University of Oulu

Huttunen, K., & Rantala, L. (2021). Effects of Humidification of the Vocal Tract and Respiratory Muscle Training in Women With Voice Symptoms—A Pilot Study. Journal of Voice, 35(1), 158.e21-158.e33.

Effects of humidification of the vocal tract and respiratory muscle training in women with voice symptoms : a pilot study

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Author: Huttunen, Kerttu1,2,3,4; Rantala, Leena5
Organizations: 1Faculty of Humanities, Research Unit of Logopedics, University of Oulu, Oulu, Finland
2PEDEGO Research Unit, University of Oulu, Oulu, Finland
3MRC Oulu, Oulu, Finland
4Department of Otorhinolaryngology, Head and Neck Surgery, Oulu University Hospital, Oulu, Finland
5Degree Programme in Logopedics, University of Tampere, Tampere, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
Persistent link:
Language: English
Published: Elsevier, 2021
Publish Date: 2020-08-12


Objective: The aim of this study was to determine the efficacy of a 4-week breathing exercise intervention in participants with voice symptoms.

Methods: Six nonsmoking women (mean age 49) experiencing voice symptoms used a novel device WellO₂ for respiratory exercises that provides counter pressure during both inspiration and expiration and warms and humidifies the breathing air. Speech samples were acoustically (Acoustic Voice Quality Index) and perceptually (grade, roughness, breathiness, asthenia, and strain scale) analyzed, and perceived voice symptoms and self-reported effort in breathing and phonation were obtained. Respiratory measurements included breathing frequency and pattern, peak expiratory flow, forced vital capacity, and forced expiratory volume in 1 minute.

Results: The total scores of Acoustic Voice Quality Index and some of its subcomponents (shimmer and harmonic-to-noise ratio), and the grade, roughness, and strain of the GRBAS scale indicated significantly improved voice quality. However, neither the nature or frequency of the experienced voice symptoms nor the perceived phonatory effort changed as the function of intervention. According to the participants, their breathing was significantly less effortful after the intervention, although no significant changes were observed in the objective respiratory measurements with a spirometer.

Conclusion: Training with the WellO₂ device has the potential to improve voice quality. The combination of inspiratory and expiratory training and warmed, humidified air is a multifaceted entity influencing several parts in the physiology of voice production. The effects of using WellO₂ need to be confirmed by further studies with a larger number of participants.

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Series: Journal of voice
ISSN: 0892-1997
ISSN-E: 1873-4588
ISSN-L: 0892-1997
Volume: 35
Issue: 1
Pages: 158.e21 - 158.e33
DOI: 10.1016/j.jvoice.2019.07.019
Type of Publication: A1 Journal article – refereed
Field of Science: 616 Other humanities
3125 Otorhinolaryngology, ophthalmology
Funding: This work was partly supported by the Otological Research Foundation [Korvatautien tutkimussäätiö], Finland, which is kindly acknowledged. We warmly thank speech and language therapists Elina Kankare, Sirpa Pirilä, Kaarina Ruusuvirta and Katja Saarelainen for participating in perceptual assessment of the voice samples.
Copyright information: © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license