The Effect of Osteopathy and Complete Vocal Technique on Phonation in Amateur Singers

NCT07007845 | Completed

• 1 other identifier: CVT Support and Osteopathy
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

This study is about breathing function during singing, specifically aimed at improving the functionof the muscles in the respiratory system involved in control over the voice.The goal of the study is to examine if osteopathic techniques and/or work with support developedby Complete Vocal Institute influences voice quality and sense of ease using voice.The study compares two types of interventions:1: An osteopathic optimization treatment for diaphragm, a major muscle responsible for breathing.And2: A singing technique for learning stamina.Both techniques work on improving patterns of breathing which should make singing feel easier and lower future risks of injury and strain. The study takes place at Complete Vocal Institute where participant voices will be recorded by a microphone and by a laryngograph. In using the laryngograph, two gold-plated electrodes will be placed over the larynx. A microphone records the voice whereas EGG-electrodes record how the vocal folds are vibrating. Measurements are made before each type of treatment and after each treatment. Both are non-invasive and carry no risk to the voice. The recordings will be done in a sound-treated room for privacy.The singing intervention will involve breathing exercises, and the osteopathic treatment will involve a single fascia treatment. It is possible that the osteopathic treatment can leave participant diaphragms and the area around the lower ribs sore, this is normal and is expected to last no more than 24-48 hours. Each session is expected to last approximately one hour, and only a single visit will be required.To ensure comfort, please wear loose-fitting clothing that allows for easy breathing and singing. For one part of the intervention, participants will be asked to remove clothing like one would for any physical massage, so the therapist can access and treat the diaphragm.There are no costs involved nor compensation for participation in the study. Participation is completely voluntary. Should participants at any time wish to withdraw from the study, they are free to do so by informing Julie Bie at julie@netfyssen.dk hereof.All data will be anonymized and any information that could identify participants as a subject will be kept strictly confidential. No personal information will be included in the study report or other publication arising from the project analysis.If there have any questions, please contact the investigators at julie@netfyssen.dk or mathias@shout.dk. This research is being overseen by an Institutional Review Board ("IRB"). The two therapists involved in this study are insured, and the study has received favorable approval from the Ethics Committee of Buckinghamshire New University.

Conditions

Singing; Breathing Exercise; Osteopathy

Keywords

Diaphragm function; Singing technique; Support; Osteopathy

Outcome Measures

Primary Outcomes (24)

• Maximum Phonation Time

  The total amount in seconds a sustained phonation can be maintained

  Baseline

• Mean sound pressure level

  Sound pressure level, SPL, to indicate vocal loudness.

  Baseline

• Maximum and minimum fundamental frequency

  The maximum and minimum fundamental frequency as an indicator of singing note pitch.

  Baseline

• Fx SD

  Fundamental Frequency Standard Deviation (Fx SD)

  Baseline

• Qx

  Average Contact Quotient (Qx)

  Baseline

• Jitter

  Amount (in %) of Jitter during cycle to cycle variation of vocal fold oscillations on a sustained vowel measured by electroglottography

  Baseline

• Normalised Noise Energy

  Normalised Noise Energy (NNE) of acoustic radiated output during phonation

  Baseline

• Cepstral Peak Prominence

  Cepstral Peak Prominence (CPP) of sustained phonation

  Baseline

• Maximum Phonation Time

  The total amount in seconds a sustained phonation can be maintained

  Day 1

• Mean sound pressure level

  Sound pressure level, SPL, to indicate vocal loudness.

  Day 1

• Maximum and minimum fundamental frequency

  The maximum and minimum fundamental frequency as an indicator of singing note pitch.

  Day 1

• Fx SD

  Fundamental Frequency Standard Deviation (Fx SD)

  Day 1

• Qx

  Average Contact Quotient (Qx)

  Day 1

• Jitter

  Amount (in %) of Jitter during cycle to cycle variation of vocal fold oscillations on a sustained vowel measured by electroglottography

  Day 1

• Normalised Noise Energy

  Normalised Noise Energy (NNE) of acoustic radiated output during phonation

  Day 1

• Cepstral Peak Prominence

  Cepstral Peak Prominence (CPP) of sustained phonation

  Day 1

• Maximum Phonation Time - post intervention

  The total amount in seconds a sustained phonation can be maintained

  Day 1

• Mean sound pressure level - post intervention

  Sound pressure level, SPL, to indicate vocal loudness.

