Voice FatigueSOVTNCT05357222
Straw Phonation Exercise Program for Pitch Extension
A study testing Straw phontion in people with Voice Fatigue and Voice Disorders, run by University of Utah at 1 site in United States.
Trial summary
To investigate the change in fundamental frequency range and vocal fold stability achievable with vocal fold stretching exercise in human populations with high and low vocal activity Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Voice Fatigue, Voice Disorders, Voice Hoarseness
- What is being tested?
- Straw phontion
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 120 participants
- Where
- 1 siteUnited States
- Study dates
- 16 Nov 2021to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Participants must be 18 years or older
- no current voice disorder
- no history of performance or professional vocal training
Who cannot join
- history of head/neck cancer, laryngeal surgery, current voice disorder requiring medical management
- cognitive limitations that would prevent them from successfully and safely participating in the study.
- history of gastrointestinal disease or surgery w
- no known neurological or structural abnormalities of vocal folds
- previous laryngeal surgeries;
- allergies to local anesthetics (used to suppress a sensitive gag reflex during laryngeal endoscopic examination);
- cardiac abnormalities;
- recent history of smoking (must be completely smoke-free for six months prior to study commencement because of the effect of smoking on the voice and laryngopharyngeal reflux severity).
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Impact of Vocal Fold Stretching Exercise on Pitch Range and Phonation Stability
To investigate the change in fundamental frequency range and vocal fold stability achievable with vocal fold stretching exercise in human populations with high and low vocal activity
Read the detailed description
The vocal ligament is part of the layered structure of the vocal fold. It is a thin band of tissue near the superior medial edge of the vocal fold. The cord-like appearance of the ligament gave rise to the traditional term "vocal cord". The ligament connects the arytenoid cartilage (lower broad dark region) to the anterior portion of the thyroid cartilage (upper dark region). The slightly thickened endpoints are known as the anterior and posterior macula flava. In the medial-lateral direction, the vocal ligament comprises the intermediate and deep layer of the lamina propria.
The physiological functions of the vocal ligament are not fully understood. One function is to limit mechanical strain (elongation), a general function of most ligaments in the body. A second function may be to produce a firm closure of the glottis by forming a straight edge along the membranous (vibrating) portion of the vocal fold. A strong ligament that can be tensed with exercise is likely to help straighten the edge of the folds. Vocal fold bowing, for example, is a pathological condition often associated with advanced age, but it can also occur in young adults who press their arytenoid cartilages together excessively in speech. Atrophy of the thyroarytenoid muscle, which lies lateral to the ligament, causes the middle of the membranous vocal fold to be retracted from the midline of the glottis. The result is a weak voice because airflow cannot be suddenly shut off for efficient acoustic excitation of the vocal tract. For self-sustained vocal fold vibration, the superficial layer must be very pliable and deformable for mucosal surface-wave motion. The role of the ligament is then to stabilize the vertical motion when large pressures are applied to vocal fold surfaces. The most important known function of the ligament, however, is to widen the fundamental frequency range. The stiffer the ligament, the greater the likelihood that several octaves of fo range can be achieved.
- Conditions
- Voice Fatigue, Voice Disorders, Voice Hoarseness
- Being tested
- Straw phontion
- Medical subject headings
- Voice Disorders, Hoarseness
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Straw phontionBehavioural
Also called Semi-occluded vocal tract exercises, flow resistant tube
Pitch Glides: (1 minute) Vocalize through the straw starting from as low as possible to as high as possible. As the participant you will want to get as much as your vocal range as possible. But, don't let the voice get growly at the bottom or press it into a painful range at the top.
- Accents: (1 minute) Vocalize progressive little hills or accents. It sounds like a revving engine of the car.
- Song: (1 minute) Pick a favorite song and vocalize it through the straw. Examples: National Anthem, Happy Birthday, Mary had a Little Lamb. These are great songs because they have a range of pitches and one can build some accents in, as well.
- Reading passage: (1 minute) Vocalize a reading passage through the straw. Be as dramatic as possible, using a lot of inflection.
| Study group | Role | What they receive |
|---|---|---|
| Straw Phonation | Experimental | Participants will undergo one session of voice habilitation via a straw phonation exercise protocol. This protocol has been extensively studied and validated in the largest randomized clinical trial in voice therapy by our team. Receives: Behavioral: Straw phontion |
What is being measured
The primary outcome is the main question the study is designed to answer.
