International Journal of Speech-Language Pathology, 2013; 15(2): 127135

Effect on long-term average spectrum of pop singers vocal warm-up

with vocal function exercises

MARCO GUZMAN1, MABEL ANGULO2, DANIEL MUOZ1 & ROSS MAYERHOFF3

1University of Chile, Santiago, Chile, 2Professional Institute of Chile, Santiago, Chile,
and 3Wayne State University, Detroit, MI, USA

Abstract
This case-control study aimed to investigate if there is any change on the spectral slope declination immediately after vocal
function exercises (VFE) vs traditional vocal warm-up exercises in normal singers. Thirty-eight pop singers with perceptu-
ally normal voices were divided into two groups: an experimental group (n 20) and a control group (n 18). One single
session with VFE for the experimental group and traditional singing warm-up exercises for the control group was applied.
Voice was recorded before and after the exercises. The recorded tasks were to read a phonetically balanced text and to sing
a song. Long-term average spectrum (LTAS) analysis included alpha ratio, L1L0 ratio, and singing power ratio (SPR).
Acoustic parameters of voice samples pre- and post-training were compared. Comparison between VFE and control group
was also performed. Significant changes after treatment included the alpha ratio and singing power ratio in speaking voice,
and SPR in the singing voice for VFE group. The traditional vocal warm-up of the control group also showed prepost
changes. Significant differences between VFE group and control group for alpha ratio and SPR were found in speaking voice
samples. This study demonstrates that VFE have an immediate effect on the spectrum of the voice, specifically a decrease on
the spectral slope declination. The results of this study provide support for the advantageous effect of VFE as vocal warm-up
on voice quality.

Keywords: Vocal function exercises, vocal warm-up, long-term average spectrum, singing voice, speaking voice.

Introduction
Physiologic voice therapy has long been used by
speech-language pathologists in treating patients
with voice disorders. Stemple (2000) defined physi-
ologic voice therapy as voice therapy programs that
have been devised to directly alter or modify the
physiology of the vocal mechanism. Physiologic voice
therapy works to balance the three sub-systems of
voice production (resonance, respiration, and phona-
tion) at one time, as opposed to working on each
component individually. Examples of physiologic
voice therapy include: Resonant Voice Therapy
(Verdolini, 1998), the Accent Method of Voice Ther-
apy developed by Smith and described by Kotby
(1995), the Lee Silverman Voice Treatment (Ramig,
Pawlas, & Countryman, 1995), and Vocal Function
Exercises (VFE) (Stemple, 2000). The Vocal Func-
tion Exercises voice therapy program was first
described by Briess (1957, 1959) and modified by
Stemple (2000). The program is intended to improve
vocal efficiency by rebalancing and strengthening the
three sub-systems of voice production. VFE has not
only been applied as a rehabilitation voice program,
but it has also been used as a vocal training tool in
subjects with normal voice.
Multiple studies have demonstrated its efficacy
with both normal and voice disordered populations
(Ensslen, Croake, & Stemple, 2007; Gillivan-Murphy,
Drinnan, ODwyer, Ridha, & Carding, 2006; Lee &
Stemple, 1995; Pasa, Oates, & Dacakis, 2007; Roy,
Gray, Simon, Dove, Corbin-Lewis, & Stemple, 2001;
Stemple, Lee, DAmico, & Pickup, 1994). Stemple
et al. (1994) found the VFE program increased the
amount of available lung capacity used for phonation,
increased maximum phonation times, and decreased
airflow rates at high pitches in adult women with nor-
mal voice production. Furthermore, frequency range
was improved, especially at the upper end. Videostro-
boscopic analysis showed an improvement in phase
symmetry. Sabol, Lee, and Stemple (1995) studied
the effects of VFE in normal adult singers, and similar
results were achieved. The parameters measured
included acoustic and aerodynamic analysis (F0, jit-
ter, phonation volume, flow rate and maximum pho-
nation time), frequency range, and videostroboscopy
analysis. Significant pre- and post-test differences

