ARTICLE IN PRESS

Resonance Tube or Lax Vox?

*Jaana Tyrmi, †Vojtěch Radolf, †Jaromír Horáček, and *Anne-Maria Laukkanen, *Tampere, Finland, and †Prague, Czech
Republic

Summary: Objective. This study compares the flow resistance of Resonance tube (RT) and Lax Vox tube (LVT)
when submerged 2 cm and 10 cm in water, as well as phonation into the tubes in these conditions.
Methods. In the in vitro experiment, the air pressure for flow rates of 60–600 mL/s was measured at the tube inlet,
when the outer end of the tube was submerged 2 cm and 10 cm below water surface in 30°, 45°, and 90° angle. In the
in vivo experiment, 14 subjects phonated in habitual loudness and loudly into both tubes, with the outer end 2 cm and
10 cm in water. RT was immersed in a 45° angle and LVT in a 90° angle in water. Oral pressure, contact quotient from
electroglottographic signal, and sound pressure level were studied. Sensations during phonation were reported in an
interview.
Results. Flow resistance was slightly lower with LVT than with RT, and slightly lower for smaller immersion angles.
In habitual loudness, transglottic pressure and frequency of oral pressure variation were lower for LVT phonation and
amplitude of oral pressure variation was higher for LVT 2 cm in water. Some subjects preferred RT, whereas others
preferred LVT or reported no differences between them.
Conclusions. The tubes differed slightly in flow resistance. Higher oral pressure oscillation with LVT 2 cm in water
may offer stronger massage effect on vocal folds.
Key Words: Flow resistance–EGG–Voice therapy–Water resistance therapy–Air pressure in phonation.

INTRODUCTION of Resonance tube treatment of students with mild dysphonia.

