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The Efficacy of the NHS Waterpipe in Superficial Hydration for People With Healthy Voices: Effects on Acoustic Voice Quality, Phonation Threshold Pressure and Subjective Sensations.

  • Tattari, Niko1
  • Forss, Milja2
  • Laukkanen, Anne-Maria3
  • Rantala, Leena4
  • 1 Master Program of Logopedics, Faculty of Social Sciences, Tampere University, Tampere, Finland. Electronic address: [email protected]. , (Finland)
  • 2 Master Program of Logopedics, Faculty of Social Sciences, Tampere University, Tampere, Finland. , (Finland)
  • 3 Speech and Voice Research Laboratory, Faculty of Social Sciences, Tampere University, Tampere, Finland. , (Finland)
  • 4 Degree Programme in Logopedics, Tampere University, Tampere, Finland. , (Finland)
Published Article
Journal of voice : official journal of the Voice Foundation
Publication Date
Jan 01, 2024
DOI: 10.1016/j.jvoice.2021.08.012
PMID: 34702612


This study examined the efficacy of the NHS waterpipe as a superficial hydration treatment in voice production in healthy young women. This is a prospective, single-blind, within- and between-subject experimental design. Thirty six female university students (mean age 24.6 years, range 19-45 years) were recruited to the study. Participants were randomized to two experimental groups (E1 and E2) and a control group. E1 underwent hydration treatment with the NHS waterpipe filled with 0.9% saline that was immersed in a cup of heated water. E2 underwent a similar treatment but without heated immersion. The control group received no treatment. Acoustic Voice Quality Index (AVQI v03.01) and its subparameters, phonation threshold pressure, self-perceived phonatory effort and sensation of throat dryness was measured at three time points (before the intervention and immediately and 15 minutes after it). The Tilt of the AVQI's subparameters increased significantly in the E1 (P = 0.027) and E2 groups (P = 0.027) after the intervention. Furthermore, the E1 group had significantly lower harmonics-to-noise-ratio values at the third measurement point compared to the E2 group (P = 0.023). These findings may result from fluid transported to the vocal fold level. The sensations of throat dryness decreased in the E1 (P = 0.001) and E2 groups (P < 0.0005) after the intervention. Perceived phonatory effort decreased statistically significantly at the final measurement point in the E1 (P = 0.002) and E2 (P = 0.031) groups. No variables changed in the control group. The waterpipe seems to be efficient in hydrating vocal folds on single use. It seems to be more efficient when employed with a hot water bath, albeit slightly impairing some acoustic values in the short term. Without the heated fluid, it still seems to decrease sensations of throat dryness and affect acoustic voice quality. The waterpipe does not seem to have an effect on phonation threshold pressure, and it seems to lower self-perceived effort just as efficiently whether the waterpipe is employed using a hot water bath or not. Further research is needed to prove the efficacy of long-term usage and usage with voice patients. Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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