Correspondence: Marco Guzmn, University of Chile, Independencia 1027, Independencia, Santiago, Chile. Email: guzmanvoz@gmail.com
ISSN 1754-9507 print/ISSN 1754-9515 online 2013 The Speech Pathology Association of Australia Limited
Published by Informa UK, Ltd.
DOI: 10.3109/17549507.2012.702283
128 M. Guzman et al.
between experimental and control groups for acous-
tic and aerodynamic analysis were found; however,
no significant differences were found in pre- and
post-test analysis of frequency range or videostrobos-
copy analysis. In a more recent study with normal
singers, Ensslen et al. (2007) examined the effects of
Vocal Function Exercises on modified voice range
profile (VRP) (Awan, 1991; LeBorgne & Weinrich,
2002) and dysphonia severity index (DSI) (Wuyts,
De Bodt, Molenberghs, Remacle, Heylen, et al.,
Millet, 2000) in opera graduate students with normal
voice. This study measured the physiologic range
prior to and following the 10-week exercise program
and compared those results to the same measures in
a peer control group. Results show that the VRP
Experimental group had significantly greater VRP
area gains than the control group after VFE training.
No significant difference was found between the two
groups on DSI.
Several studies have been carried out on VFE
effects in teachers (Gillivan-Murphy et al., 2006;
Pasa, Oates, & Dacakis, 2007; Roy et al., 2001).
Roy et al. (2001), in a randomized controlled study,
compared the effect of Vocal Hygiene education with
VFE in teachers with self-reported voice problems.
The VFE group showed greater improvement in self-
perceived handicap than the vocal hygiene group
after treatment, using the Voice Handicap Index as
the only outcome measurement. Gillivan-Murphy
et al. (2006) conducted a study of the effectiveness
of a voice treatment approach in a group of teachers
with voice problems. The study participants included
20 teachers with self-reported voice problems who
were randomly assigned to one of two groups: the
treatment or no-treatment group. The participants in
the treatment group received 6 weeks of combined
treatment using VFE and vocal hygiene education.
Upon completion of the treatment, significant
improvement was found in the treatment group as
measured by the Voice Symptom Severity Scale
(Deary, Wilson, Carding, & Mackenzie, 2003) and
Voice Care Knowledge Visual Analogue Scale; how-
ever, there was no significant improvement in the
treatment group as measured by the Voice-Related
Quality-of-Life instrument (Hogikyan & Sethura-
man, 1999). This study suggests that the combined
VFE and vocal hygiene approach was effective in
improving self-reported voice symptoms and voice
care knowledge in a group of teachers.
The effect of VFE has also been described on
vocal aerodynamics and maximum phonation time
in elderly males (Gorman, Weinrich, Lee, & Stemple,
2008), and on monozygotic (identical) twins with
vocal fold bowing (Tanner, Sauder, Thibeault,
Dromey, & Smith, 2010).
Although VFE have been demonstrated to be
effective based on improvement in the post-therapy
or post-training physiological and acoustical mea-
sures in pathological and normal voice in long-term
treatment, the immediate effects of VFE as vocal
warm-up have not been described.
The purposes of vocal warm-up exercises described
in the literature are varied. According to Francato,
Nogueira, Pela, and Behlau (1996), vocal warm-up
allows a proper glottal adduction, generating a voice
quality characterized by a higher harmonic energy
and decreased transglottal airflow. Therefore, a voice
with less noise energy is obtained. In addition,
warm-up exercises should increase the vocal folds
flexibility to shorten and lengthen during variation
of fundamental frequency. Stone (1994) pointed out
that vocal warm-up exercises are directed to control
the glottal resistance, voice projection, and parame-
ters of frequency and intensity, thereby decreasing
the vocal cost-benefit relationship. Moreover, vocal
warm-up exercises are expected to increase blood
flow to the vocal folds and decrease muscle viscosity
and perhaps non-muscular tissue viscosity (Milbrath
& Solomon, 2003). Despite several different defini-
tions of vocal warm-up, most authors agree that
vocal warm-up exercises contribute to the prevention
of vocal fold injury in professional voice users. For
professional singers and students of singing, a regu-
lar vocal warm-up regimen is considered essential
(Gish, Kunduk, Sims, & McWhorter, 2012; Goldberg,
2007; Miller, 1990).
Subjective evaluation of vocal warm-up effect has
shown that, after warm-up, singers feel that they have
better voice quality, less effort during singing, and
better control over the voice (Elliot, Sundberg, &
Gramming, 1995). These outcomes are consistent
with other subjective studies of improved vocal
flexibility, range, and voice quality after warm-up
(Stegman, 2003).
Even though it is widely accepted that vocal
warm-up improves vocal production and facilitates
easier phonation, very little is known about the
mechanism underlying its effect. Several studies
that have examined the effect of vocal warm-up
have been focused on aerodynamic measurements
such as phonation threshold pressure (PTP),
which is the minimum sub-glottal pressure required
to initiate and sustain phonation. These studies
have yielded conflicting results. Elliot et al. (1995)
examined the effect of vocal warm-up on the PTP
in a group of male and female singers. The effect
varied considerably between subjects, presumably
because the vocal fold viscosity was not a dominat-
ing factor for the PTP. Similar results were found
in a study conducted by Milbrath and Solomon
(2003). The authors concluded that PTP is not a
sensitive or specific measure to study changes in
vocal function after vocal warm-up, because the
results failed to support any significant changes in
PTP after each of the vocal tasks. On the other
hand, Vintturi, Alku, Lauri, Sala, Sihvo, and
Vilkman (2001) and Motel, Fisher, and Leydon
(2003) reported a significant rise of PTP after
vocal warm-up exercises.