Voice training and therapy utilize phonation into tubes to improve
voice quality. Phonation into a tube that artificially lengthens and
narrows the vocal tract increases flow resistance (mean air pres-
sure divided by mean airflow). Phonation into tubes is performed
so that the outer end is either free in the air or immersed in water.1
The latter is called “water resistance therapy.” In Finnish tradi-
tion, glass Resonance tubes (24–28 cm in length, 8–9 mm in inner
diameter), lanced by Sovijärvi,2 are used. The depth of immer-
sion in water in a bowl is 2–10 cm (sometimes even 15 cm).
Shallow immersion depth, which offers lower flow resistance,
is used for hyperfunctional voice disorder, whereas deep im-
mersion with high flow resistance is used for hypofunctional voice
disorder, in order to increase compensatory adductory activity.2,3
For children, Sovijärvi recommended tubes of 24 cm in length
and 8 mm in inner diameter. For adults, the recommended length
of tubes depended on voice category: For altos and basses, longer
tubes (28 cm) were recommended, whereas for sopranos and
tenors shorter tubes (26 cm) were regarded best. In addition to
glass Resonance tubes, flexible silicon tubes, called Lax Vox tubes
(length of 35 cm, inner diameter of 9–12 mm), are nowadays used
for water resistance therapy.4,5 The recommended immersion depth
for a Lax Vox tube is 2–7 cm, and typically a bottle is used instead
of a bowl.
Various beneficial effects have been reported after undergo-
ing water resistance therapy. Simberg et al6 reported improved
perceptual voice quality and fewer vocal symptoms after 7 weeks
Accepted for publication October 27, 2016.
Conflicts of interest: The authors have no conflicts of interest to report.
From the *Speech and Voice Research laboratory, University of Tampere, Tampere, Finland;
and the †Institute of Thermomechanics, The Academy of Sciences of the Czech Repub-
lic, Prague, Czech Republic.
Address correspondence and reprint requests to Jaana Tyrmi, Speech and Voice Research
Laboratory, School of Education, University of Tampere, Virta, Åkerlundinkatu 5, 33100
Tampere, Finland. E-mail: jaana.tyrmi@uta.fi
Journal of Voice, Vol. ■■, No. ■■, pp. ■■-■■
0892-1997
© 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.jvoice.2016.10.024
Paes et al7 found increased phonatory comfort, improved per-
ceptual voice quality, and decreased instability, subharmonics,
and noise in dysphonic patients’ voices immediately after water
resistance exercising with Resonance tube. Mailänder et al4 re-
ported improved perceptual voice quality and self-evaluation of
voice and increased sound level in voice range profile in healthy
teachers after 3 weeks of Lax Vox training.
So far, few studies exist on the effect on phonation of the length
and diameter of Resonance tube. Laukkanen compared phona-
tion into three glass tubes (26 cm, 27 cm, and 28 cm in length,
and 9 mm in inner diameter) of two female subjects.8 The outer
end of the tubes was free in the air. No systematic differences
in the effects of the tubes were found. A recent study9 investi-
gated the effect of phonation into Resonance tubes of 26 cm and
28 cm in length on vertical position of the larynx and oral pres-
sure in two subjects. The distal end of the tube was in water.
Tube length did not seem to have a systematic effect on the results.
In general, it is known that the length and diameter of a tube
affect the impedance of the tube,10,11 with the diameter having
a stronger effect than the length. Furthermore, flow resistance
(mean pressure divided by mean airflow) is naturally higher when
a tube is in water than when it is free in the air,12,13 and higher
when the immersion is deeper. It is plausible that the immer-
sion angle also affects the flow resistance of the tube.
Among clinicians, there has been an ongoing discussion
whether one should use glass Resonance tube or Lax Vox tube
for water resistance therapy. Some speech therapists prefer a glass
Resonance tube as it seems to give stronger sensations of res-
onance vibrations on the lips and because it is easier to clean.3
Other therapists prefer Lax Vox tube because it is more practi-
cal and non-breakable, and offers the possibility of inserting it
in a straight angle into a bottle to avoid splashing of water from
a bowl and to help in keeping the head position natural, that is
not bent down. It has also been mentioned that a Lax Vox tube
ensures a better jaw position due to its slightly wider diameter.5
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2 Journal of Voice, Vol. ■■, No. ■■, 2016
To the best of our knowledge, no systematic study exists so far
on the differences between Resonance tube and Lax Vox tube,
neither as it comes to the flow resistance properties of the tubes
as such nor as it comes to the effect the tubes have on phonation.
Hence, this study compares (1) the flow resistance of Resonance