Voice Range Profile (VRP)
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
Measured: pre-intervention (initial evaluation)
Voice Range Profile (VRP)
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
Measured: 8 weeks post intervention
Voice Range Profile (VRP)
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
Measured: 3 months following intervention
Secondary outcomes (6)
Electroglottography (EGG)
Electroglottograph, or EGG, is a device used for the noninvasive measurement of the degree of contact between the vibrating vocal folds during voice production. Electrodes are applied on the surface of the neck so that the EGG records variations in the transverse electrical impedance of the larynx can be measured.
Measured: pre-intervention
Electroglottography (EGG)
Electroglottograph, or EGG, is a device used for the noninvasive measurement of the degree of contact between the vibrating vocal folds during voice production. Electrodes are applied on the surface of the neck so that the EGG records variations in the transverse electrical impedance of the larynx can be measured.
Measured: 8 weeks post intervention
Electroglottography (EGG)
Electroglottograph, or EGG, is a device used for the noninvasive measurement of the degree of contact between the vibrating vocal folds during voice production. Electrodes are applied on the surface of the neck so that the EGG records variations in the transverse electrical impedance of the larynx can be measured.
Measured: 3 months following treatment.
Acoustic measurement
An audio recording of each participant will be obtained. The participant will sustain the "ah" and "ee" vowel three times for the maximum amount of time they are able. They will then read the CAPE-V (Zraick et al., 2011), rainbow passage (Fairbanks, 1960), and describe the cookie theft picture (Borod et al., Boston Diagnostic Aphasia Examination 1980). The samples will then be analyzed using Phonanium, an automated acoustic analysis software. Acoustics will include fundamental frequency, fundamental frequency standard deviation, relative sound pressure level (SPL), SPL standard deviation, cepstral peak prominence smooth (CPPS), harmonic to noise ratio, and noise to harmonic ratio, acoustic voice quality index (AVQI), and spectral slope.
Measured: pre-intervention
Acoustic measurement
An audio recording of each participant will be obtained. The participant will sustain the "ah" and "ee" vowel three times for the maximum amount of time they are able. They will then read the CAPE-V (Zraick et al., 2011), rainbow passage (Fairbanks, 1960), and describe the cookie theft picture (Borod et al., Boston Diagnostic Aphasia Examination 1980). The samples will then be analyzed using Phonanium, an automated acoustic analysis software. Acoustics will include fundamental frequency, fundamental frequency standard deviation, relative sound pressure level (SPL), SPL standard deviation, cepstral peak prominence smooth (CPPS), harmonic to noise ratio, and noise to harmonic ratio, acoustic voice quality index (AVQI), and spectral slope.
Measured: 8 weeks post intervention
Acoustic measurement
An audio recording of each participant will be obtained. The participant will sustain the "ah" and "ee" vowel three times for the maximum amount of time they are able. They will then read the CAPE-V (Zraick et al., 2011), rainbow passage (Fairbanks, 1960), and describe the cookie theft picture (Borod et al., Boston Diagnostic Aphasia Examination 1980). The samples will then be analyzed using Phonanium, an automated acoustic analysis software. Acoustics will include fundamental frequency, fundamental frequency standard deviation, relative sound pressure level (SPL), SPL standard deviation, cepstral peak prominence smooth (CPPS), harmonic to noise ratio, and noise to harmonic ratio, acoustic voice quality index (AVQI), and spectral slope.
Measured: 3 months following treatment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 May 2022
- Study start16 Nov 2021
- Primary completion31 Dec 2024
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Voice FatigueStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Participants will be grouped based on their daily vocal usage (i.e. vocal user (4+ hours of speaking per day) or low vocal user (less than 4 hours per day). Both groups will be given a series of vocal stretching exercises that will be completed through a 2mm diameter straw.
- Masking
- None (open label)
- Enrolment
- 120 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Utah
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Deafness and Other Communication Disorders (NIDCD)
- Responsible party
- Principal investigator, Lynn Maxfield, University of Utah
- Investigators
- Lynn Maxfield, PhD, Principal investigator, University of Utah
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05357222
- Sponsor's protocol ID
- IRB_00141650
- Other IDs
- R01DC018280
- Acronym
- SOVT
- Status last verified
- Feb 2026
- First submitted
- 10 May 2021
- Last updated
- 27 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Vocal Fold Stretching Exercise on Pitch Range and Phonation Stability
- ClinicalTrials.gov ID
- NCT05357222
- Acronym / sponsor ID
- SOVT / IRB_00141650
- Conditions
- Voice Fatigue, Voice Disorders, Voice Hoarseness
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 120 participants (estimated)
- Lead sponsor
- University of UtahUniversity, hospital or other
- Collaborators
- National Institute on Deafness and Other Communication Disorders (NIDCD)
- Study start
- 16 Nov 2021 (actual)
- Primary completion
- 31 Dec 2024 (actual)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 2 May 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To investigate the change in fundamental frequency range and vocal fold stability achievable with vocal fold stretching exercise in human populations with high and low vocal activity
Detailed description
The vocal ligament is part of the layered structure of the vocal fold. It is a thin band of tissue near the superior medial edge of the vocal fold. The cord-like appearance of the ligament gave rise to the traditional term "vocal cord". The ligament connects the arytenoid cartilage (lower broad dark region) to the anterior portion of the thyroid cartilage (upper dark region). The slightly thickened endpoints are known as the anterior and posterior macula flava. In the medial-lateral direction, the vocal ligament comprises the intermediate and deep layer of the lamina propria.