Few studies have explored the effect of vocal
warm-up exercises by computerized acoustic analysis.
Some of them have accomplished the measurements
using perturbation of fundamental frequency and
noise-to-harmonics ratio (Amir et al., 2005; McHenry
et al., 2008); waveform, sonogram, and spectrogram
(Blaylock, 1999); and relative average perturbation,
pitch perturbation quotient, shimmer, amplitude
perturbation quotient, voice turbulence index, and
singing power ratio (Amir et al. 1999). There are,
however, no concluding data regarding the question
of whether these acoustic measures can fully assess
the effect of warm-up exercises on voice production.
The present study was designed to investigate if
there is any change on the spectral slope declination
in the speaking and singing voice immediately after
one session of vocal function exercises and tradi-
tional singing warm-up exercises in normal singers.
The long-term average spectrum (LTAS) was cho-
sen because it allows one to measure spectral changes
(spectral slope declination) during speaking and
singing voice samples. This acoustic feature has not
been used in previous studies of vocal warm-up.
Materials and methods
Participants
Informed consent was obtained from 38 volunteer
(unpaid) pop singers with perceptually normal voices
(20 women and 18 men). Participants were recruited
from different pop singing groups. The grade of dys-
phonia was assessed with GRBAS scale (Hirano,
1981) by one of the authors of this article (MG) who
has more than 10 years of experience in voice clinic.
All participants had a GRBAS scale 00000 (per-
ceptually normal voice) and no history of vocal dif-
ficulty for the last year. The average age of these
participants was 34 years. No participants reported
a history of vocal therapy prior to enrollment in this
study. Participants were divided into two groups: an
experimental group (n 20) and a control group
(n 18). All of them were asked to attend a single
recording and training session lasting no more than
30 minutes. This session included voice recordings
for both groups. For the experimental group, the ses-
sion included voice training with vocal function exer-
cises, whereas, for the control group, the session
included voice training with traditional singing
warm-up exercises.
Voice recordings
Participants were recorded twice (before and after
vocal exercises) during a read-aloud task of a 242-
word phonetically balanced text, in habitual intensity
level. The duration of each recording was 80 sec-
onds. Participants were also asked to sing the song
Happy Birthday in a comfortable musical key.
In both speaking voice and singing voice tasks,
Vocal warm-up with vocal function exercises 129
participants were ask to produce the same loudness
during recordings pre- and post-vocal training.
Loudness level was also controlled by the amplitude
of the audio waveform during recordings. A console:
Digidesign-Focusrite model control 24; audio inter-
face: Digidesign 96, hardware HD2; and a pro-
fessional condenser microphone Audio-Technica,
model AT4050 were used to capture the voice sam-
ples before and after voice training. The microphone
was positioned 10 cm from the mouth of the par-
ticipants who remained standing. Recording took
place in a soundproof booth, and samples were
recorded digitally in a WAV format at a sampling rate
of 44 KHz with 16 bits/samples quantization. The
capture and recording of voice signals were made
using the software Protools HD, version 7.1. Samples
were edited with the software Wavesurfer, version
1.8.5. Acoustical analysis with long-term average
spectrum was performed (LTAS).
Voice training
The vocal warm-up program for the experimental
group consisted of one entire sequence of vocal func-
tion exercises including a warm-up exercise, stretch-
ing exercise, contraction exercise and low-impact
adductory power exercises. Musical tones were
adapted to each patients voice type according to vocal
function exercises protocol (Stemple, 2000). The
duration of the exercise sequence was 15 minutes.
The complete recording session lasted 25 minutes
for each subject: 5 minutes for recording prior to
warm-up, 15 minutes of training with VFE and
5 minutes of recording post-warm-up.
For the control group, traditional singing warm-up
exercises were used. Each participant was asked to
sing a simple melody using musical intervals of thirds
with the vowel /a/. Musical tones were adapted to
each participants voice type according to the same
criteria used on vocal function exercises protocol,
e.g. for middle voice, the starting note was C, next
notes were E, G, E and the last one was the same
starting C (Figure 1). This melody was performed in
an ascending and descending musical tonality by half
steps. Voice warm-up was accomplished throughout
a comfortable vocal range. No specific minimum or
maximum fundamental frequency was asked. The
duration of the exercise sequence was 15 minutes.
Acoustic analysis
In the LTAS analysis, the acoustic variables in this
study were the energy level differences between the
Figure 1. Melody used as traditional vocal warm-up exercise.
130 M. Guzman et al.

