Resonant Voice Therapy (RVT) targets oral vibratory sensations at the alveolar ridge and lips to encourage forward focus, easy phonation and increased sensory awareness.
This study utilized an experimental research design with a control group. The experimental group received RVT and vocal hygiene education; their voice recordings were analysed for acoustic and aerodynamic measurements; while subjective assessments included Voice Handicap Index 10 and GRBAS scale evaluations.
Background
Resonant Voice Therapy (RVT) is an approach to vocal treatment that harnesses natural resonances within your vocal tract, such as your mouth and throat, to produce full and clear sounds without strain on your voice cords. RVT is used by singers looking to improve vocal quality and range, speakers for captivating presentations, as well as casual communicators looking to ease strain in everyday speech.
Resonant voice therapy‘s primary methods include vocal fold vibration and closure, manipulation of vocal tract resonances, breathing support, and speech articulation. Speech-language pathologists who specialize in this technique will customize treatment plans based on your unique voice needs and goals.
SLPs play an integral part in providing patients with education on proper breathing, articulation and the principles of resonant voice production. Through one-on-one training sessions with their patients, these experts help patients gain an enhanced understanding of how their voice works as well as ways to maintain good vocal health.
Your SLP will assess your overall voice quality during an evaluation, including how your muscles of the vocal tract are functioning and your cords’ mobility and flexibility. They will then use various exercises and techniques to teach you how to achieve a healthy, resonant voice that meets your expectations.
Negative Practice is a key element of Resonant Voice Therapy. Patients using negative practice must alternate between their habitual “old” voice and desired “new” voice, in order to recognize and differentiate between healthy and unhealthy behaviors.
Researchers evaluated thirteen studies to measure the efficacy of resonant voice therapy, finding several positive results such as improved vocal quality, vocal fold vibration and closure, speaking flexibility and phonation effort. Furthermore, they discovered that this form of voice therapy proved more successful than non-voice therapies such as voicing, vowel modification and lip slurring therapies.
Researchers conducted a systematic review of RVT using meta-analysis to quantify its statistical significance. They searched MEDLINE and Embase databases between 1950 and 2019 for randomised controlled trials that used VHI-30 as an outcome measure; studies conducted outside of English, including those that involved neurological motor speech disorders as well as vocally healthy participants, were excluded from analysis; research was further restricted to studies published in peer-reviewed journals.
Methods
Resonant voice therapy (RVT) is a collection of exercises and techniques used by speech language pathologists (SLPs) to assist individuals experiencing vocal strain, hoarseness or other voice quality issues. RVT focuses on improving vocal resonance and breath control to reduce tension in the throat and cords by way of humming, resonance shaping techniques and gentle onset techniques – often combined with deep diaphragmatic breathing for maximum impact on overall vocal health and quality.
An SLP conducting a resonant voice therapy evaluation will listen carefully as you speak in various pitches and loudnesses, observe how your voice responds to different tasks and exercises, as well as pay close attention to its pitch, loudness and overall quality for evaluation purposes.
Researchers conducted an in-depth literature analysis, searching peer-reviewed journals from 1974 to 2014. Articles detailing various forms of resonant voice therapy approaches such as humming, resonant vocalization, semi-occluded phonation, open tube phonation and acoustic voicing were included in their search criteria. Two independent reviewers selected 13 papers for inclusion into this final study – two were randomized controlled trials while nine were observational studies.
To evaluate the efficacy of resonant voice therapy, the authors employed both group-level and individual-level analyses (linear mixed models). They assessed changes in dysphonia severity index scores, perceptual ratings of voice quality, speaking flexibility, phonation effort between groups.
Results demonstrated that resonant voice therapy effectively reduced dysphonia across multiple dimensions of Dysphonia Severity Index subscales and perceptual ratings of overall quality and clarity, with greater effects being seen among those with lower dysphonia severity scores. Furthermore, analysis indicated that its impact was greatest among patients who scored lower on this index.
Researchers conducted studies on how resonant voice therapy affected patient knowledge of vocally healthy and unhealthy behaviors before and after therapy; knowledge was assessed based on how often participants remembered correct information correctly recalled from written and oral sources; this showed resonant voice therapy significantly increasing how many facts patients remembered correctly after receiving therapy.
Results
Resonant voice therapy teaches individuals how to utilize natural resonating spaces within the vocal tract to produce rich and powerful tones. It may reduce breathiness, hoarseness and straining as well as improving vocal quality so it’s easier for others to hear and understand them.
This systematic review employed a modified Rehabilitation Treatment Specification System (RTSS) to examine the effectiveness of different voice therapies. Ten experts participated in a Delphi process chosen so as to ensure representativeness across clinical areas and minimize facilitator bias by including two external readers for each round rated and providing feedback.
13 studies were identified for inclusion in this review. Their results demonstrated that resonant voice therapy was associated with significant improvements in both symptoms severity and vocal function for organic and functional voice disorder patients alike, making resonant voice therapy effective both individually and collectively treated settings.
To maximize outcomes of resonant voice therapy, it should be administered by a licensed speech-language pathologist trained and experienced in treating voice disorders. A speech-language pathologist can assess vocal behavior to identify which aspects are causing issues before creating an individualized treatment plan to target these specific issues.
One of the most effective approaches to conducting resonant voice therapy is through structured evaluation tools or rating scales, such as Stimulability Assessment and Vocal Quality Inventory (SAVQ). Therapists using such evaluation tools or rating scales can quickly assess a patient’s response to various vocal exercises and techniques; post-treatment ratings of their voice allow therapists to gauge its efficacy.
Resonant voice therapy should go beyond using an evaluation tool; it should include an in-depth history and examination of a patient’s vocal tract, including laryngological examination to rule out medical conditions like vocal nodules and polyps which could be an underlying cause of dysphonia. Resonant voice therapy programs should provide patients with information on healthy and unhealthy vocal behaviors as well as strategies for eliminating those that are unhealthy.
Conclusions
This scoping review concluded that there was evidence for the efficacy of resonant voice therapy in improving some outcomes, such as patient-reported outcome measures (PROMs) and maximum phonation time. Unfortunately, these studies had many methodological issues, with unclear mechanisms as underlying causes that prevented improvement to voice quality. Therefore, future research should concentrate on well-designed randomized controlled trials that are age-specific while taking into account clinical and morphological characteristics of vocal nodules for better voice quality improvement.
The results from 13 included studies demonstrated that resonant voice therapy was successful at improving some outcomes measures, including decreasing symptom severity. But mixed results were observed when evaluating overall symptom reduction and dysphonia severity: group-level analyses failed to reveal significant differences among SP, RVT, and control groups while individual-level analyses demonstrated 36% and 45% improvement to clinically relevant degrees among SP and RVT groups respectively.
Resonant Voice Therapy involves various vocal techniques designed to optimize vocal resonance and reduce strain on vocal folds, such as vocal placement exercises, breathing exercises, and resonant humming. Resonant Voice Therapy increases vocal stamina and impact thereby improving communication across all aspects of life.
Lessac-Madsen Resonant Voice Therapy (LMRVT) uses vocal placement to direct vocal sound toward resonating cavities within the head and neck. Furthermore, LMRVT guides vocal behavior toward barely abducted voicing by applying constant inward and downward pressure with an index finger (configured like a reverse karate chop), beginning anteriorly over the hyoid bone then moving down its body, inferior aspect and finally arriving in the thyrohyoid space.
LMRVT utilizes negative practice by offering opportunities for patients to switch between habitual and new normal voicing during automatic speech, providing a sense of empowerment and control over voice quality that encourages behavioral change.
