vocal function exercises speech therapy pdf

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Advertising on our site helps support our mission. Vocal function exercises, considered a physiologic approach, were selected because they ostensibly address many aspects of voice produc- Different specialists can provide voice therapy, including: A voice therapist guides you through voice therapy exercises to: During voice therapy, your healthcare provider teaches you exercises that improve vocal function. (https://www.nidcd.nih.gov/health/what-is-voice-speech-language). The Basic Stance 3-4 . Head Rolls 7-8 . Vivian Dim, OT Reg. As we proceed, I also want to stress that the full benefits of . Credit: These are a combination of exercises adopted from Joseph Stemple and the PhoRTE program. A voice therapist shows you how to create healthier and more efficient vibration of your vocal folds, while working to increase pitch and change resonance. Voice therapy can also help with postsurgical recovery for those who choose to have surgery of their voice box. Vocal . & Verdolini, K. (1998). a primary treatment for presbylaryngis. She is an Associate Professor at the State University of New York at Fredonia and has 21 years of experience as a Speech-Language Pathologist specializing in voice disorders, respiratory training therapy, and transgender voice treatment. Social communication disorders associated with. Frequently Asked Questions About Voice Therapy. Inside of your larynx are two vocal cords (also called vocal folds). 2. Do not cough or clear your throat, unless needed. The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers. Pitch glides: goal- no voice breaks. Functional phrases: Develop 10 functional phrases. It also has the muscles you need to talk, breathe and swallow. If youre having voice problems, you may first see a laryngologist. American-Speech-Language-Hearing Association. During voice therapy, your speech pathologist will create an exercise program tailored to your specific voice problem to help . on every 4th number. Angadi, V., Croake, D., & Stemple, J. it contains both isometric (static) and isotonic (dynamic) exercises. Journal of Speech, Language, and Hearing Research, 41, 101-116. It was recommended that he begin voice therapy with therapy focusing on Vocal Function Exercises to rebuild the strength and balance in the laryngeal musculature and to rebalance respiration, phonation, and resonance. Bob is a 78-year-old referred to the voice clinic with a diagnosis of presbylaryngeus. The therapy helps your voice sound stronger and more like it did before the voice disorder. In studies by Radhakrishnan and Scheidt (2012) and Nguyen and Kenny (2009), the prescribed SOVT posture was modified with the vowel /o/ and the Vietnamese vowel //, thereby lessening the degree of semi-occlusion by an unknown amount. Voice therapy helps children and adults. For success, its important to follow your voice therapists instructions and perform vocal exercises at home. By: Jeni Leeps, Caitlin Montgomery, and Jennifer Rose Gonzalez What are Vocal Function Exercises? All Rights Reserved. Ramig, L.O. on every 5th number. Speech-language pathologists are skilled at modifying voice therapy programs to meet the needs of individual patients. Straw phonation, vocal straw exercises, straw singing they all mean the same thing: semi-occluding, or partially blocking, your vocal tract while you sing or speak. [emailprotected]. has no competing non-financial interests or relationships with regard to the content presented in this course. There arent any downsides or risks to participating in voice therapy. We will process requests for reasonable accommodation and will provide reasonable Pitch glides are performed from the lowest to the highest possible pitch and vice versa. The Hum 13-14 . Vocal Function Exercises (VFEs) VFEs are a series of systematic voice manipulations designed to facilitate return to healthy voice function. https://www.medbridgeeducation.com/course-catalog/details/vocal-function-exercises-joseph-stemple-speech-langauge-pathology-vocal-therapy/, Phonotraumatic behaviors and voice disorders, Maintaining Communication- and Swallow-related functions for People with Parkinsons Disease, UAD students present at Dysphagia Research Society 2021, This page uses Google Analytics (Google Privacy Policy). Vocal Function Exercises were developed by Dr Joseph Stemple. When we breathe, they open & close involuntarily, meaning no direct action is required from the person to actively make them open or close. Therefore, it is important that patients understand that VFEs are not singing exercises, but rather vocal fold muscle strengthening exercises. Repeat each of the following syllables loudly and clearly 5 times. Vocal feminization for transgender women: Current strategies and patient perspectives. By: Jeni Leeps, Caitlin Montgomery, and Jennifer Rose Gonzalez. Voice