F1 and F0 regions (L1 L0), that is the level differ-

ence between 300800 Hz and 50300 Hz, which
provides information on the mode of phonation; the
alpha ratio (Frkjaer-Jensen & Prytz, 1976), that is
the energy level difference between 501000 Hz and
15 kHz, which provides information on the spectral
slope declination; and the singing power ratio
(Omori, Kacker, Carroll, Riley, & Blaugrund, 1996)
(the difference of energy between the highest peak
02 KHz and the highest peak 24 KHz). These
acoustical measurements were obtained from both
speaking and singing voice samples. The reason for
choosing these spectral measurements is because
previous studies have suggested that high spectral
harmonic energy should increase after vocal exer- Figure 2. Long-term average spectrum (LTAS) parameters pre-
and post-treatment Vocal function exercises (VFE) group in
cises, especially if they include semi-occluded pos- speaking voice analysis.
tures of the vocal tract (Story, Laukkanen, & Titze,
2000; Titze, 1994, 2006).
significant difference (p .0001) between pre- and
The LTAS spectra for each subject were obtained
post-treatment values (Pre: 13.72 3.16 dB, post:
by Praat program, version 5.2 (Boersma & Weenink,
12.72 4.47 dB). There was no statistically sig-
2008). For each sample, energy peaks were calcu-
nificant difference (p .4115) between the pre- and
lated between 05000 Hz, with Hanning window
post-treatment samples for L1L0 (Pre: 1.17 4.35
and a bandwidth of 100 Hz. It was analysed for at
dB, post: 1.48 2.73 dB).
least 80 seconds of each sample. To perform the
LTAS parameters pre- and post-treatment in
LTAS, unvoiced sounds and pauses were auto-
speaking voice analysis for control group are pre-
matically eliminated from the samples by Praat
sented in Table II. Statistically significant differences
software using the pitch corrected version with
between pre- and post-treatment (p .0096) for
standard settings. The amplitude values of the
alpha ratio were found (Pre: 20.19 2.94 dB,
spectral peaks were normalized to control for
post: 18.18 2.97 dB). There was no statistically
loudness variations between subjects. Acoustic
significant differences (p .3958) between the pre-
objective analysis was performed by one of the
and post-treatment samples for L1L0 (Pre:
authors of this paper (MG), who has more than
.38 5.6 dB, post: .50 3.51 dB) and Singing
10 years of experience in acoustic analysis of voice
power ratio (SPR) (p .3491) between pre- and
and speech.
post-treatment values (Pre: 15.15 1.91 dB, post:
Descriptive statistics were calculated for the vari-
11.21 4.13 dB).
ables, including median and interquartile ranges.
Figure 3 and Table III show the results of LTAS
Wilcoxon signed-rank test was performed to compare
parameters when comparing the VFE group vs con-
results for acoustic parameters between pre- and post-
trol group prepost treatment differences in speaking
treatment evaluation and Wilcoxon rank-sum test to
voice. Statistically significant differences between the
compare treatment with the control group (pre- and
VFE group (3.25 3.24) and control group
post-treatment measures differences were used). An
(.8 1.21) for alpha ratio (p .0046) were found.
alpha of 0.05 was used for the statistical procedures.
Also, significant differences between VFE group
Stata 12.0 (StataCorp. 2011. StataCorp LP, Col-
(4.25 1.45) and control group (.89 4.81) for
lege Station, TX) statistical software was used for
SPR (p .0002) were found. There was no statisti-
analysis.
cally significant differences between the VFE group
This study was approved by the research ethics
(.16 3.54) and control group (.14 3.43) for
committee of the School of Communication Disor-
L1L0 (p .8378).
ders of the Professional Institute of Chile.