tube and Lax Vox tube in vitro as the tubes are submerged 2 cm
and 10 cm in water, and (2) the characteristics of phonation into
Resonance tube and Lax Vox tube with the outer end immersed
2 cm and 10 cm in water in a bowl. The immersion depths of 2 cm
and 10 cm were chosen as they represent shallow and deep im-
mersion and are most often used in clinical practice.
METHODS
Measurement of flow resistance of the tubes
The flow resistance of a glass Resonance tube (27 cm, 9 mm)
and a silicon Lax Vox tube (35 cm, 10 mm) was measured as
follows. The inlet of the tube was attached to a flow source
(Figure 1). The air pressure (backpressure, P(back)) for various
steady flow rates was measured at the tube inlet (1 cm upstream
of the tube), when the outer end of the tube was submerged 2 cm
and 10 cm below water surface in an aquarium. Compressed air
(1 atm) was used as the flow source. The airflow rate, as the man-
ually controlled parameter, was measured by a floating flowmeter
(EMKO DF3 09K5, EMKOMETER s.r.o., Ledec nad Sazavou,
Czech Republic). The air pressure on the inner wall of the up-
stream tube was measured with a digital manometer (GDH 07
AN, with the measurement accuracy of 1 mm H2O, GHM
Messtechnik GmbH Standort Greisinger, Regenstauf, Germany).
The signal was registered by a PC-controlled measurement system
Brüel & Kjaer PULSE 10 (Brüel & Kjær Sound & Vibration
Measurement A/S, Nærum, Denmark) using a 32.8 kHz sam-
pling frequency and a 16 bit A/D convertor. Flow values ranging
from 60 to 600 mL/s were used, as they comprise the most typical
range measured from humans.14 Three different immersion angles
were tested: 30°, 45°, and 90°. These angles were chosen because
90° is recommended for vocal exercising with the Lax Vox tube
and 45° for the Resonance tube, and 30° was considered as the
lowest degree that is practical to use when phonating through a
tube in water. A movable laboratory support was used for en-
suring the exact tube position in the water (Figure 1).
FIGURE 1. The experimental setup for measurement of flow resis-
tance of the tubes.
FIGURE 2. A. The experimental setup for studying phonation into
the tubes. Photo published with permission of the person. B. Shutter-
ing of the distal end of the tube under water at random intervals with
finger.
Recording of the subjects
Fourteen volunteers with no known pathology of the larynx or
voice (6 males, 8 females, mean age of 43 years) were re-
corded. Six subjects (4 females, 2 males) had taken at least their
bachelor’s degree in vocology and were familiar with Reso-
nance tube and Lax Vox exercising. The other subjects (4 males,
4 females) were not familiar with vocal exercising. Trained and
untrained subjects were compared in order to get a representa-
tive sample of both types of potential users of tube exercises,
and to find out whether possible differences in phonation into
the two tubes would be related to the tubes as such or to com-
pensatory strategies that have been learned. The subjects were
instructed to phonate into the tube a vowel-like sound between
[u:] and [o:], which are the most natural alternatives with lip
rounding (lips around the tube). They phonated three times in
comfortable pitch and loudness and three times loudly into a Res-
onance tube (27 cm) and Lax Vox tube, with the outer end
submerged first 2 cm and then 10 cm in water (Figure 2). Each
sustained phonation lasted approximately 5 seconds. Half of the
subjects started with Resonance tube and the other half with Lax
Vox tube. The Resonance tube was immersed in 45° angle in
water and Lax Vox tube in 90° angle, as these angles allow the
best body posture during the task. Recordings were made for
oral pressure (MS-110 transducer electronics unit by Glottal En-
terprises, Syracuse, NY; and transducer PT-75, which enables
registering pressures of up to 75 cm H2O), electroglottographic
signal (dual-channel Electroglottograph (EGG), Glottal Enter-
prises), and acoustic signal (AKG head-mounted microphone
C5441 at 6 cm from the lips; AKG, Vienna, Austria). Comput-
erized Speech Laboratory (CSL 4500, KayPENTAX, Lincoln
Park, NJ) was used in the recording (44.1 kHz, 16 bits). Acous-
tic signals were calibrated with a standard sound source to enable
measurement of sound pressure level (SPL). Sensations during
tube phonation were reported in an interview. The questions posed
were the following: (1) Did you feel any differences between
the tubes? (2) If yes, which tube you preferred and why?
Analyses of the signals
The peak oral pressure P(oral) during manual shuttering of the
distal tube end was measured for an estimate of subglottic pres-
sure P(sub), and the mean P(oral) was measured when the tube
was open (Figure 3). These measurements enabled the calcula-
tion of the mean transglottic pressure: P(trans) = P(sub) − P(oral).
 ARTICLE IN PRESS
Jaana Tyrmi, et al Resonance Tube or Lax Vox? 3

