Respiratory, laryngeal and vocal tract articulators dynamics of vocally healthy young to elderly adults during phonation tasks to assess vocal functionality and morphophysiology of vocal techniques

• Grant number: 23/11420-2
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2024
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Speech Therapy
• Principal Investigator: Rosiane Kimiko Yamasaki Odagima
• Grantee: Rosiane Kimiko Yamasaki Odagima
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Arlindo Neto Montagnoli ; Bruno Moreira Silva ; Mara Suzana Behlau ; Marco Guzman ; Noemi Grigoletto De Biase
• Associated scholarship(s): 24/17744-7 - Respiratory Dynamics of Vocally Healthy Elderly Women during Phonatory Tasks to Assess Vocal Functionality: Normative Data for Clinical Practice, BP.IC; 24/17745-3 - Respiratory Dynamics of Vocally Healthy Elderly Men During Phonatory Tasks to Assess Vocal Functionality: Normative Data for Clinical Practice, BP.IC; 24/17759-4 - Respiratory Dynamics of Vocally Healthy Middle-Aged Men during Phonatory Tasks for Assessment of Vocal Functionality: Normative Data for Clinical Practice, BP.IC

Abstract

Vocal assessment and rehabilitation require the selection of phonatory tasks and vocal techniques for diagnostic and treatment purposes. Vocal functionality is one of the main targets of voice assessment and can be analyzed using the dynamic vocal analysis-DVA, a set of phonatory tasks that involve frequency and intensity variation. Voice therapy involves cognitive-behavioral approaches and the use of vocal techniques to promote more balanced adjustments in vocal production subsystems. Despite the advances in the area, there is still a lack of information about healthy individuals' respiratory, laryngeal, and supralaryngeal dynamics during DAV and about the morphophysiology of vocal techniques in real-time. Objectives: Study 1: To investigate the respiratory, laryngeal, and vocal tract articulators dynamics in vocally healthy young and elderly adults, during DAV, using plethysmography, nasofibrolaryngoscopy, and dynamic magnetic resonance-DMR; compare respiratory, laryngeal and vocal tract articulators dynamics between the three age groups; test the reproducibility of respiratory plethysmography and laryngeal morphometry measurements; to establish acoustic normative data of the DAV tasks, describing the values of the habitual, soft and loud intensity and the habitual, high and low frequency, as well as the MPT. Study 2: To investigate the morphophysiological adjustments of the vocal tract articulators, using DMR, while performing vocal techniques commonly used in clinical practice. Method: Cross-sectional and prospective study. The respiratory and laryngeal dynamics will be analyzed in 216 adults, equally divided into 6 groups: Group of Young Adults (GYAFem and GYAMasc), 18 to 45 years old, Group of Middle-Aged Adults (GMAAFem and GMAAMasc), 46 to 59 years old, and of Elderly Adults (GEAFem and GEAMasc), 60 to 85 years old. Non-phonatory tasks: silent breathing for 10s and forced vital capacity test. CDV phonatory tasks: 1) Count from 1 to 20 in habitual, soft, and loud intensity; and 2) Emission of five sustained vowels "é" in maximum phonation time-MPT: one in habitual frequency and intensity; one in high frequency and one in low frequency; one in soft intensity and one in loud intensity. The respiratory dynamics will be analyzed by plethysmography with the use of three respiratory belts, one at the height of the armpit, one at the height of the floating ribs and one at the level of the abdominal region. Parameters of plethysmography: number and duration of respiratory cycles and measurements of amplitude of inspiratory and expiratory movements of DAV tasks (mV). Laryngeal dynamics will be analyzed using nasofibrolaryngoscopy images. Laryngological parameters: qualitative and quantitative analysis of the laryngeal and paralaryngeal region. For reproducibility testing purposes, respiratory plethysmography and nasofibrolaryngoscopy, during the DAV tasks, will be performed twice. The morphophysiological dynamics of the vocal tract articulators during DAV, by DMR, will be performed on 15 participants from the GYA and 15 from the GEA. Study 2: The DMR will be performed during the execution of eight vocal techniques plus variations, seven of semi-occluded vocal tract. In this study, 15 individuals from GYA and 15 from GEA will participate. DMR parameters for Studies 1 and 2: vertical, horizontal, area, and angle morphological measurements of the vocal tract and the sequencing of articulator movements, from rest to vocal technique. Analysis of results: The results of Study 1 will contribute to the production of normative data for clinical practice, allowing future comparisons with dysphonic individuals. Study 2, on the other hand, will be able to contribute to the maximization of vocal rehabilitation, favoring the selection of vocal techniques based on morphophysiology, showing new clinical applications of the techniques, and helping in the production of scientific evidence. (AU)