Voice Care India-A New Project By Medical Advance Research Foundation (Dr.M.Kumaresan

Tholkappiyam leads Bernoulli’s Phenomenon in voice Production and Maintenance

Aim of the study:

The main aim of our seminar is to prevent disease & develop a health peaceful life.We aims to train the individual to maintain a strong, clear and melodious voice, effective voice, warm – ups, strategies for coping with vocal difficulty and techniques that benefit to perform better in the career.

Introduction:
We got interest on this subject through our Tamil literature “Tholkappiam”. It clearly indicates that voice is originated in the lower abdomen. Many literatures clearly suggest that voice produced in the larynx may leads to strain too much if the voice is initiated in the throat. To avoid strain in the throat the voice has to be initiate from the lower abdomen.
Millions of people have voice problem and lost their career due to their voice problem. We mainly concentrate on teachers who are having 20% voice problems. We have conducted many programmes to the professional voice users to protect their voice from misuse, overuse and abuse. We found improvement in 10% in voice quality and 100% in their physical wellbeing.
On the basis of this Tamil literature, we got a special interest on voice research and voice maintenance, especially for professional voice users.

Subject and Period of study:

What is voice?

We relay on our voices to inform, persuade, and connect with other people. Your voice is as unique as your fingerprints. Many people you know use their voices all day long, day in and day out. Singers, Teachers, Doctors, Lawyers, Nurses, Sales people and Public Speakers are among those who make great demands on their voices. Unfortunately, these individuals are most prone to experiencing voice problems. It is believed that 7.5 millions people have diseases or disorders of voice. Some of these disorders can be avoided by taking care of your voice.

Cause of voice problems:

Causes of vocal problem may include upper respiratory infections, inflammation caused by acid reflex, vocal misuse and abuse, vocal nodule or laryngeal papillomatosis(growth), laryngeal cancer, neuromuscular disease(such as spasmodic dysphonia or vocal cord paralysis), and psychogenic conditions due to psychological trauma. Keep in mind that most voice problems are reversible and can be successfully treated when diagnosed early.

Voice production:

Voice as We Know It = Voiced Sound + Resonance + Articulation
The "spoken word" results from three components of voice production: voiced sound, resonance, and articulation.
Voiced sound: The basic sound produced by vocal fold vibration is called "voiced sound." This is frequently described as a "buzzy" sound. Voiced sound for singing differs significantly from voiced sound for speech.
Resonance: Voiced sound is amplified and modified by the vocal tract resonators (the throat, mouth cavity, and nasal passages). The resonators produce a person's recognizable voice.
Articulation: The vocal tract articulators (the tongue, soft palate, and lips) modify the voiced sound. The articulators produce recognizable words.
Voice Depends on Vocal Fold Vibration and Resonance
Sound is produced when aerodynamic phenomena cause vocal folds to vibrate rapidly in a sequence of vibratory cycles with a speed of about:
110 cycles per second or Hz (men) = lower pitch
180 to 220 cycles per second (women) = medium pitch
300 cycles per second (children) = higher pitchhigher voice: increase in frequency of vocal fold vibrationlouder voice: increase in amplitude of vocal fold vibration.
The following symptoms suggest unhealthy voice: Hoarseness, Vocal fatigue, Inability to speak/sing loudly, Throat pain, Cough, Increased throat phlegm, Throat clearing habit
Period of study:
For the past one year we have conducted several voice care programmes in various schools and colleges and found that 20% of teachers had voice problems, Many of the teachers had recovered from their problem by following our tips and exercise.
Basic principle of the study:
The basic principle of our study is “Bernoulli’s Principle”. The principle states that "the pressure of a fluid [liquid or gas] decreases as the speed of the fluid increases." Within the same fluid (air in the example of aircraft moving through air), high-speed flow is associated with low pressure, and low-speed flow is associated with high pressure.
In our study the same concept can be taken as that when the air passes through a narrow orifice it creates negative pressure in the surroundings. So if sufficient air is pushed through the vocal cord it brings the vocal cord together and vibrates. Sound is produced in the vocal cord by this maneuver. By this principle we can create sound in the vocal cord without any strain in the neck. What we needed is only good breathing capacity and a simple training to use the diaphragmatic breathing for a prolong expiratory air flow to vibrate the vocal cord in adducted position.
Basic exercise for care of the voice:
Breathing Exercise:1. Cervical Breathing2. Chest Breathing3. Abdominal Breathing4. Vital Breathing
The following simple yoga will give you a clear idea of Complete Breath :
Stand or sit erect. Breath through the nostrils, inhale steadily, first filling the lower part of the lungs, which is accomplished by bringing the diaphragm down, which descending exerts a gentle pressure on the abdominal organs, pushing forward the front walls of the abdomen. Then fill the middle part of the lungs, pushing out the lower ribs, inter costal muscle and chest. Then fill the higher portion of the lungs, protruding the upper chest, thus lifting the chest, expanding the upper of ribs. In the final movement, the lower part of the abdomen and other parts of the genitals will be slightly drawn up. This will give fixation of the chest and support the entire body. Hold the breath, which gives the lungs a support and also helps to fill the apex of the lungs. The apex of the lung is the region where oxygen concentration is less and so any infection can lodge and spread. It is well known that T.B affects first apex of the lungs and called as apical tuberculosis. T.B bacilli grow well in less oxygen concentration and so the bacillus is called as facultative anaerobic.
Vital breathing stretches and giving vital oxygen to the organs situated in the lower part of the abdomen. Doing vital breathing exercise definitely help to improve the function of the reproductive system. The effect of the reproductive organs upon the general health is too well known.The Complete Breath produces a rhythm which is Nature's own plan for keeping this important part of the system in normal condition. It will be noticed that the reproductive functions are strengthened and vitalized, by sympathetic reflex action, giving tone to the whole system.
The Physical Benefits of Breathing Properly:
Over 90% of people have restricted breathing patterns that limit the available air by 10% or more. This limitation creates stress and increases the probability that the body’s major systems will not function properly. Many processes are affected by our body’s inability to breathe fully, but let’s just focus on one aspect, oxygen.• Without oxygen the body cannot operate properly. Oxygen drives everything in the body. In fact, over 90% of the body’s energy is generated through these means. If the body does not have enough oxygen, it will create energy through less efficient anaerobic means. • Oxygen is also used to create a dry cell state. This assists the cells in removing waste products, distributing them into the interstitial fluids where the lymphatic system removes them from the body.• Oxygen supports the immune system.• Mental acuity is enhanced by increased blood oxygen.• Blood toxins like carbon monoxide are neutralized through adequate oxygen supplies.• Many diseases thrive in low oxygen environments. In fact, if a cell loses 60% of its oxygen, it becomes cancerous. This was discovered by Otto Warburg, a scientist who won a Nobel Prize for his work. • Common viruses and bacteria also do not live in an oxygenated environment. Maybe this is why I have not been sick over the last few years.