FIGURE 3. Example of oral pressure measurement during tube phonation and random shuttering of the distal end of the tube.

P(trans) was measured as it is the driving force of vocal fold
vibration. Analyses were made with Soundswell Signal Work-
station (Nyvalla DSP, Stockholm, Sweden). Additionally, the
frequency and amplitude of peak-to-peak oscillation in P(oral)
during water bubbling were measured (Figure 4). For that purpose,
the P(oral) signal was filtered by fourth-order Butterworth digital
filter in order to exclude acoustic pressure variations from the
signal. Limits in filtering (cutoff frequencies) were set so that
they could reliably exclude both static part (high-pass filter) and
fundamental frequency of vocal fold vibration (low-pass filter)
in all signals. The low limit in filtering was set to 4 Hz and the
high limit was set to 30 Hz. Filtering and measurements were
made with Matlab (MathWorks, Natick, MA). The SPL was mea-
sured from the acoustic signal using the Praat software (Paul
Boersma and David Weenink, version 5.3.55, Amsterdam, The
Netherlands). Contact quotient (CQ = contact time/period time),
derived from EGG, was calculated as it reflects phonation type.15,16
VoceVista (Roden, The Netherlands) was used for automatic cal-
culation of CQ. A threshold level of 35% of the EGG signal
amplitude was used to distinguish between open and closed times
of the glottis (Figure 5).
Statistical analyses of the data from subjects
The measured parameters—CQ, P(sub), P(oral), P(trans), fre-
quency and amplitude of P(oral) oscillation, and SPL—were
described by calculated mean values and standard deviations.
Population variance was investigated by Kolmogorov-Smirnov
one-sample t test. The sample types (Resonance tube vs Lax Vox
tube) were compared using Student’s t test or Wilcoxon signed
rank paired t test, depending on the population variance. A non-
parametric test (Wilcoxon) was used when the values did not
show normal distribution. The level of statistical significance was
set to P < 0.05. The SPSS-21 software (International Business
Machines (IBM) Corporation, Armonk, North Castle, New York,
the USA) was used in the analyses.
RESULTS
Differences between the tubes for the flow
resistance measured in vitro
Figure 6A shows the measured backpressure as a function of
flow rate for both tubes. The differences between the tubes were
small. In the range of 0–0.3 L/s flow rate, which corresponds
to ordinary phonation,14 the maximum difference considering all
immersion angles was only 0.4 cm H2O, which is within the
margin of error in clinical measurement of air pressure vari-
ables in phonation, especially during phonation into water.
Figure 6B shows the corresponding airflow resistance curves,
where the differences between the tubes are negligible.
The pressure drop in a circular tube conveying incompress-
ible viscous steady fluid flow depends on whether the flow is
laminar or turbulent. Laminar flow occurs at lower velocities,
when a fluid flows in parallel layers. Turbulent flow is a less

FIGURE 4. Example of determining bubbling frequency and the peak-to-peak amplitude of the filtered oral pressure signal. Frequency of P(oral)
variation = number of (positive or negative) P(oral) peaks per time. Amplitude of P(oral) variation = mean difference Di between consecutive pos-
itive peak and negative peak = sum(Di)/n, where n is number of pairs of + and − peaks in filtered signal. P(oral), oral pressure.
 ARTICLE IN PRESS
4 Journal of Voice, Vol. ■■, No. ■■, 2016

TABLE 1.
Differences for Pressure Values for RT and LVT Within
0–0.3 L/s Flow Rate
P(sub) (cm H2O)
Q (L/s) Glass (2 cm) Lax Vox (2 cm) Diff
0.06 2.96 2.96 0.00
0.10 3.11 3.16 -0.05
0.20 3.42 3.42 0.00
0.30 3.82 3.82 0.00

P(sub) (cm H2O)

Q (L/s) Glass (10 cm) Lax Vox (10 cm) Diff
0.06 10.91 10.91 0.00
0.10 11.11 11.06 0.05
FIGURE 5. Example of measurement of contact quotient (CQ) from 0.20 11.42 11.22 0.20
electroglottographic signal. 0.30 11.83 11.62 0.20
Abbreviations: LVT, Lax Vox tube; P(sub), subglottic pressure; RT, Reso-
nance tube.

