Restricted accessResearch articleFirst published online 2011-10
Investigation of Fatigue,Delayed-Onset Muscle Soreness,and Spectral-Based Cepstral Measurements in Healthy Speakers after Neuromuscular Electrical Stimulation
We observed whether 30 minutes of neuromuscular electrical stimulation applied to the necks of healthy speakers would result in significant acoustic changes and perceptions of fatigue and/or delayed-onset muscle soreness (DOMS).
Methods:
Twelve participants were assigned to experimental (n = 6; 3 male and 3 female) and control groups (n = 6; 3 male and 3 female). Neuromuscular electrical stimulation was applied to the anterior neck in the experimental group only. All participants produced 3 trials of the vowel /a/ and the Rainbow Passage before and after completing a 30-minute phonation protocol. Recorded samples were analyzed for measures of the cepstral peak prominence, the ratio of low- to high-frequency spectral energy, and their respective standard deviations. Perceptions of fatigue and DOMS were rated on visual analog scales before, 5 minutes after, and 24 hours after completion of the phonation protocol.
Results:
Statistically significant acoustic findings reflecting reduced relative sound pressure level, increased high-frequency noise, and phonatory instability were observed in the experimental group. In addition, reports of fatigue and DOMS were also reported by some participants.
Conclusions:
A 30-minute dosage may be too high for some people experiencing neuromuscular electrical stimulation for the first time.
ShawGYSechtemPRSearlJKellerKRawiTADowdyE.Transcutaneous neuromuscular electrical stimulation (VitalStim) curative therapy for severe dysphagia: Myth or reality?Ann Otol Rhinol Laryngol2007;116:36–44.
2.
Carnaby-MannGDCraryMA, Examining the evidence on neuromuscular electrical stimulation for swallowing: A meta-analysis. Arch Otolaryngol Head Neck Surg2007;133:564–71.
3.
LagorioLACarnaby-MannGDCraryMA, Cross-system effects of dysphagia treatment on dysphonia: A case report. Cases J2008;1:67.
4.
LagorioLACarnaby-MannGDCraryMA, Treatment of vocal fold bowing using neuromuscular electrical stimulation. Arch Otolaryngol Head Neck Surg2010;136:398–403.
5.
GuirroRRJBigatonDRSilvérioKCA, Transcutaneous electrical nerve stimulation in dysphonic women. Pro Fono2008;20:189–95.
6.
PtokMStrackD.Electrical stimulation-supported voice exercise therapy are superior to voice exercises alone in patients with unilateral recurrent laryngeal nerve paresis: Results from a prospective, randomized clinical trial. Muscle Nerve2008;38:1005–11.
7.
FowlerLPGorham-RowanMHapnerER, An exploratory study of voice change associated with healthy speakers after transcutaneous electrical stimulation to laryngeal muscles. J Voice2011;25:54–61.
8.
WijtingYFreedM.VitalStim therapy: Training manual for the use of neuromuscular electrical stimulation in the treatment of dysphagia. Hixson, Tenn: Chattanooga Group, 2004:70.
9.
Gorham-RowanMFowlerLHapnerE.Acoustic analysis of voice change in normal speakers following transcutaneous electrical stimulation to the laryngeal area. Open Rehabil J2010;3:67–74.
10.
CardingPNSteenINWebbAMacKenzieKDearyIJWilsonJA, The reliability and sensitivity to change of acoustic measures of voice quality. Clin Otolaryngol Allied Sci2004;29:538–44.
11.
AwanSNRoyN.Outcomes measurement in voice disorders: Application of an acoustic index of dysphonia severity. J Speech Lang Hear Res2009;52:482–99.
12.
DejonckereGHWienekePH, Cepstra of normal and pathological voices: Correlation with acoustic, aerodynamic and perceptual data. In: BallMJDuckworthM, eds. Advances in clinical phonetics. Amsterdam, the Netherlands: John Benjamins, 1996:217–26.
13.
De KromG.A cepstrum-based technique for determining a harmonics-to-noise ratio in speech signals. J Speech Hear Res1993;36:254–66.
HillenbrandJHoudeRA, Acoustic correlates of breathy vocal quality: Dysphonic voices and continuous speech. J Speech Hear Res1996;39:311–21.
16.
BakenRJOrlikoffRF, Clinical measurement of speech and voice. 2nd ed.San Diego, Calif: Singular Publishing, 2000:164–6.
17.
WolfeVIMartinDPPalmerCI, Perception of dysphonic voice quality by naive listeners. J Speech Lang Hear Res2000;43:697–705.
18.
HartlDMHansSVaissièreJRiquetMBrasnuDF, Objective voice quality analysis before and after onset of unilateral vocal fold paralysis. J Voice2001;15:351–61.