Table I. Long-term average spectrum parameters pre- and post-

Results treatment, vocal function exercises group, in speaking voice
Speaking voice analysis analysis.

The results of LTAS parameters pre- and post- Pre-treatment Post-treatment

Variable Median IQR Median IQR p-value
treatment in speaking voice analysis for the VFE
group are presented in Figure 2 and Table I. Alpha ratio 20.64 2.27 19.83 2.17 .0004
Statistically significant differences between pre- L1:L0 ratio 1.17 4.35 1.48 2.73 .4115
and post-treatment (p 0.0004) for alpha ratio were SPR 13.72 3.16 12.72 4.47 .0001
found (Pre: 20.64 2.27 dB, post: 19.83 Note: Long-term average spectrum (LTAS) analysis included
2.17 dB). Singing power ratio (SPR) also showed a alpha ratio, L1L0 ratio, and singing power ratio (SPR).
 Vocal warm-up with vocal function exercises 131

Table II. Long-term average spectrum parameters pre- and post- Table III. Vocal function exercises (VFE) vs control group
treatment, control group, in speaking voice analysis. comparison in speaking voice analysis.

Pre-treatment Post-treatment Prepost-treatment VFE group Control group

Variable Median IQR Median IQR p-value difference Median IQR Median IQR p-value

Alpha ratio 20.19 2.94 18.18 2.97 .0096 Alpha ratio 3.25 3.24 .8 1.21 .0046
L1:L0 ratio .38 5.6 .50 3.51 .3958 L1:L0 ratio .16 3.54 .14 3.43 .8378
SPR 15.15 1.91 11.21 4.13 .3491 SPR 4.25 1.45 .89 4.81 .0002

Note: Long-term average spectrum (LTAS) analysis included Note: Long-term average spectrum (LTAS) analysis included
alpha ratio, L1L0 ratio, and singing power ratio (SPR). alpha ratio, L1L0 ratio, and singing power ratio (SPR).