orderly flow regime that is characterized by eddies which result

in lateral mixing of the fluid layers. In contrast to laminar flow,
turbulence is associated with high Reynolds numbers. Theoret-
ically for the Reynolds number—Re = U D/ν < 2300, where U
is the flow velocity, D is the inner tube radius, and ν is the ki-
nematic air viscosity—the flow in the tube should be laminar,
and for Re > 4000 turbulent see for example White.17 For the
Resonance tube, we can estimate that the flow inside the tube
should be laminar for the flow rate of Qlam < 0.244 L/s and tur-
bulent for the flow rate of Qturb > 0.424 L/s. For the Lax Vox tube,
these boundaries are shifted up to the flow rates of Qlam < 0.271 L/s
for laminar flow and up to Qturb > 0.471 L/s for turbulent flow.
In the region between the limits for laminar (Qlam) and turbu-
lent (Qturb) flows, there is a transition between laminar and
turbulent flow inside the tube.
The amount of pressure needed for a certain flow rate was
somewhat dependent on the immersion angle of the tube in water,
see for example Figure 6A for Lax Vox tube 2 cm in water. The
30° immersion angle required slightly less air pressure com-
pared with the larger angles. The maximal differences within the
whole range of flow rates, Q = 0.06–0.6 L/s, were small, however,
just 0.4 cm H2O for Lax Vox tube immersed 30° in water and
0.6 cm H2O for Resonance tube immersed 90° in water. Such
small differences are comparable with the hydrostatic pressure
difference given by the tube radius (see the definition of the water
depth in Figure 1).
It must be noted that it is difficult to phonate through a glass
tube in water with 90° immersion angle and yet keep the body
and neck unbent, as it is recommended in voice therapy.3 The
most natural choice with the Resonance tube seems to be 45°,
whereas for a Lax Vox tube 90° is recommended.5,18 In that
case, the maximal difference between the two tubes would be
0.7 cm H2O for 2 cm immersion depth and 0.9 cm H2O for
10 cm immersion depth, with a flow rate of 0.6 L/s considered
(Figure 7). Thus, for the flow range that is more typical in
phonation, 0–0.3 L/s, the maximal difference would be 0.05 cm
H2O for 2 cm immersion and 0.2 cm H2O for 10 cm immer-
sion (Table 1).
Results for the subjects
No significant differences were observed in CQ, P(sub), P(oral),
and SPL between phonation into Resonance tube and Lax Vox
tube (Table 2). P(trans), instead, was somewhat lower with Lax
Vox tube in phonation at habitual loudness. The amplitude of
P(oral) oscillation tended to be higher and the frequency of the
oscillation tended to be lower with Lax Vox tube.
With regard to the subjects’ answers to questions concern-
ing possible preference of the tubes, half of them (7) preferred
Resonance tube, whereas others preferred Lax Vox tube (5 out
of 14) or did not report sensing any special difference between
them (2 out of 14). The reasons given for the preferred choice
were, for example, a stronger sensation of resonance vibration
on the lips and sensation of less air consumption with the Res-
onance tube, whereas Lax Vox tube was regarded as more pleasant
between the lips, and according to some subjects sensations of
resonance vibrations were felt also on the cheek tissues and
forehead.
Figure 8 shows the distribution of the parameter values in terms
of the first and third quartiles, median, and the minimum and
maximum values. In general, somewhat higher CQ values (wider
distribution), lower P(trans), and smaller amplitude and fre-
quency of P(oral) oscillation were observed for the trained subjects
(Figure 8). The differences were not categorical though, but there
was considerable overlapping in the values between the groups.
DISCUSSION
Flow resistance was slightly lower with Lax Vox tube than
with Resonance tube, and slightly lower for smaller (<90°)
immersion angles (Figure 6B). Flow resistance was higher for
lower flow values (corresponds to soft phonation). The flow pres-
sure results of the present study are in line with those obtained
in a recent study by Amarante Andrade et al.19 It is possible to
estimate on the bases of their figure that a Resonance tube (26 cm
in their case) required at maximum ca 0.25 cm H2O more pres-
sure than Lax Vox tube at a flow rate of ca 0.3 L/s, whereas at
 ARTICLE IN PRESS
Jaana Tyrmi, et al Resonance Tube or Lax Vox? 5

FIGURE 6. A. Pressure flow curves for Resonance tube and Lax Vox tube when submerged 2 cm and 10 cm in water with three immersion angles.
B. Flow resistance (mean pressure/mean flow) curves for Resonance tube and Lax Vox tube when submerged 2 cm and 10 cm in water with three
immersion angles.
 ARTICLE IN PRESS
6 Journal of Voice, Vol. ■■, No. ■■, 2016

FIGURE 7. Pressure flow curves for Resonance tube (glass) submerged in 45° angle and Lax Vox tube submerged in 90° angle in water.

