.e41. doi:

Martins RHG, Pereira ERBN, Hidalgo CB, Tavares ELM. Voice Disorders in Teachers. A Review. J Voice [Internet]. 2014;28:716-24. doi:

Cantor Cutiva LC, Burdorf A. Medical Costs and Productivity Costs Related to Voice Symptoms in Colombian Teachers. J Voice [Internet]. 2015;29:776.e15-776.e22. doi:

Atará-Paraquive ÁP, Ángel-Gordillo LF. Amplificación vocal en el ámbito ocupacional educativo: una revisión de la literatura. Rev la Fac Med [Internet]. 2018;66:485-93. Recuperado a partir de:

Titze IR. Voice Training and Therapy With a Semi-Occluded Vocal Tract: Rationale and Scientific Underpinnings. J Speech, Lang Hear Res [Internet]. 2006;49:448-59. doi:

Story BH, Laukkanen A-M, Titze IR. Acoustic impedance of an artificially lengthened and constricted vocal tract. J Voice [Internet]. 2000;14:455-69. doi:

Titze IR. Phonation into a straw as a voice building exercise. J Sing. 2000;57:27-8.

Guzman M, Rubin A, Muñoz D, Jackson-Menaldi C. Changes in Glottal Contact Quotient During Resonance Tube Phonation and Phonation With Vibrato. J Voice [Internet]. 2013;27:305-11. doi:

Titze IR, Laukkanen A-M. Can vocal economy in phonation be increased with an artificially lengthened vocal tract? A computer modeling study. Logop Phoniatr Vocology [Internet]. 2007;32:147-56. doi:

Simberg S, Sala E, Tuomainen J, Sellman J, Rönnemaa A-M. The Effectiveness of Group Therapy for Students With Mild Voice Disorders: A Controlled Clinical Trial. J Voice [Internet]. 2006;20:97-109. doi:

Amarante Andrade P, Wistbacka G, Larsson H, Södersten M, Hammarberg B, Simberg S, et al. The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises. J Voice [Internet]. 2016;30:36-41. doi:

Andrade PA, Wood G, Ratcliffe P, Epstein R, Pijper A, Svec JG. Electroglottographic Study of Seven Semi-Occluded Exercises: LaxVox, Straw, Lip-Trill, Tongue-Trill, Humming, Hand-Over-Mouth, and Tongue-Trill Combined With Hand-Over-Mouth. J Voice [Internet]. 2014;28:589-95. doi:

Maxfield L, Titze I, Hunter E, Kapsner-Smith M. Intraoral pressures produced by thirteen semi-occluded vocal tract gestures. Logop Phoniatr Vocology [Internet]. 2015;40:86-92. doi:

Vlot C, Ogawa M, Hosokawa K, Iwahashi T, Kato C, Inohara H. Investigation of the immediate effects of humming on vocal fold vibration irregularity using electroglottography and high-speed laryngoscopy in patients with organic voice disorders. J Voice [Internet]. 2017;31:48-56. doi:

Ogawa M, Hosokawa K, Yoshida M, Iwahashi T, Hashimoto M, Inohara H. Immediate Effects of Humming on Computed Electroglottographic Parameters in Patients With Muscle Tension Dysphonia. J Voice [Internet]. 2014;28:733-41. doi:

Laukkanen A-M, Titze IR, 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 [Internet]. 2008;60:298-311. doi:

Yiu EM-L, Lo MCM, Barrett EA. A systematic review of resonant voice therapy. Int J Speech Lang Pathol [Internet]. 2017;19:17-29. doi:

Cielo CA, Frigo LF, Christmann MK. Pressão sonora e tempo máximo de fonação após a técnica de finger kazoo. Rev CEFAC [Internet]. 2013;15:994-1000. doi:

Cordeiro GF, Montagnoli AN, Ubrig MT, Menezes MHM, Tsuji DH. Comparison of Tongue and Lip Trills with Phonation of the Sustained Vowel /ε/ Regarding the Periodicity of the Electroglottographic Waveform and the Amplitude of the Electroglottographic Signal. Open J Acoust [Internet]. 2015;05:226-38. doi:

Cordeiro GF, Montagnoli AN, Nemr NK, Menezes MHM, Tsuji DH. Comparative Analysis of the Closed Quotient for Lip and Tongue Trills in Relation to the Sustained Vowel /ε/. J Voice [Internet]. 2012;26:e17-22. doi:

Denizoglu II, Sahin M, Bayrak S, Uygun MN. Efficacy of Doctorvox Voice Therapy Technique for Mutational Falsetto. J Voice [Internet]. 2019;33:950.e1-950.e8. doi:

Saters TL, Ribeiro VV, Thaís L, Siqueira D, Marotti BD, Brasolotto AG, et al. The Voiced Oral High-frequency Oscillation Technique ’ s Immediate Effect on Individuals With Dysphonic and Normal Voices. J Voice [Internet]. 2017;32:449-58. doi:

Laukkanen A-M. About the so called “resonance tubes” used in Finnish voice training practice: An electroglottographic and acoustic investigation on the effects of this method on the voice quality of subjects with normal voice. Scand J Logop Phoniatr [Internet]. 1992;17:151-61. doi:

