Massage-Like Sensation and Tissue Mobilization During Phonation With Two Oscillatory Positive Expiratory Pressure Devices

Purpose: This study primarily aimed at observing whether high-frequency vibration devices generate tissue mobilization on facial, neck, and chest tissues. An additional objective was to inspect resulting self-perceived sensation of massage-like sensation. Method: Fifty-two participants engaged in a set of three phonatory tasks: (a) phonation with Shaker Medic Plus device, (b) phonation with Acapella Choice device, and (c) sustained vowel [a:] (control task). Self-perceived massage-like sensation was also assessed. All exercises were performed at three loudness levels. Tissue mobilization was captured by four accelerometers placed in four different locations: (a) over the cheek, (b) over the neck, (c) over the thyroid cartilage, and (d) over the suprasternal notch. Frequency, amplitude, and regularity of tissue oscillation were measured. Results: Analyses of variance showed significant second-order interactions for vibration amplitude and frequency. A two-way interaction (Task × Location) was observed for jitter, and no significant interactions were found for shimmer. Selfperceived massage-like sensation results showed that Acapella and Shaker generate almost identical effects, both being significantly higher to the one delivered by vowel [a:]. Conclusion: Both Acapella and Shaker devices are able to mobilize tissues. Tasks, loudness level, and location could produce an effect on tissue oscillation variables. The Acapella device tends to produce a larger amplitude of vibration than the Shaker does. However, self-reported sensation of massage is virtually the same for both devices. Control of dependent variables of tissue oscillation (frequency, amplitude, and regularity) is apparently relevant to obtain the greatest massage-like effect in patients.