TABLE 2.
Mean Values and Standard Deviations of CQ, Estimated Subglottic, Oral (Supraglottic), and Transglottic Pressure, Fre-
quency and Amplitude of P(oral) Oscillation, and SPL for Phonation into RT and LVT at Two Immersion Depths (2 cm
and 10 cm) and Two Loudness Levels (Habitual and Loud Phonation)
CQ 35% P (sub) P (oral) P (trans) Freq. P (oral) Ampl. P (oral) SPL
Habitual Loudness (%) (cm H2O) (cm H2O) (cm H2O) (Hz) (cm H2O) (dB)
Glass tube 2 cm
Mean 53.8 10.4 4.3 6.1 17.4 1.7 71.7
SD 10.3 3.7 1.4 2.9 1.7 0.7 5
Lax tube 2 cm
Mean 53.8 9.2 4.6 4.6 15.1 2 70.5
SD 12.8 3.1 1.6 2.4 2.5 0.8 2.8
Diff. for tubes (Student / Wilcoxon) ns ns ns p 0,03 p 0,001 p 0,008 ns
Glass tube 10 cm
Mean 55.3 15.7 10.7 7 15.8 1.7 71.6
SD 10.2 3.4 0.9 2.6 2.7 0.7 4.9
Lax tube 10 cm
Mean 54.9 14.6 10.9 5.1 14.6 1.7 71.6
SD 8.1 3 1 2.8 2.4 0.6 3.4
Diff. for tubes (Student / Wilcoxon) ns ns ns p 0,047 p 0,004 ns ns

CQ 35% P (sub) P (oral) P (trans) Freq. P (oral) Ampl. P (oral) SPL

Loud (%) (cm H2O) (cm H2O) (cm H2O) (Hz) (cm H2O) (dB)
Glass tube 2 cm
Mean 54.8 15.9 7.6 8.2 17.8 2.1 77.4
SD 10.9 5.4 2.7 3.9 1.8 0.9 3.4
Lax tube 2 cm
Mean 55.8 15.1 7.7 7.4 16.6 2.3 77.7
SD 12.9 5.1 2 4.8 1.5 0.8 3.8
Diff. for tubes (Student / Wilcoxon) ns ns ns ns p 0,026 ns ns
Glass tube 10 cm
Mean 58.6 23.2 12.9 11.4 16.5 2.1 75.9
SD 10.5 6.7 1.8 5.6 2.1 0.7 7.8
Lax tube 10 cm
Mean 54.9 22.5 13 10.1 16.4 2.3 78.2
SD 12.3 5.8 1.9 5.3 2 0.6 4.1
Diff. for tubes (Student) ns ns ns ns ns p 0,033 ns
Differences between the tubes are studied with t tests; ns = non-significant (P > 0.05).
Abbreviations: CQ, contact quotient; LVT, Lax Vox tube; P(oral), oral pressure; P(sub), subglottic pressure; RT, Resonance tube; SD, standard deviation; SPL,
sound pressure level.
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Jaana Tyrmi, et al Resonance Tube or Lax Vox? 7

FIGURE 8. Distribution of (A) CQ, (B) P(trans), and (C) amplitude and (D) frequency of peak-to-peak P(oral) for trained (N = 6) and un-
trained subjects (N = 8) in different tasks (both loudness together). CQ, contact quotient; P(trans), transglottic pressure; P(oral), oral pressure.