19.
Heman-AckahYDMichaelDDGodingGSJr., The relationship between cepstral peak prominence and selected parameters of dysphonia. J Voice2002;16:20–7.
20.
AwanSNRoyN.Acoustic prediction of voice type in women with functional dysphonia. J Voice2005;19:268–82.
21.
AwanSNRoyN.Toward the development of an objective index of dysphonia severity: A four-factor model. Clin Linguist Phon2006;20:35–49.
22.
SulicaLBlitzerA.Electromyography and the immobile vocal fold. Otolaryngol Clin North Am2004;37:59–74.
BuchthalF.Electromyography of intrinsic laryngeal muscles. Q J Exp Physiol Cogn Med Sci1959;44:137–48.
25.
Faaborg-AndersenKBuchthalF.Action potentials from internal laryngeal muscles during phonation. Nature1956;177:340–1.
26.
Faaborg-AndersenKEdfeldtAW, Electromyography of intrinsic and extrinsic laryngeal muscles during silent speech: Correlation with reading activity. Acta Otolaryngol1958;49:478–82.
27.
KreimanJGerrattBR, Sources of listener disagreement in voice quality assessment. J Acoust Soc Am2000;108:1867–76.
KerteszA.Western aphasia battery–revised. San Antonio, Tex: Pearson Education, 2006.
32.
AwanSNRoyNJettéMEMeltznerGSHillmanRE, Quantifying dysphonia severity using a spectral/cepstral-based acoustic index: Comparisons with auditory-perceptual judgements from the CAPE-V. Clin Linguist Phon2010;24:742–58.
33.
BakenRJOrlikoffRF, Clinical measurement of speech and voice. 2nd ed.San Diego, Calif: Singular Publishing, 2000:172.
34.
FieldA.Discovering statistics using SPSS. 3rd ed.London, England: Sage Publications, 2009:57.
35.
HumbertIAPolettoCJSaxonKG, The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol2006;101:1657–63.
36.
LudlowCLHumbertISaxonKPolettoCSoniesBCrujidoL.Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia. Dysphagia2007;22:1–10.
37.
American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 7th ed.Philadelphia, Pa: Lippincott Williams & Wilkins, 2006.
38.
ArmstrongRB, Mechanisms of exercise-induced delayed onset muscular soreness: A brief review. Med Sci Sports Exerc1984;16:529–38.
39.
SmithLL, Acute inflammation: The underlying mechanism in delayed onset muscle soreness?Med Sci Sports Exerc1991;23:542–51.
40.
ClarksonPMNosakaKBraunB.Muscle function after exercise-induced muscle damage and rapid adaptation. Med Sci Sports Exerc1992;24:512–20.
41.
HowellJNChlebounGConatserR.Muscle stiffness, strength loss, swelling and soreness following exercise-induced injury in humans. J Physiol1993;464:183–96.
42.
MacIntyreDLReidWDMcKenzieDC, Delayed muscle soreness. The inflammatory response to muscle injury and its clinical implications. Sports Med1995;20:24–40.
43.
LieberRLFridénJ.Morphologic and mechanical basis of delayed-onset muscle soreness. J Am Acad Orthop Surg2002;10:67–73.
44.
KesarTBinder-MacleodS.Effect of frequency and pulse duration on human muscle fatigue during repetitive electrical stimulation. Exp Physiol2006;91:967–76.
45.
EnokaRMStuartDG, Neurobiology of muscle fatigue. J Appl Physiol1992;72:1631–48.
46.
MacDougallJDTuxenDSaleDGMorozJRSuttonJR, Arterial blood pressure response to heavy resistance exercise. J Appl Physiol1985;58:785–90.
47.
SanbornKBorosRHrubyJ, Short-term performance effects of weight training with multiple sets not to failure vs. a single set to failure in women. J Strength Cond Res2000;14:328–31.
48.
BembenDAFettersNLBembenMGNabaviNKohET, Musculoskeletal responses to high- and low-intensity resistance training in early postmenopausal women. Med Sci Sports Exerc2000;32:1949–57.
49.
NosakaK.Muscle soreness and damage and the repeated-bout effect. In: TiidusPM, ed. Skeletal muscle damage and repair. Champaign, Ill: Human Kinetics, 2008:59–68.
50.
ConnollyDAJSayersSPMcHughMP, Treatment and prevention of delayed onset muscle soreness. J Strength Cond Res2003;17:197–208.
51.
SzymanskiDJ, Recommendations for the avoidance of delayed-onset muscle soreness. J Strength Cond Res2001;23:7–13.
52.
WarrenGLLoweDAArmstrongRB, Measurement tools used in the study of eccentric contraction-induced injury. Sports Med1999;27:43–59.