Singing voice analysis It compared pre-treatment and post-treatment voice

samples of pop singers with perceptually normal
Figure 4 and Table IV show the results of LTAS
voice using three parameters of LTAS: the alpha
parameters pre- and post-treatment for the VFE
ratio, the singing power ratio (both provide infor-
group in singing voice analysis. Statistically signifi-
mation on the spectral slope declination), and the
cant differences between pre- and post-treatment
(L1 L0), which provides information on the mode
(p .0479) for SPR were found (Pre: 14.31 3.77 dB,
of phonation.
post: 13.11 4.17 dB). There was no statisti-
Results of this investigation revealed that the alpha
cally significant difference (p .1730) between the
ratio and singing power ratio values increased sig-
pre- and post-treatment samples for alpha ratio
nificantly (less negatives values) in the speaking
(Pre: 19.03 2.07 dB, post: 18.31 2.53 dB).
voice analysis post-treatment with VFE. These data
There was no statistically significant difference (p .1212)
suggest a clear immediate effect on spectral charac-
between the pre- and post-treatment samples for L1 L0
teristics after one single session of VFE, specifically
(Pre: 8.87 4.59 dB, post: 9.28 6.95 dB).
a change in the spectral slope declination (i.e., less
Table V shows the results of LTAS parameters pre-
steep slope) (Figures 6 and 7). Values of alpha ratio
and post-treatment for control group in singing voice
and singing power ratio after VFE represent an
analysis. There were no statistically significant differ-
increased energy in the higher harmonics of the
ences between pre- and post-treatment for any of the
spectral slope. In other words, there is less difference
LTAS parameters (Alpha ratio, SPR, and L1 L0).
between the energy of the lower harmonics and
Figure 5 and Table VI show the results of LTAS
energy of the higher harmonics after VFE than
parameters when comparing the VFE group vs con-
before VFE.
trol group prepost treatment differences. There
Results of the control group also showed a sig-
were no statistically significant differences between
nificant difference between pre- and post-treatment
the VFE group and control group for any of the
for alpha ratio. However, the comparison of this dif-
LTAS parameters (Alpha ratio, SPR, and L1 L0).
ference (pre and post) with the difference in VFE
group was statistically different (greater pre/post dif-
ference for VFE). Therefore, it is possible to assume
Discussion
that VFE produced a greater positive effect than
The present study examined and compared acou- traditional singing warm-up on the spectral slope
stical parameters of the LTAS before and after declination in speaking voice analysis. Furthermore,
one single session of voice warm-up with vocal func- statistically significant differences between the VFE
tion exercises (experimental group) and singing group and control group for singing power ratio were
voice traditional warm-up exercises (control group). found in speaking voice analysis.

Figure 3. Vocal function exercises (VFE) vs control group Figure 4. Long-term average spectrum (LTAS) parameters pre-
comparison in speaking voice analysis. and post-treatment VFE group in singing voice analysis.
132 M. Guzman et al.
Table IV. Long-term average spectrum parameters, pre- and post-
treatment vocal function exercises (VFE) group, in singing voice
analysis.
Pre-treatment Post-treatment
Variable Median IQR Median IQR p-value
Alpha ratio 19.03 2.07 18.31 2.53 .1730
L1:L0 ratio 8.87 4.59 9.28 6.95 .1212
SPR 14.31 3.77 13.11 4.17 .0479
Note: Long-term average spectrum (LTAS) analysis included
alpha ratio, L1L0 ratio, and singing power ratio (SPR).
Even though singing power ratio is a spectral
measurement created originally for quantifying the
singers formant, it can be used to measure any kind
of phonation including speaking voice. Its main pur-
pose is to calculate the ratio of the greater harmonic
peak in the 24 kHz range to the greater harmonic
peak in the 02 kHz range. The present study shows