very low flow rates (<0.05 L/s) the opposite was measured. We
did not consider flow rates lower than 60 mL/s, as measure-
ment accuracy gets low then, and because very low flow rates
are not typically reported in humans. It seems that when im-
mersion depth in water is the same, the differences in length,
material, and inner diameter of these tubes have rather little effect
on the flow resistance. Some differences were observed in pho-
nation of the subjects though.
P(trans) was somewhat lower with Lax Vox tube in phona-
tion at habitual loudness, which could imply softer phonation.12
CQ is typically smaller with softer phonation, but in our results
there were no significant differences in either CQ, P(sub), or SPL
between phonation into the tubes. P(oral) oscillation during water
resistance exercising results from water bubbling. Bubbling starts
as the air pressure inside the tube slightly exceeds the hydro-
static pressure in water, and the bubble separates from the tube
end when the buoyancy force acting on the bubble is about the
same or higher than the aerodynamic force in the tube.20 The
frequency of bubbling is known to increase with flow rate and
with a decrease of tube orifice, and to be practically indepen-
dent on the depth of orifice immersion if it is between 2.54 cm
and 25.4 cm.21 Thus, for the same airflow rate, a slightly lower
bubbling frequency would be expected for Lax Vox tube com-
pared with Resonance tube. On average, the frequency of P(oral)
 ARTICLE IN PRESS
8 Journal of Voice, Vol. ■■, No. ■■, 2016
variation was slightly lower with deeper immersion, which is
also in line with the results of other studies.9,13,20,22 This may
suggest that people tend to lower the flow rate when P(oral) rises.
The amplitude of P(oral) oscillation tended to be higher with
Lax Vox tube than with Resonance tube. This may be related
to higher flow rate and larger water bubbles due to a slightly
wider tube diameter in Lax Vox tube and due to the higher im-
mersion angle used by the Lax Vox tube. A slightly higher flow
rate and larger bubbles might also explain the subjects’ reports
of more air consumption and more sensations of vibrations in
the cheeks with Lax Vox tube. Water resistance therapy has been
supposed to provide a massage-like effect on the vocal tract and
larynx.23 Earlier results have shown that the amplitude of the
P(oral) variation (during Resonance tube phonation) may be re-
markably (even 15 dB) higher than the amplitude of the
fundamental.20 Large variations in the EGG signal amplitude,
CQ, and vertical position of the larynx have also been reported
during water bubbling.20,22 A higher p-t-p P(oral) of Lax Vox tube
could perhaps promote a more effective massage effect. On the
other hand, a slightly higher resistance of the Resonance tube
could offer more training for respiratory muscles. Further-
more, the stronger vibratory sensations felt on the lip region with
the glass tube suggest that a hard-walled tube offers stronger feed-
back of energy transfer in the glottis and thus would help regulate
phonation.24
The trained and untrained subjects of the present study did
not show much difference in tube phonation. The tendency that
trained subjects had slightly larger CQ and smaller P(trans), p-t-p
P(oral) amplitude, and frequency than the untrained during water
resistance exercising may suggest that they used less airflow
during increased vocal tract resistance.
CONCLUSIONS
Lax Vox tube offers slightly lower flow resistance than Reso-
nance tube when the outer end of the tube is in water. Flow
resistance is lower at lower immersion angles of the tube in water.
Differences of flow resistance between the tubes are very small,
within the margin of error in clinical air pressure measure-
ment. However, some subjects commented about sensation of
higher air consumption with the Lax Vox tube. Lower P(trans)
was observed for Lax Vox tube when loudness of phonation was
comfortable. Higher P(oral) oscillation was observed with Lax
Vox tube at comfortable loudness when the tube was sub-
merged 2 cm in water and at loud phonation when the tube was
10 cm in water probably due to a more intensive boiling-like effect
on the water surface.
Lax Vox tube may thus offer stronger massage effect on the
vocal folds. Stronger resonance vibrations on the lips offered
by the hard-walled Resonance tube, in turn, may offer a slightly
more effective tool for monitoring energy transfer in the glottis.
Acknowledgments
The study was supported by the Academy of Finland (Grant
Number 134868) and the Czech Science Foundation (Grant
Number 16-01246S).
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