The physiological functions of the vocal ligament are not fully understood. One function is to limit mechanical strain (elongation), a general function of most ligaments in the body. A second function may be to produce a firm closure of the glottis by forming a straight edge along the membranous (vibrating) portion of the vocal fold. A strong ligament that can be tensed with exercise is likely to help straighten the edge of the folds. Vocal fold bowing, for example, is a pathological condition often associated with advanced age, but it can also occur in young adults who press their arytenoid cartilages together excessively in speech. Atrophy of the thyroarytenoid muscle, which lies lateral to the ligament, causes the middle of the membranous vocal fold to be retracted from the midline of the glottis. The result is a weak voice because airflow cannot be suddenly shut off for efficient acoustic excitation of the vocal tract. For self-sustained vocal fold vibration, the superficial layer must be very pliable and deformable for mucosal surface-wave motion. The role of the ligament is then to stabilize the vertical motion when large pressures are applied to vocal fold surfaces. The most important known function of the ligament, however, is to widen the fundamental frequency range. The stiffer the ligament, the greater the likelihood that several octaves of fo range can be achieved.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Participants will be grouped based on their daily vocal usage (i.e. vocal user (4+ hours of speaking per day) or low vocal user (less than 4 hours per day). Both groups will be given a series of vocal stretching exercises that will be completed through a 2mm diameter straw.
| Arm | Type | Receives |
|---|---|---|
| Straw Phonation | Experimental | Behavioral: Straw phontionParticipants will undergo one session of voice habilitation via a straw phonation exercise protocol. This protocol has been extensively studied and validated in the largest randomized clinical trial in voice therapy by our team. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Participants must be 18 years or older
- no current voice disorder
- no history of performance or professional vocal training
Key exclusion criteria (8 listed)
- history of head/neck cancer, laryngeal surgery, current voice disorder requiring medical management
- cognitive limitations that would prevent them from successfully and safely participating in the study.
- history of gastrointestinal disease or surgery w
- no known neurological or structural abnormalities of vocal folds
- previous laryngeal surgeries;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Straw phontionAlso: Semi-occluded vocal tract exercises, flow resistant tubePitch Glides: (1 minute) Vocalize through the straw starting from as low as possible to as high as possible. As the participant you will want to get as much as your vocal range as possible. But, don't let the voice get growly at the bottom or press it into a painful range at the top. 2. Accents: (1 minute) Vocalize progressive little hills or accents. It sounds like a revving engine of the car. 3. Song: (1 minute) Pick a favorite song and vocalize it through the straw. Examples: National Anthem, Happy Birthday, Mary had a Little Lamb. These are great songs because they have a range of pitches and one can build some accents in, as well. 4. Reading passage: (1 minute) Vocalize a reading passage through the straw. Be as dramatic as possible, using a lot of inflection. | Behavioural | Straw Phonation |
Primary outcome
Voice Range Profile (VRP)
Time frame: pre-intervention (initial evaluation)
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
Voice Range Profile (VRP)
Time frame: 8 weeks post intervention
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
Voice Range Profile (VRP)
Time frame: 3 months following intervention
a thorough voice range profile will be created by testing the participants lowest (minimum) and highest (maximum) achievable pitches across a spectrum of vocal intensities (soft, medium and loud).
6 secondary outcomes
Electroglottography (EGG)
Time frame: pre-intervention
Electroglottography (EGG)
Time frame: 8 weeks post intervention
Electroglottography (EGG)
Time frame: 3 months following treatment.
Acoustic measurement
Time frame: pre-intervention
Acoustic measurement
Time frame: 8 weeks post intervention
Acoustic measurement
Time frame: 3 months following treatment.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Lynn Maxfield, PhD principal investigator
University of Utah
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Straw phontion in people with Voice Fatigue and Voice Disorders, run by University of Utah at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Voice Range Profile (VRP) (time frame: pre-intervention (initial evaluation)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2026.