that SPR is a sensitive acoustical measurement to
detect spectral changes in 24 kHz spectral section
during speaking voice. This spectral region has been
studied previously in speaking voice productions.
Leino (1994) relates a peak at 3.5 kHz, the speak-
ers formant or actors formant, and a relatively
gentle spectrum envelope declination with the per-
ception of good voice quality. In a study with actors,
Pinczower and Oates (2005) explored the spectral
energy between 24 kHz using LTAS analysis. They
observed increased acoustic energy in the higher
(24 kHz) frequency region compared to a lower
(02 kHz) one of voice samples with maximal pro-
jected voice. Laukkanen, Syrja, Laitala, and Leino
(2004) state that the actor or speaker formant can
be intensified with specific voice training directed to
the enhancement of high frequencies in the spec-
trum. Our outcomes were consistent with previous
literature. Specifically, the present study showed an
increased spectral energy in the greater harmonic
peak in the 24 kHz range after warm-up with vocal
function exercise.
In the singing voice analysis, there was a signifi-
cant difference only in singing power ratio between
pre- and post-treatment (p .035) for the VFE group,
but this difference was not as significant as the
difference in speaking voice analysis (p .0001). A
possible explanation for this difference (More evi-
dent changes in speaking voice than singing voice
after VFE) is that singers in this study probably
Table V. Long-term average spectrum parameters, pre- and post-
treatment control group, in singing voice analysis.
Pre-treatment Post-treatment
Variable Median IQR Median IQR p-value
Alpha ratio 18.48 2.59 17.7 2.15 .3978
L1:L0 ratio 6.47 5.70 7.12 5.75 .9306
SPR 13.62 3.24 12.18 3.58 .3271
Note: Long-term average spectrum (LTAS) analysis included
alpha ratio, L1L0 ratio, and singing power ratio (SPR).
Figure 5. Vocal function exercises (VFE) vs control group
comparison in singing voice analysis.
applied more vocal technique in the singing voice
task than the speaking voice. Therefore, the differ-
ence between pre- and post-treatment values is less
clear (less significant) in singing voice than speaking
voice. This assumption needs further testing.
In addition, no statistically significant differences
between the VFE group and control group for alpha
ratio, L1L0, and singing power ratio were found
when comparing prepost treatment differences in
these two groups. Thus, it is possible to state that
VFE did not produce a greater positive effect than
traditional singing warm-up on the spectral slope
declination in singing voice. Recall that, contrary to
singing voice analysis, a significant difference was
found for speaking voice samples between the effect
of VFE and traditional singing warm-up.
The less steep fall of the spectrum slope after VFE
in the present study may be explained physiologically
by increased skewing or tilt of the glottal flow wave.
This suggests a faster closing time of the vocal folds
in relation to the open time produced by the use of
semi-positions of the occluded vocal tract (Story
et al., 2000). This posture also lowers the phonatory
threshold pressure and increases maximum flow dec-
lination rate (Titze, 2006), leading to strengthening
of the higher harmonics and even to an increase in
sound pressure level (SPL) (Titze, 1994). This
increase in maximum flow declination rate (MFDR)
would imply more economic voice production (more
sound output with less mechanical stress imposed on
the vocal fold tissue) (Titze & Laukkanen, 2007).
The VFE protocol (Stemple, 2000) is actually based
on semi-occluded vocal tract postures. During the
Table VI. Vocal function exercises (VFE) vs control group
comparison in singing voice analysis.
Prepost-treatment VFE group Control group
difference Median IQR Median IQR p-value
Alpha ratio .52 1.96 .44 1.03 .4647
L1:L0 ratio .97 3.86 .01 .72 .1605
SPR .86 3.22 .56 2.78 .3495
Note: Long-term average spectrum (LTAS) analysis included
alpha ratio, L1L0 ratio, and singing power ratio (SPR).

