Pitch elevation and vocal loudness are related to swallowing safety. A proposal to improve their performance

Abstract

The ability to perform high-pitched and loud tasks have been associated with lower risks of penetration and aspiration in people with oropharyngeal dysphagia (OD). Previous studies suggest that these two vocal tasks may improve swallowing-related kinematics; laryngeal elevation and glottic closure. This study aims to identify which types of vocal exercises can maximize pitch elevation and vocal loudness. This ongoing project involved five subjects with OD who were asked to perform three vocal exercises: effortful pitch glide, straw phonation, and water resistance therapy (WRT). Fundamental frequency (fo) and maximum dB SLP were obtained during their performance; moreover, the vocal effort was quantified using a Borg CR100 scale. Descriptive statistics were used to characterize the differences between the three proposed exercises. WRT was the exercise that allowed toobtain higher pitch elevation values with less vocal effort (median fo = 603Hz), over EPG(594 Hz), and then straw phonation (512 Hz). Furthermore, EPG allowed reaching a higher vocal loudness during its performance. These preliminary results indicate that WRT could be a potential therapeutic adjunct to improve swallowing-related biomechanics. Further details will be presented. Future studies could incorporate accelerometry to obtain more accurate fo and dB SPL measures during vocal exercise performance.