Hypertension has been shown to respond favorably to a daily regimen of diaphragmatic breathing (a form of breathing that only focuses on breathing in the belly), and it shows impressive improvements in treating anxiety states. I have also witnessed the healing of those suffering from asthmaBenefits also accrue to heart patients.
These are some other conditions that can benefit from conscious breathing: Pain Control, Phobias, PMS, Headaches, Addictions, Infertility, Digestive Ailments, TMJ, Easing Birth Process, Sleep Apnea, and Post Surgery Recovery.
Program Goals: Voice Therapy Regimens:
To develop a basic understanding of the 1. Resonant voice therapy.
Mechanics of voice and speech production. 2. Confidential Voice.
To learn of the foundations for vocal health 3. Circumalaryegeal massage.
And explore the relationship between the 4. Lee Silverman Voice Treatment.
Voice and physical and emotional health. 5. The Accent Method.
To examine the differences between good 6. Vocal Function Exercises.
Voice use, voice misuse and voice abuse. 7. Singing Therapy.
To identify and learn to compensate for 8. Phonation and Inhalation.
Difficult speaking situations, both and off the 9. Reflexive and Vegetative Behaviors.
Job. 10. Voice therapy for Puberphonia.
5. To learn to recognize postural Imbalance and 11. Auditory Integration Training.
To restore more optimal Posture, especially in 12. Speech Therapy with Palatogram.
Speaking situations. 13. Self – Relaxation.
6. To recognize specific muscle misuse and relearn 14. Positive Thinking.
easy coordinated use of the vocal 15. Self-Hearing.
System, by exploring how muscles in the breathing 16. Mind-Reading.
system, larynx and vocal track work together in 17. Vision-Speaking.
free and natural voice production. 18. Mirror-Practice.
To work towards a voice that is free and 19. Auto-Suggestion.
Responsive in all speaking situations. 20. Teleprompter.
21. Shavasana.
Methods of presentations – Live video presentation & Materials:
I phase – Anatomy of voice Production.
II phase – Physiological of voice Production.
III phase – Abuse and Misuse of Voice.
IV phase – Pathological changes in the Voice producing Materials.
V phase – What are the steps can be taken.
VI phase – What are the facilities that Siva ENT Hospital is having:
1. Video photoing of voice box.
2. Recording of the voice.
3. Creation og database of the patient.
4. Finding out the anatomical change in Voice box.
5. Finding out physiological changes.
6. Reverting the pathology to normal by:
(a) Physio Therapy,
(b) Accu pressure,
(c) Massage,
(d) Speech Therapy,
(e) Yoga,
(f) Meditation.
Tips to the Professional voice users:
Limit your intake of drinks that include alcohol or caffeine. These act as diuretics (substances that increase urination) and cause the body to lose water. This loss of fluids dries out the voice. Alcohol also irritates the mucous membranes that line the throat.
Drink plenty of water. Six to eight glasses a day is recommended.
Don't smoke and avoid second-hand smoke. Cancer of the vocal folds is seen most often in individuals who smoke.
Practice good breathing techniques when singing or talking. It is important to support your voice with deep breaths from the diaphragm, the wall that separates your chest and abdomen. Singers and speakers are often taught exercises that improve this breath control. Talking from the throat, without supporting breath, puts a great strain on the voice.
Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or esophagus (reflux).
Use a humidifier in your home. This is especially important in winter or in dry climates. Thirty percent humidity is recommended.
Try not to overuse your voice. Avoid speaking or singing when your voice is hoarse.
Wash your hands often to prevent colds and flu.
Include plenty of whole grains, fruits, and vegetables in your diet. These foods contain vitamins A, E, and C. They also help keep the mucus membranes that line the throat healthy.
Do not cradle the phone when talking. Cradling the phone between the head and shoulder for extended periods of time can cause muscle tension in the neck.
Exercise regularly. Exercise increases stamina and muscle tone. This helps provide good posture and breathing, which are necessary for proper speaking.
Get enough rest. Physical fatigue has a negative effect on voice.
Avoid talking in noisy places. Trying to talk above noise causes strain on the voice.
Avoid mouthwash or gargles that contain alcohol or irritating chemicals. If you still wish to use a mouthwash that contains alcohol, limit your use to oral rinsing. If gargling is necessary, use a salt water solution.
Avoid using mouthwash to treat persistent bad breath. Halitosis (bad breath) may be the result of a problem that mouthwash can't cure, such as low grade infections in the nose, sinuses, tonsils, gums, or lungs, as well as from gastric reflux from the stomach.
Consider using a microphone. In relatively static environments such as exhibit areas, classrooms, or exercise rooms, a lightweight microphone and an amplifier-speaker system can be of great help.
· Consider voice therapy. A speech-language pathologist who is experienced in treating voice problems can provide education on healthy use of the voice and instruction in proper voice techniques.
Warm - up exercise: Pranayama, Humming exercise, Lip trill exercise.
Conclusion: Thus through our one year of research especially among Teachers of various schools and colleges, we found that many Teachers can able to maintain their voice and some can get rid of their voice problems. In addition to that all had the benefits of Pranayama, like body becomes smart, strong and healthy, fat is reduced, luster in face, voice becomes sweet and melodious, gastric fire is augmented, develops concentration, increasing the mental and physical powers, complete relaxation to the nervous system.