Figure 6. Representative graph of the Long-term average spectrum (LTAS) for a pre-treatment in speaking voice analysis.
warm-up section, the patient produces a vowel /i/,
which is phonetically classified as a closed vowel
(semi-occluded posture). Additionally, the stretch-
ing, contraction, and low-impact adductory power
exercises in this protocol involve an inverter mega-
phone shape of the vocal tract in order to produce
the characteristic lip buzz of VFE. These required
postures in the VFE sequence may produce these
physiological and acoustic changes in the spectral
slope according to evidence of previously cited
research, thus contributing to the production of a
perceptually more resonant and bright sound.
For both VFE group and control group, the L1 L0
ratio was not statistically significant different in
either analysis of the speaking or singing voice. This
parameter is the level difference between 300800 Hz
and 50300 Hz, which provides information on
Figure 7. Representative graph of the Long-term average spectrum (LTAS) for a post-treatment in speaking voice analysis.
Vocal warm-up with vocal function exercises 133
the mode of phonation. Usually the energy of the
fundamental frequency (L0) is higher than the
energy of the first formant (F1) in breathy voices
(Hammarberg, Fritzell, Gauffin, Sundberg, &
Wedin, 1980). On the other hand, the energy of F1
is higher than the energy of F0 in normal and reso-
nant voices (more vocal fold adduction). In this
study all the subjects were singers classified with
perceptually normal voice, and most of them had a
higher value of L1 than L0 before VFE and tradi-
tional singing warm-up. The lack of statistically sig-
nificant differences in this parameter is probably
explained because the subjects voices were normal,
thus no clear physiologic change can be produced.
Interestingly, although L1 L0 values were not sta-
tistically significantly different, the median of L1 L0
increased from pre-treatment to post-treatment for
134 M. Guzman et al.
VFE group in speaking and singing voice samples.
According to evidence of previous research (Fischer-
Jorgensen, 1967; Gauffin & Sundberg, 1989;
Hammarberg et al., 1980; Kitzing, 1989), these
results would indicate that participants voices after
warm-up with VFE were less breathy because the
degree of vocal fold adduction increased, thus
it could be stated that after one session of VFE,
F0 was slightly weaker than samples taken before.
The immediate effects of VFE as vocal warm-up
had not been reported before conducting this study.
However, some recent studies performed with others
semi-occluded techniques have been carried out.
Guzman, Higueras, Fincheira, Munoz, and Guajardo
(in press) revealed similar positive results in a study
designed to assess the immediate effect of a sequence
of four phonatory exercises involving stirring straws
in a group of 24 teachers. Upon completion of the
treatment, significant improvements were found in
cepstral analysis, perturbation measurements (jitter
and shimmer), and noise measurements (harmonic-
noise ratio).
Van Lierde, Dhaeseleer, Baudonck, Claeys,
De Bodt, and Behlau (2011) carried out a study
whose purpose was to determine the impact of a
specific vocal warm-up program focused on the
improvement of the dynamics of the extrinsic and
intrinsic laryngeal muscles. The authors concluded
that there is clear evidence that warming up the vocal
mechanism is beneficial to the objective vocal quality
and the vocal performance. This vocal warm-up pro-
gram included semi-occluded postures of the vocal
tract such as pursed lips during the production of a
high-pitched sound, voiced tongue trills, resonance
exercises with the lowering of the velum, increasing
the length of the vocal tract and hand-over-mouth
technique. Results revealed a significant effect of
vocal warm-up exercises for the objective overall
vocal quality, represented by the Dysphonia Severity
Index (DSI) outcome measure. Furthermore, an
increased vocal performance (with lower intensity
and higher frequency), and increased fundamental
frequency (F0) were measured.
The results of these two previous works and the
decreased slope declination in speaking voice analy-
sis found in the present study with VFE suggest that
acoustical and physiological changes can be acquired
by performing vocal exercises with semi-occluded
postures of the vocal tract during a few minutes as
vocal warm-up.
Beside the aforementioned studies, the effect of
vocal warm-up has been previously studied through
acoustic measurements. Moreover, computerized
acoustic analysis has been previously demonstrated
as a valid and reliable tool for measuring subtle
changes in voice quality and stability (Case, 1999).
Amir, Amir, and Michaeli (1995) evaluated the
immediate effect of vocal warm-up on voice pro-
duction among young female singers using a set
of acoustic parameters. The authors concluded
that warm-up reduces the frequency perturbation
(jitter), amplitude perturbation (shimmer), and
harmonic-noise ratio (HNR). The same study also
found an increase of the singers formant amplitude
(formant located between 25003500 Hz) mea-
sured by singing power ratio (the same measure-
ment used in the present study). The authors
presented the acoustic analysis as a tool that is
sensitive to the changes produced by vocal warm-up
exercises. Blaylock (1999) studied the effect of a
systematized vocal warm-up procedure on voices
with disorders. It was noted that the waveform, the
sonogram, and the spectrogram indicate objectively
that the voice quality is affected positively by vocal
warm-ups. The waveform showed a consistent
increase in the intensity levels and a spectrogram
showed a boost in energy and distribution of the
harmonics.
Future research should explore the immediate
effect of FVE by aerodynamic and electroglotto-
graphic characteristics in order to know more
physiologic findings and relate them to the acoustic
changes. In addition, the present study, similar to
previous ones, used single before and after measure-
ments. Added support for the immediate effect of
VFE on voice quality could be obtained, therefore,
in future studies by using multiple pre-treatment and
post-treatment measures.
Conclusion
In summary, the present study demonstrates with
acoustic analysis that vocal function exercises have
an immediate effect in the spectrum of the voice.
Specifically, it leads to a greater positive effect than
traditional singing warm-up on the spectral slope
declination in speaking voice analysis (less steep
slope). The results of the present study provide
encouraging support for the continued study of the
effectiveness of VFE on voice quality as a physiologic
vocal warm-up. This study also presents the long-
term average spectrum analysis as a valuable and
sensitive tool for quantifying this effect.
Declaration of interest: The authors report no
conflicts of interest. The authors alone are respon-
sible for the content and writing of the paper.
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