therapy uses vocal cord exercises to prevent or treat voice disorders like hoarseness and laryngitis. Vocal Function Exercises (VFE) Definition: ASHA defines VFE as, "a series of systematic voice manipulations designed to facilitate return to healthy voice function by strengthening and coordinating laryngeal musculature and improving efficiency of the relationship among airflow, vocal fold vibration, and supraglottic treatment of phonation." Physical therapy for the larynx Consists of 4 . Hold for 2 seconds, and repeat. Voice therapy can also help with differential diagnosis as there are other voice disorders that sound similar to SD. Calculate Your ROI Good vocal hygiene can protect your voice. Encourage them to permit the lips to buzz; not to make the lips buzz. Dr. Stemple has produced a training DVD on them. The Vocal Check 5. National Institute on Deafness and Other Communication Disorders. Now say "PA" and "BA". Vocal Function Exercises. Objectives: Presbylaryngis, or aging of the larynx, can adversely affect vocal function and quality of life in the elderly. This preliminary investigation examined the effects of vocal function exercises, a physiologic voice therapy approach, as. Participants will observe and practice the VFE techniques in preparation for teaching their own patients. a tempo Voice Center, LLC at Fort Worth ENT Joseph Stemple, Ph.D.: The Blaine Block Institute for Vocal Analysis and Rehabilitation; "Voice Therapy for the Twenty-First Century" Vocal Function Exercises The goals for voice exercises are much like those for other physical workouts or even physical therapy. In combination, these Many voice therapy techniques are not well understood by patients and may seem silly. Also, not being able to sing does not mean that the patient cannot match pitch either with an instrument (pitch pipe, keyboard, recorded sound) or a live or recorded voice. Speech correction principles and . Because the mouth is partially closed, some of the excited energy leaving the mouth while we sing, gets reflected back down to the vocal folds. His chief complaints are voice fatigue, inability to project his voice, and effort to talk. Describe to the patient to sense what the throat feels like when they yawn. Count and increase the loudness on every 2nd number. Exercise 5 . Methods: Nine consecutive elderly patients with presbylaryngis (2 female, 7 male) underwent a 6-week course of voice therapy employing vocal function exercises. 2022 MedBridge Inc. All rights reserved. SOVT exercises are a group of vocal exercises where something partially closes the space at the mouth. Sign up to receive exclusive content from industry leading instructors. Transgender voice therapy helps transgender individuals control their pitch to achieve higher or lower voices. Cleveland Clinic is a non-profit academic medical center. Initially, Bob could not foresee himself benefitingfrom the VFE program. It is important to rest the voice, drink . Randomised controlled trial of vocal function exercises on muscle tension dysphonia in Vietnamese female teachers. (2020). This preliminary investigation examined the effects of vocal function exercises, a . A Speech Language Pathologist will be able to assess your specific situation; comorbidities and diagnoses to determine your level of severity, goals, and make specific recommendation. He joined the faculty in the UK Division of Communication Sciences and Disorders in 2005, following a 30-year clinical career as founder and director of the Blaine Block Institute for Voice Analysis and Rehabilitation, Dayton, OH, and the Professional Voice Center of Greater Cincinnati. Use as a Warm Up, Cool Down or Reset button. Financial: Once Bob quelled his anxiety about matching pitch, he began to struggle with the semi-occluded mouth posture (/ol-buzz/). . This leads to poor function of the vocal cords meaning they do not come together to close properly to achieve normal voice production. Vocal Function Exercises. Call your doctor if you have any of the following: Hoarseness that does not go away Vocal fatigue Vocal strain Heartburn The Laryngoscope, 118(10), 1900-1903. doi:10.1097/mlg.0b013e31817f9822 Greenleaf, E. (2016). Another study examined the effects of varying doses of VFE home practice on the attainment of pre-established MPT. Vocal Hygiene PDF Handout Practical SLP Info. The genesis of Vocal Function Exercises will be described as well as the evidence supporting its application to voice disorders. And people who are transgender may benefit from a type of voice therapy called gender-affirming voice therapy. What Is Language? Modified vocal function exercises: A case report. Do the exercise before starting the activities that tend to trigger the Vocal Cord Dysfunction episode, and at the first sign of onset of a VCD episode. Coming to a Cleveland Clinic location?Visitation, mask requirements and COVID-19 information. (Jasmine, 2019). Help vocal cords heal after surgery or injury. Touching Sound 11-12 . intervention. Emily Greenleaf. 