  Day 1

• Maximum and minimum fundamental frequency - post intervention

  The maximum and minimum fundamental frequency as an indicator of singing note pitch.

  Day 1

• Fx SD - post intervention

  Fundamental Frequency Standard Deviation (Fx SD)

  Day 1

• Qx - post intervention

  Average Contact Quotient (Qx)

  Day 1

• Jitter - post intervention

  Amount (in %) of Jitter during cycle to cycle variation of vocal fold oscillations on a sustained vowel measured by electroglottography

  Day 1

• Normalised Noise Energy - post intervention

  Normalised Noise Energy (NNE) of acoustic radiated output during phonation

  Day 1

• Cepstral Peak Prominence - post intervention

  Cepstral Peak Prominence (CPP) of sustained phonation

  Day 1

Study Arms (2)

CVT Support optimisation

ACTIVE COMPARATOR

The CVT Emergency Aid program focused on optimising the work on the diaphragm was conducted in 3 steps. Step 1 related to establishing diaphragmatic breathing by feeling expansion around lower ribs at inhalation. Step 2 related to establishing connection between pulmonary pressure and subtotal pressurisation by invoking inwards abdominal movements on controlled exhaled voiceless exercises (ssss-sound) Step 3 related to establishing dynamic control of subglottal pressure by performing fricative voice sounds (vvvf- and zzz-sounds) while contracting the abdominal wall inwards and thereby pressurising the pulmonary space leading to increased subglottal pressure on accents and extended pitch accents.

Behavioral: CVT Support intervention

Osteopathy

EXPERIMENTAL

Osteopathic treatment: Dooming Diaphragm. The inferior costal margin was contacted with the hands, allowing the thumbs to rest just below the ribcage anteriorly. Care was taken to avoid contact with the xiphoid process, as this could cause discomfort for the patient. The patient was instructed to breathe deeply, and as they exhaled, gentle pressure was applied superiorly and laterally with the thumbs, rolling them underneath the ribcage as far as was comfortable. This process was repeated for 3-5 breath cycles or until no tension was felt in the thumbs during exhalation.

Procedure: Dooming Diaphragm

Interventions

CVT Support intervention BEHAVIORAL

The CVT Emergency Aid program focused on optimising the work on the diaphragm was conducted in 3 steps. Step 1 related to establishing diaphragmatic breathing by feeling expansion around lower ribs at inhalation. Step 2 related to establishing connection between pulmonary pressure and subtotal pressurisation by invoking inwards abdominal movements on controlled exhaled voiceless exercises (ssss-sound) Step 3 related to establishing dynamic control of subglottal pressure by performing fricative voice sounds (vvvf- and zzz-sounds) while contracting the abdominal wall inwards and thereby pressurising the pulmonary space leading to increased subglottal pressure on accents and extended pitch accents.

Also known as: CVT Support

CVT Support optimisation

Dooming Diaphragm PROCEDURE

Osteopathic treatment: Dooming Diaphragm. The inferior costal margin was contacted with the hands, allowing the thumbs to rest just below the ribcage anteriorly. Care was taken to avoid contact with the xiphoid process, as this could cause discomfort for the patient. The patient was instructed to breathe deeply, and as they exhaled, gentle pressure was applied superiorly and laterally with the thumbs, rolling them underneath the ribcage as far as was comfortable. This process was repeated for 3-5 breath cycles or until no tension was felt in the thumbs during exhalation.

Also known as: Osteopathic treatment of diaphragm

Osteopathy

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• General health, no known vocal pathology or ongoing respiratory infection
• No ongoing reflux symptoms
• Amateur singer

You may not qualify if:

• No prior osteopathic treatment related to voice
• No prior CVT Support Training

Sponsors & Collaborators

• Complete Vocal Institute: lead
• Buckinghamshire New University: collaborator

Study Sites (1)

Complete Vocal Institute

Copenhagen, 1208, Denmark

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 28, 2025
• First Posted: June 6, 2025
• Study Start: March 3, 2025
• Primary Completion: March 7, 2025
• Study Completion: April 28, 2025
• Last Updated: June 6, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)