With regard to cognitive and emotional load, we will present the “Model for Voice and Effort” (MoVE) that comprises the integration of ongoing top-down and bottom-up activity under different types of load and combined patterns of voice output. In the section “Discussion,” with regard to physical load, a competition for ventilation processes required to speak and those to meet metabolic demand of exercised muscles is described. In reviewing the function of these three stages of voice output, we will give an overview of the voice parameters encountered in studies on voice stress analysis (VSA) and review the impact of the different types of physiological, cognitive and/or emotional load. In the current paper, we will outline the different stages of voice output, i.e., breathing, phonation and resonance in relation to a neurovisceral integrated perspective on stress and human performance. Since vocalization is entirely integrated within both our central (CNS) and autonomic nervous system (ANS), a mounting number of studies have examined the relationship between voice output and the impact of stress. People rely on speech for communication, both in a personal and professional context, and often under different conditions of physical, cognitive and/or emotional load. 5MFYS-BLITS, Department of Human Physiology, Vrije Universiteit Brussel, Brussels, Belgium. ![]() 4School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom.3Clinical and Lifespan Psychology, Department of Psychological and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.2Brain, Body and Cognition, Experimental and Applied Psychology, Department of Psychological and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.1VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.Martine Van Puyvelde 1,2,3* Xavier Neyt 1 Francis McGlone 4 Nathalie Pattyn 1,2,5
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