{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:16:11Z","timestamp":1778055371001,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1249721N"],"award-info":[{"award-number":["1249721N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp; Comm Disor"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A promising way to obtain vocal economy and efficiency is by semi\u2010occluding the vocal tract while phonating. Current knowledge about the immediate effects of semi\u2010occluded vocal tract (SOVT) phonation on the laryngeal function and configuration is based mainly on computer modelling or excised larynges studies. In in vivo SOVT studies, electroglottography (EGG) has been the most commonly used laryngeal outcome, showing contradictory results between studies. Therefore, exploring these aspects by direct visualisation of the human larynx during SOVT phonation using strobovideolaryngoscopy (SVL) is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to investigate and compare the immediate effects of straw phonation (SP) in air, SP in 2\u00a0cm water, and SP in 5\u00a0cm water (with stirring straws), on the laryngeal function and configuration of a homogeneous group of vocally healthy female speech\u2010language pathology students, visualised with flexible SVL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedure<\/jats:title><jats:p>A randomised controlled trial was used. Fifty\u2010two female speech\u2010language pathology students (mean age: 18.7 years, SD: 0.6) were assigned randomly to one of three experimental groups or a control group: (1) SP in air, (2) SP in 2\u00a0cm water, (3) SP in 5\u00a0cm water or (4) [u] phonation with similar soft onset and slightly pursed lips as in SP but without a straw (control group). The participants underwent flexible SVL during habitual [u] phonation, followed by the specific SOVT exercise of their group assignment. All video samples were evaluated randomly and blindly by two experienced investigators using the Voice\u2010Vibratory Assessment with Laryngeal Imaging (VALI) rating form, first independently and then by consensus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome &amp; Results<\/jats:title><jats:p>Compared to habitual phonation, the vibrational amplitude decreased during SP in 5\u00a0cm water and SP in 2\u00a0cm water, being more prominent in the first, more flow\u2010resistant exercise. The mucosal wave also decreased during SP in 5\u00a0cm water. The anteroposterior (AP) supraglottic compression similarly increased during SP in air, SP in 2\u00a0cm water, and SP in 5\u00a0cm water. Further, a rise in mediolateral (ML) compression and a decrease in phase symmetry and regularity were found during SP in 2\u00a0cm water. A similar decrease in regularity was observed during SP in 5\u00a0cm water.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>Both SP in air and SP in water cause positive immediate laryngeal effects for voice training opportunities. More AP supraglottic activity found during each SP exercise might indicate epilarynx narrowing, an economic phenomenon associated with SOVT. Immersing the straw in water additionally diminished the vibrational amplitude, lowering vocal fold impact stress and risk for phonotrauma during the exercise. The decreased regularity of the vibrational cycles during SP in water might be due to the varying back pressure created by the water bubbling. The impact of SP in water on ML supraglottic compression needs further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>What This Paper Adds<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p>A promising way to obtain vocal economy and efficiency is by semi\u2010occluding the vocal tract while phonating. Current knowledge about the immediate effects of semi\u2010occluded vocal tract (SOVT) phonation on the laryngeal function and configuration is based mainly on computer modelling or excised larynges studies. In in vivo SOVT studies, electroglottography (EGG) has been the most commonly used laryngeal outcome, showing contradictory results between studies. Therefore, exploring these aspects by direct visualisation of the human larynx during SOVT phonation using strobovideolaryngoscopy (SVL) is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p>Group results of the current study generally support earlier computer modelling and in vivo studies, strengthening the current SOVT knowledge. Both SP in air and SP in water cause positive immediate laryngeal effects for voice training opportunities. More anteroposterior (AP) supraglottic activity found during each SP exercise might indicate epilarynx narrowing, an economic phenomenon associated with SOVT. Immersing the straw in water additionally diminished the vibrational amplitude, lowering vocal fold impact stress and risk for phonotrauma during the exercise. The decreased regularity of the vibrational cycles during SP in water might be due to the varying back pressure created by the water bubbling. The impact of SP in water on ML supraglottic compression needs further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p>Current results support that both SP in air and SP in water can be useful exercises in voice training. SP in water has shown the additional gain of lowering the vibrational amplitude during the exercise, hence supporting its appropriateness for vocal warm\u2010ups by minimising vocal fold impact stress and the risk of phonotrauma. In the future, large\u2010scale randomised controlled trials in other subgroups of voice users, including dysphonic patients, are needed to support evidence\u2010based practice. SVL can facilitate the search for individualised training and therapy approaches.<\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12838","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T08:28:04Z","timestamp":1675240084000},"page":"944-958","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Immediate effects of straw phonation in air or water on the laryngeal function and configuration of female speech\u2010language pathology students visualised with strobovideolaryngoscopy: A randomised controlled trial"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1147-1708","authenticated-orcid":false,"given":"Iris","family":"Meerschman","sequence":"first","affiliation":[{"name":"Centre for Speech and Language Sciences, Department of Rehabilitation Sciences Ghent University  Ghent 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