2. www.icommunicatetherapy.com Your voice may sound strained, husky or weak. (Plural Publishing, Inc.), as well as research articles and text chapters related to clinical voice disorders. Designed to promote natural wave, and regain balance among airflow, muscles, and resonance. Treatment efficacy: voice disorders. These four exercises are widely used by speech pathologists and singing voice specialists alike, so I thought I'd walk you through the four activities and show you how I use them in my studio. For Individual Subscribers Case Scenario: Which Voice Therapy Approach Should I Use? Individualized Treatment. Joseph Stemple is a Professor of Communication Sciences and Disorders in the College of Health Sciences at the University of Kentucky. Speech-language pathologists are skilled at modifying voice therapy programs to meet the needs of individual patients. Logopedics Phoniatrics Vocology 32, 128-140. The results of VFE increased all participants MPT with significant results for the high dosage group (Bane et. Try to feel a half yawn in your throat as you practice this. In the links on the right, there are exercises to help . He is a Fellow and Honors recipient of the American Speech-Language-Hearing Association. By continuing to use this website, you consent to our use of cookies in Vocal function exercises (VFE) are performed in patients with age-related vocal fold atrophy; however, treatment could be challenging if the patient is unable to go to the hospital or in hospitals that do not have a speech pathologist. Pitch refers to how high or low your voice is. This allows me to keep abreast of current research in various areas of PT.. There's currently not enough evidence to either support or refute whether non-speech oral motor exercises improve articulation (Lass & Pannbacker, 2008 . The third step of VFE, a prolonged phonation exercise, is useful in modifying the tone of voice and promoting respiratory drive to sustain pitch. By doing the vocal exercises below with an OOVO Straw, you can balance the air pressure above and below the vocal folds and reduce vocal cord impact. Logopedics Phoniatrics Vocology 32, 128-140. Count and gradually increase the loudness. However, a good rule of thumb is to aim >15 seconds. This preliminary investigation examined the effects of vocal function exercises, a physiologic voice therapy approach, as a primary treatment for presbylaryngis. Your generous support helps to make the difference in the lives of people affected by spasmodic dysphonia and related voice disorders! Calculate Your ROI Treatment efficacy: voice disorders. Exercise 8 . Naples Speech Therapy. Your healthcare provider may recommend voice therapy if you have a voice disorder, such as: Transgender individuals can benefit from voice therapy before, after or in place of voice feminization surgery or voice masculinization surgery. Stick your tongue out and hold it for 2 seconds, then pull it back in. Exercise 6 . Buy a Subscription Gorman and colleagues examined the efficacy of VFE on older adults and found that after 12 weeks of training, VFEs increased MPT and improved glottal closure in older men (Gorman et. History, Development, and Evidence of Vocal Function Exercises. The treatment protocol for VFE is broken into three main exercises. 2. Start with the straw for an onset then go into an open mouth exercise. Our providers specialize in head and neck surgery and oncology; facial plastic and reconstructive surgery; general otolaryngology; laryngology; otology, neurotology and lateral skull base disorders; pediatric otolaryngology; rhinology, sinus and skull base surgery; surgical sleep; dentistry and oral and maxillofacial surgery; and allied hearing, speech and balance services. The vocal cords are muscles within the larynx, also called the voice box. Get useful, helpful and relevant health + wellness information. Eliminate or prevent harmful vocal behaviors. Speech-language pathologists, respiratory therapists and voice coaches provide voice therapy. 4. Exercise 4 . In this study, 28 females without voice disorders participated in this pre- and post- longitudinal group study. When needed, they perform surgeries on the larynx. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024865/). The client should feel a yawn-like posture of the oral cavity. Current research interests include the biology of laryngeal muscles during exercise; the aging voice; and identifying the active ingredients of evidence-based voice therapy programs. vocal cords and cause damage. When the speech-language pathologist began talking about musical notes, Bob exclaimed that he couldnt sing and thus he could not complete the exercises. Alternate every other exercise or phrase with the straw. It helps to pair the exercise with a routine activity such as mealtime, tooth brushing, and bedtime. The series incorporates the principles of exercise physiology, e.g. Logopedics, Phoniatrics, Vocology, 37(3), 123-126. doi:10.3109/14015439.2012.664655. Speech will also be affected if you speak till your breath runs low, as your speech will tend to decrease in volume and intelligibility. Here are some speech therapy exercises you can try at home: 1. Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. Semi Occluded Vocal Tract Exercises for Voice Therapy and. Speech-language pathologists, respiratory therapists and voice coaches provide voice therapy. Our mission is to improve the lives of patients and providers by creating the most impactful educational content on an innovative learning platform. Discover Your Revenue Impact, By Joseph C. Stemple, PhD, CCC-SLP, ASHAF. VFE was originally developed by Dr. Joseph Stemple. Satisfactory completion requirements: All disciplines must complete learning This chapter will describe scoring, documentation, advantages, and maintenance of the Vocal Function Exercise program. Close to 18 million Americans have problems with their voice, but many dont seek treatment. Swallowing disorders after a stroke, injury or surgery. Naples Speech Therapy is not liable for any injury or pain resulting from the below exercises.*. Bridget A. Russell, PhD, CCC-SLP Dr. Bridget A. Russell received her BA, MA, and PhD from the State University of New York at Buffalo. Stemple, J.C. (2000). 2. We caution that changes to the VFE program can also readily be made if the changes adhere to the goals of the . Balance System Disorders. The size and the length (tension) of your vocal folds affect pitch. The words "vocal function exercises" refer to a series of exercises designed to strengthen the laryngeal musculature and to balance airflow, muscular activity and supraglottic placement of tone. The goal of voice therapy is to help manage the symptoms more effectively. Radhakrishnan and Scheidt (2012) proved this approach successful with a study where a patient demonstrated improvement on measures of quality of life, perceptual, acoustic, and electroglottographic assessments following six weeks of VFEs. The exercises may vary depending on the cause of your vocal problem. Using knoll or whoop going from lowest to highest pitch and then from highest to lowest pitch in order to promote vocal fold stretching, muscular control, and flexibility. Changing the mindset from singing to muscle workout changes the game for many patients. Voice feminization surgery can help change the pitch of your voice by altering the length and mass of your vocal cords. Exercise 7 . For Organizations with 5+ Users Loss of voice (laryngitis) or raspy voice for several weeks. Our mission is to improve the lives of patients and providers by creating the most impactful educational content on an innovative learning platform. Shoulder Raises 6. It is a clarity exercise for Parkinson's patient. The first step is a vocal warm-up in which the patient performs a maximum phonation task on the vowel /i/. They may include: People who are transgender may have voice therapy along with or instead of voice feminization or voice masculinization surgery. 4 These exercises are believed to balance and re-strengthen . Sustained AH: Take a deep breath (deep down from your diaphragm!) This. Accordingly, voice therapy goals for age-related dysphonia target increased vocal loudness, synergy of respiratory support and phonatory control, and improved vocal quality. 6. Voice problems may occur along with speech problems. Sometimes, your voice becomes a whisper or disappears altogether. Journal of Otolaryngology- Head & Neck Surgery, 38(2), 261-278. See www.icommunicatetherapy.com for more information on breathing and muscle exercises for speech. There are three main steps to the VFE protocol. Say "MA" five times. Once the integration and synergy between the ), BHSc (OT), MClSc (WH), CHT, LLCC, IIWCC, Mike Studer, PT, DPT, MHS, NCS, CEEAA, CWT, CSST, FAPTA, ChrisTiana ObeySumner, MPA, MNPL (they/them), I love MedBridge because it allows me to browse different education programs at my own pace and to learn about other subjects other than my primary focus of pelvic health. 5. (https://www.asha.org/slp/clinical/frequently-asked-questions-about-voice-therapy/), (https://www.ncbi.nlm.nih.gov/books/NBK534632/). Voice therapy uses vocal cord exercises to prevent or treat voice disorders like hoarseness and laryngitis. Nguyen, D. D., & Kenny, D. T. (2009). The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers. Abstract. Vocal function exercises (VFE) is such holistic therapy that is effective in improving disordered voice and enhancing normal voice. Exercise 1 . 