Vocal exercise may attenuate acute vocal fold inflammation

J Voice. 2012 Nov;26(6):814.e1-13. doi: 10.1016/j.jvoice.2012.03.008.


Objectives/hypotheses: The objective was to assess the utility of selected "resonant voice" (RV) exercises for the reduction of acute vocal fold inflammation. The hypothesis was that relatively large-amplitude, low-impact vocal fold exercises associated with RV would reduce inflammation more than spontaneous speech (SS) and possibly more than voice rest.

Study design: The study design was prospective, randomized, and double blind.

Methods: Nine vocally healthy adults underwent a 1-hour vocal loading procedure, followed by randomization to a SS condition, vocal rest condition, or RV exercise condition. Treatments were monitored in clinic for 4 hours and continued extraclinically until the next morning. At baseline (BL), immediately after loading, after the 4-hour in-clinic treatment, and 24 hours post-BL, secretions were suctioned from the vocal folds bilaterally and submitted to enzyme-linked immunosorbent assay to estimate concentrations of key markers of tissue injury and inflammation: interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor α, matrix metalloproteinase (MMP)-8, and IL-10.

Results: Complete data sets were obtained for three markers--IL-1β, IL-6, and MMP-8--for one subject in each treatment condition. For these markers, results were poorest at 24-hour follow-up in the SS condition, sharply improved in the voice rest condition, and was the best in the RV condition. Average results for all markers and responsive subjects with normal BL mediator concentrations revealed an almost identical pattern.

Conclusions: Some forms of tissue mobilization may be useful to attenuate acute vocal fold inflammation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Biomarkers / metabolism
  • Double-Blind Method
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Inflammation Mediators / metabolism
  • Laryngitis / metabolism
  • Laryngitis / pathology
  • Laryngitis / physiopathology
  • Laryngitis / therapy*
  • Laryngoscopy
  • Linear Models
  • Male
  • Middle Aged
  • Pennsylvania
  • Phonation*
  • Pressure
  • Prospective Studies
  • Rest
  • Speech Production Measurement
  • Stroboscopy
  • Time Factors
  • Treatment Outcome
  • Vibration
  • Video Recording
  • Vocal Cords / metabolism
  • Vocal Cords / pathology
  • Vocal Cords / physiopathology*
  • Voice Quality*
  • Voice Training*
  • Young Adult


  • Biomarkers
  • Inflammation Mediators