Immediate effects of the incentive spirometer in women with healthy voice

Lopes, Bárbara Pereira; Korn, Gustavo Polacow; Nunes, Flávio Barbosa; Gama, Ana Cristina Côrtes

doi:10.1590/2317-1782/20232022291en

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Original Article • CoDAS 36 (1) • 2024 • https://doi.org/10.1590/2317-1782/20232022291en copy

Immediate effects of the incentive spirometer in women with healthy voice

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To evaluate the immediate effect of the incentive spirometer on acoustic measures, aerodynamic measures and on the auditory-perceptual assessment of vocal quality in vocally healthy women.

Methods

This is an experimental intra-subject comparison study with the participation of 22 women without vocal complaints. Acoustic measures, aerodynamic measures and auditory-perceptual assessment of vocal quality were obtained before and immediately after using the incentive spirometer by the participants. The device was used in the orthostatic position and the participants performed three sets of ten repetitions with a one-minute interval between sets.

Results

After using the incentive spirometer, there was a significant reduction in jitter, shimmer and PPQ (period perturbation quotient) measurements and an increase in maximum expiratory volume, while the other acoustic and aerodynamic measurements were not significantly impacted. In addition, there was improvement in vocal quality in eight (36.4%) participants and 11 (50.0%) participants showed no changes in the auditory perceptual assessment of voice quality after using the incentive spirometer.

Conclusion

The use of the incentive spirometer is safe and, in its immediate effect, positively impacts the acoustic measures of short-term aperiodicity of frequency and intensity and increases the maximum expiratory volume in women with healthy voices.

Voice; Voice Training; Respiration; Breathing Exercises; Speech; Language and Hearing Sciences

		Mean	SD	Median	p-value
F0 (Hz)	M1	218.49	27.50	218.95	0.171^* * Paired t-test;
F0 (Hz)	M2	224.75	27.99	222.83	0.171^* * Paired t-test;
Jitter (%)	M1	1.684	0.931	1.461	˂0.001**
Jitter (%)	M2	1.147	0.759	1.000	˂0.001**
Shimmer (%)	M1	5.225	1.486	5.185	0.011*
Shimmer (%)	M2	4.295	1.509	3.809	0.011*
APQ (%)	M1	3.490	1.065	3.352	0.055^ Wilcoxon test
APQ (%)	M2	2.979	1.159	2.613	0.055^ Wilcoxon test
PPQ (%)	M1	1.052	0.786	0.864	0.001**
PPQ (%)	M2	0.759	0.766	0.538	0.001**
NHR	M1	0.141	0.026	0.140	0.052*
NHR	M2	0.130	0.024	0.127	0.052*
CPP vowel	M1	22.279	3.039	21.432	0.745**
CPP vowel	M2	22.290	3.090	22.232	0.745**
CPPs vowel	M1	11.229	2.631	10.341	0.897**
CPPs vowel	M2	11.288	2.642	11.303	0.897**
CPP speech	M1	15.406	1.235	15.050	0.603**
CPP speech	M2	15.365	1.017	15.116	0.603**
CPPs speech	M1	4.865	1.225	4.580	0.112**
CPPs speech	M2	4.990	1.078	4.803	0.112**

		N	Mean	SD	Median	p-value
Maximum expiratory volume(l)	M1	22	2.972	0.867	3.040	0.022*
Maximum expiratory volume(l)	M2	22	3.164	0.979	3.275	0.022*
Maximum speech time (s)	M1	22	12.923	3.228	12.180	0.890^* * Paired t-test;
Maximum speech time (s)	M2	22	12.991	3.337	12.325	0.890^* * Paired t-test;
Peak air pressure – cm H₂O	M1	21	8.590	1.460	8.210	0.580*
Peak air pressure – cm H₂O	M2	21	8.439	1.802	7.900	0.580*
Mean peak air pressure – cm H₂O	M1	21	7.141	1.249	7.090	0.750*
Mean peak air pressure – cm H₂O	M2	21	7.243	1.547	6.790	0.750*
Voice airflow – l/s	M1	21	0.118	0.083	0.110	0.632^ Wilcoxon test
Voice airflow – l/s	M2	21	0.124	0.093	0.100	0.632^ Wilcoxon test
Peak expiratory flow – l/s	M1	21	0.282	0.169	0.240	0.888**
Peak expiratory flow – l/s	M2	21	0.347	0.454	0.260
Aerodynamic resistance – cm H₂O/ (l/s)	M1	21	65.750	33.257	59.380	0.121**
Aerodynamic resistance – cm H₂O/ (l/s)	M2	21	72.606	45.727	59.000	0.121**
Aerodynamic force – W	M1	20	0.097	0.066	0.083	0.401**
Aerodynamic force – W	M2	21	0.103	0.084	0.088	0.401**
Acoustic impedance – Ω	M1	20	68.114	34.437	60.815	0.113**
Acoustic impedance – Ω	M2	21	74.236	46.445	60.160	0.113**
Aerodynamic efficiency – p.p.m.	M1	21	171.45	167.75	90.75	0.271**
Aerodynamic efficiency – p.p.m.	M2	20	245.76	230.11	179.20	0.271**

Auditory perception of speech	Comparison before and after N = 22
Auditory perception of speech	N	%
Better	8	36.4
Worse	3	13.6
Unchanged	11	50.0

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[1] Conflict of interests: nothing to declare.