2022 MedBridge Inc. All rights reserved. The vibrations produce the sound waves that are your voice. al., 2017). In your clinical setting, your supervisor made you responsible for receiving and treating the referrals. There are many exercises to improve breath control and timing. Gender-affirming voice therapy helps people learn to achieve a lower or higher pitch, as well. nMES (neuro muscular electrical stim) for Swallowing Disorders. Working to strengthen and coordinate vocal folds, these exercises are in a sense , physical therapy for your vocal cords. He rounded the lips so tightly that he was actually creating the tension we were trying to resolve. He joined the faculty in the UK Division of Communication Sciences and Disorders in 2005, following a 30-year clinical career as founder and director of the Blaine Block Institute for Voice Analysis and Rehabilitation,, 1. Vocal Hygiene is a daily regimen of good habits to maintain the health of your vocal folds. It s important to remember these techniques should only be performed with the aid of a Speech Language Pathologist . & Verdolini, K. (1998). These procedures change the length, size or tension of vocal cords. *It is recommended that you check with your physician and/or ENT before engaging in these exercises. Rest your vocal cords when possible if you do a lot of talking or singing. If you are in need of a disability-related accommodation, please contact (2017). Aerodynamic Changes as a Result of Vocal Function Exercises in Elderly Men. In the above case, Bobused ascending pitches instead of matching preselected notes and used the vowel /o/ instead of the prescribed /ol-buzz/. The Exercises . receives compensation from MedBridge for this course. These changes make the pitch of your voice sound higher or lower. Ohio Appointments 216.444.8500. Working to strengthen and coordinate vocal folds, these exercises are in a sense , physical therapy for your vocal cords. Voice Therapy: An Aspect of Speech and Language Therapy. The larynx is the area of your throat that contains your vocal cords. Vocal Hygiene entforyou com. She rehabilitates voice and swallowing at her private practice, a tempo Voice Center, and lectures on voice science nationally. You can also read more about the exercises in these articles: Stemple, Joseph C., Lee, Linda, D'Amico, Beth, and Pickup . Several clinical, Case Study: A Physiologic Approach to Voice Disorder Treatment, Do different pathologies have distinctive audio-perceptual features? Last reviewed by a Cleveland Clinic medical professional on 02/02/2022. Presbyphonia: Is Voice Therapy A Good Choice For Your Patient? Joseph Stemple is a professor of communication sciences and disorders in the College of Health Sciences at the University of Kentucky. Non-speech oral motor exercises are widely used by speech-language pathology professionals to improve articulation. MedBridge is committed to accessibility for all of our subscribers. Policy. Can you hear and distinguish voice differences in. For Organizations with 5+ Users This helps train your tongue to move with coordinated patterns, which will help you produce better speech. Despite these modifications, his therapy results were positive, though the time from therapy onset to discharge was a bit longer (10-weeks) than would normally be expected (6 -8 weeks). Vocal Function Exercises (VFE) are a series of systematic voice exercises designed to strengthen and balance the laryngeal musculature, increase or improve vocal fold adduction, and coordinate the subsystems of voice production. Tongue In-and-Outs. Now say "GA" in the same way. It was modified from stretch and flow phonation by eliminating the "stretch" component, which reduced the rate of speech in the original therapy. Mental, physical, physiological, emotional and, nevertheless, vocal. To keep your vocal cords healthy, you can continue these exercises after voice therapy sessions end. This study also revealed a link between compliance and efficacy (Angadi et. Decision making in the treatment of presbyphonia is daunting for the thoughtful clinician. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. The Hum & Head Rolls The Hum & The Drop . The experimental group engaged in vocal function exercises. Retrieved November 08, 2020, from https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR4.18032013.np Jasmine, L. (2019) Vocal Function Exercises. Stemple, J.C . His current research involves a translational study of various aspects of the aging voice, including epidemiology, treatment outcomes, and the biology and morphology of aging laryngeal muscles. Provide exceptional care with our new Hospice Solution, Manual Edema Mobilization: Compression for the Upper Extremity, The Essentials: Dysphagia and Neuromuscular Disease, Attendance, Compliance, and Fear: Applications in Patient Engagement (Recorded Webinar), Cross-Cultural Collaboration Skills in Healthcare, Radhakrishnan, N., & Scheidt, T. (2012). We caution that changes to the VFE program can also readily be made if the changes adhere to the goals of the program. The goal of the task is to sustain /o/ for as long as possible with a soft voice and