Efficacy of Water Resistance Therapy in Subjects Diagnosed With Behavioral Dysphonia: A Randomized Controlled Trial

Marco Guzman*, Rodrigo Jara, Christian Olavarria, Paloma Caceres, Geordette Escuti, Fernanda Medina, Laura Medina, Sofia Madrid, Daniel Muñoz, Anne Maria Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Purpose The purpose of the present study was to determine the efficacy of water resistance therapy (WRT) in a long-term period of voice treatment in subjects diagnosed with voice disorders. Methods Twenty participants, with behavioral dysphonia, were randomly assigned to one of two treatment groups: (1) voice treatment with WRT, and (2) voice treatment with tube phonation with the distal end in air (TPA). Before and after voice therapy, participants underwent aerodynamic, electroglottographic, acoustic, and auditory-perceptual assessments. The Voice Handicap Index and self-assessment of resonant voice quality were also performed. The treatment included eight voice therapy sessions. For the WRT group, the exercises consisted of a sequence of five phonatory tasks performed with a drinking straw submerged 5 cm into water. For the TPA, the exercises consisted of the same phonatory tasks, and all of them were performed into the same straw but the distal end was in air. Results Wilcoxon test showed significant improvements for both groups for Voice Handicap Index (decrease), subglottic pressure (decrease), phonation threshold pressure (decrease), and self-perception of resonant voice quality (increase). Improvement in auditory-perceptual assessment was found only for the TPA group. No significant differences were found for any acoustic or electroglottographic variables. No significant differences were found between WRT and TPA groups for any variable. Conclusions WRT and TPA may improve voice function and self-perceived voice quality in individuals with behavioral dysphonia. No differences between these therapy protocols should be expected.

Original languageEnglish
Pages (from-to)385.e1-385.e10
JournalJournal of Voice
Issue number3
StatePublished - May 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 The Voice Foundation


  • Phonation threshold pressure
  • Semi-occluded vocal tract
  • Subglottic pressure
  • Tube phonation
  • Voice therapy


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