Gaskill CS, Erickson ML. The effect of an artificially lengthened vocal tract on estimated glottal contact quotient in untrained male voices. J Voice [Internet]. 2010;24:57-71. doi:

Gaskill CS, Quinney DM. The effect of resonance tubes on glottal contact quotient with and without task instruction: A comparison of trained and untrained voices. J Voice [Internet]. 2012;26:e79-93. doi:

Gaskill CS, Erickson ML. The Effect of a Voiced Lip Trill on Estimated Glottal Closed Quotient. J Voice [Internet]. 2008;22:634-43. doi:

Hamdan AL, Nassar J, Al Zaghal Z, El-Khoury E, Bsat M, Tabri D. Glottal contact quotient in Mediterranean tongue trill. J Voice [Internet]. 2012;26:669.e11-669.e15. doi:

Guzman M, Calvache C, Romero L, Muñoz D, Olavarria C, Madrid S, et al. Do Different Semi-Occluded Voice Exercises Affect Vocal Fold Adduction Differently in Subjects Diagnosed with Hyperfunctional Dysphonia? Folia Phoniatr Logop [Internet]. 2015;67:68-75. doi:

Mailänder E, Mühre L, Barsties B. LaxVox as a voice training program for teachers: a pilot study. J voice [Internet]. 2017;31:262.e13-262.e22. doi:

Calvache-Mora CA CA. Efectividad del calentamiento vocal fisiológico para cantantes. Ciencias la Salud [Internet]. 2016;14:367-79. Recuperado a partir de:

Calvache C, Guzman M, Bobadilla M, Bortnem C. Variation on Vocal Economy After Different Semioccluded Vocal Tract Exercises in Subjects With Normal Voice and Dysphonia. J Voice [Internet]. 2020;34:582-9. doi:

Zamponi V, Mazzilli R, Mazzilli F, Fantini M. Effect of sex hormones on human voice physiology: from childhood to senescence. Hormones [Internet]. 2021;20:691-6. Recuperado a partir de:

Nanjundeswaran C, Li NYK, Chan KMK, Wong RKS, Yiu EM-L, Verdolini-Abbott K. Preliminary Data on Prevention and Treatment of Voice Problems in Student Teachers. J Voice [Internet]. 2012;26:816.e1-816.e12. Recuperado a partir de:

Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, et al. The Voice Handicap Index (VHI). Am J Speech-Language Pathol [Internet]. 1997;6:66-70. doi:

Núñez-Batalla F, Corte-Santos P, Señaris-González B, Llorente-Pendás JL, Górriz-Gil C, Suárez-Nieto C. Adaptación y validación del índice de incapacidad vocal (VHI-30) y su versión abreviada (VHI-10) al español. Acta Otorrinolaringológica Española [Internet]. 2007;58:386-92. Recuperado a partir de:

Howard DM. Electroglottography/electrolaryngography. In: Fried M, Ferlito A, editores. The larynx. San Diego: Plural Press; 2008. p. 1-17.

Miller D. Voce Vista [Internet]. 2017. Recuperado a partir de:

Rothenberg M, Mahshie JJ. Monitoring Vocal Fold Abduction through Vocal Fold Contact Area. J Speech Lang Hear Res [Internet]. 1988;31:338. doi:

Laukkanen A-M, Lindholm P, Vilkman E. Phonation into a Tube as a Voice Training Method: Acoustic and Physiologic Observations. Folia Phoniatr Logop [Internet]. 1995;47:331-8. doi:

Mills RD, Rivedal S, DeMorett C, Maples G, Jiang JJ. Effects of straw phonation through tubes of varied lengths on sustained vowels in normal-voiced participants. J Voice [Internet]. 2017;32(3):386. doi:

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. J Voice [Internet]. 2016;30:759.e1-759.e10. doi:

Radolf V, Laukkanen AM, Horáček J, Liu D. Air-pressure , vocal fold vibration and acoustic characteristics of phonation during vocal exercising . part 1 : measurement in vivo. Eng Mech [Internet]. 2014;21:53-9. doi:

Guzman M, Jara R, Olavarria C, Caceres P, Escuti G, Medina F, et al. Efficacy of Water Resistance Therapy in Subjects Diagnosed With Behavioral Dysphonia: A Randomized Controlled Trial. J Voice [Internet]. Elsevier Inc.; 2017;31:385.e1-385.e10. doi:

Gaskill CS, O’Brien SG, Tinter SR. The Effect of Voice Amplification on Occupational Vocal Dose in Elementary School Teachers. J Voice [Internet]. 2012;26:667.e19-667.e27. Recuperado a partir de:

Stathopoulos E, Felson Duchan J. History and Principles of Exercise-Based Therapy: How They Inform Our Current Treatment. Semin Speech Lang [Internet]. 2006;27:227-35. Recuperado a partir de:

Delprado-Aguirre F. Fisiología del ejercicio en la práctica de la vocología colombiana: una necesidad. Rev Investig e Innovación en Ciencias la Salud [Internet]. 2020;2:44-55. Recuperado a partir de:

Titze IR. Principles of voice production. 2 ed. Iowa: Prentice-Hall; 2000.


Download data is not yet available.