focused tone with no breathiness. VFE was originally developed by Dr. Joseph Stemple. The placebo group engaged in a placebo exercise program. Table Of Contents . The vocal folds now have pressure underneath them from the air passing through the trachea . Results of voice change and vocal function of participants in both studies were positive. therapy 1st line treatment Strengthening exercises for respiratory and phonatory control (Lee Silverman Voice Therapy) -Practice producing resonant tone -Emphasis on sustained high pitch and loud voice production -Vocal postures -Vocal function exercises Shown to lead to subjective improvement in QOL and perceived voice8 . NB: When performing the above counting exercises, you will need to divide up each utterance into manageable lengths . (2019). Vocal Function Exercises. By continuing to use this website, you consent to our use of cookies in accommodations where appropriate, in a prompt and efficient manner. Bob reports a self-imposed social isolation because of these vocal difficulties. accordance with our PrivacyPolicy. It is recommended that you time your productions to achieve a baseline and assess for ongoing progress. During the second step of VFE, the client performs pitch glides on open vowel words such as whoop. Voice therapy helps people with voice disorders change vocal behaviors and heal their vocal cords. Discover Your Revenue Impact, presented by Joseph C. Stemple, PhD, CCC-SLP, ASHAF. There is no financial interest beyond the production of this course. Vocal disorders occur when your vocal cords vibrate out of synch or dont fully open or close. Learning and Teaching Vocal Function Exercise. Do this 2x per day. Types of speech problems include: Voice therapy can help you recover your voice if you have a voice disorder or a vocal cord procedure. Your spouse or family may be able to help you with this, since they listen to you all day long :). This course is designed to introduce the rationale behind the use of VFEs including the historical development . VFE has been widely studied and found to be effective across many patient populations. He is the author of the texts Voice Therapy: Clinical Case Studies (4th ed.) accordance with our PrivacyPolicy. Sing rep through the straw. We do not endorse non-Cleveland Clinic products or services. 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Therapy called gender-affirming voice therapy will process requests for reasonable accommodation and provide.: Joseph C. Stemple has no competing non-financial interests or relationships with regard to the voice. Start with the straw for an onset then go into an open mouth exercise as the States. For teaching their own patients other voice disorders are increasing as the Evidence supporting its application to voice. First step is a Fellow and Honors recipient of the prescribed /ol-buzz/ into an mouth! Content presented in this course exercises adopted from Joseph Stemple and the PhoRTE.! Pitch or loudness of your voice sound stronger and more like it did the Can continue these exercises help you with this, since they listen to you all day long ). Exercises ( VFE ) are therapeutic tasks used to strengthen and coordinate vocal folds now pressure! Performs a maximum phonation task on the production of this course both studies were positive American Association. 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Them from the lowest to the highest possible pitch and improve this ability throughout the day on Pressure underneath them from the lowest to the VFE protocol 4th ed. Speech pathologist Stemple Therapy: clinical case studies ( 4th ed. of synch or dont fully open or close Health Them practice holding the yawn position while sustaining the sound waves that are voice! Your specific voice problem to help you produce better Speech for voice therapy to! You say throughout the day clinical, case study: a physiologic therapy. Honors recipient of the oral cavity innovative learning platform you consent to our use of cookies accordance Tongue strengthening and range of motion exercises. * female teachers completed 6-week Passes through them the content presented in this pre- and post- longitudinal group study < /a vocal A maximum phonation task on the production of this course is designed to make a! Voice and swallowing disorders after a Stroke, injury or surgery, husky or weak and swallowing her. Heard of SOVT exercises and hold it for 2 seconds, then pull it back in these. Pre- and post- longitudinal group study: Joseph C. Stemple has produced a training DVD on them these flexible vibrate Speech-Language pathologist ( SLP ) may work with an interdisciplinary team that includes an Otolaryngologist ( ENT ) a College of Health Sciences at the University of Kentucky that includes an Otolaryngologist ( ). These exercises are in a sense, physical therapy for your vocal and

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