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Ohlsson AC, Li Y, Gustavsson I, Hofling K, Wahle U, Österlind C, Iwarsson J. Voice Therapy Outcome: A Comparison Between Imitation Model Voice Therapy and Verbal Instructions Model Voice Therapy. J Voice 2024; 38:903-910. [PMID: 35227553 DOI: 10.1016/j.jvoice.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/18/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim was to compare voice outcomes over time in patients treated with Imitation Model voice therapy and Verbal Instructions Model voice therapy. METHODS A prospective clinical trial was performed with 56 consecutive patients diagnosed with a primary or secondary functional voice disorder. Thirty-one patients were included for voice therapy following the Imitation Model and 25 patients for the Verbal Instructions Model. Assessments included a self-rated Voice Handicap Index, self-perceived hoarseness and vocal fatigue, perceptual voice evaluation by a Speech Language Pathologist, and maximum Voice Range Profiles. All assessments were completed before therapy, at end of therapy, at six-months posttherapy follow-up and 12-months posttherapy follow-up. For maximum Voice Range Profiles group differences were also compared for effects from end-of-treatment to follow-up assessments. Linear mixed models were used for analysis. RESULTS Comparison between treatment groups showed significantly larger long-term improvement from the baseline, for verbal instructions model as compared to imitation model for Voice Handicap Index total, and also the physical and emotional subscales, while there was no difference between groups for the functional subscale. Also, voice quality improved more after verbal instructions model, as compared to imitation model, at end of therapy. Results from self-rated hoarseness and vocal fatigue showed no difference between groups. There was no difference between treatment groups in the change of maximum Voice Range Profile from end-of-treatment to follow-up assessments. CONCLUSIONS The study showed that both Imitation Model voice therapy and Verbal Instructions Model voice therapy improved voice function. Compared to Imitation Model, the Verbal Instructions model showed larger long-term effect on physical and emotional aspects of voice function in everyday life. The two approaches for voice therapy might have different impacts on patients' learning.
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Affiliation(s)
- Ann-Christine Ohlsson
- Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Ying Li
- Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gustavsson
- Department of Speech Language Pathology, ENT Clinic, Hospital of South of Älvsborg, Borås, Sweden
| | - Kerstin Hofling
- Department of Speech Language Pathology, Hospital of Skaraborg (SkaS) Lidköping, Lidköping, Sweden
| | - Ulrika Wahle
- Department of Logopedics and Phoniatrics, ENT Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Claes Österlind
- Department of Speech Language Pathology, NU- healthcare, Trollhättan, Sweden
| | - Jenny Iwarsson
- Department of Scandinavian Studies and Linguistics, Audiologopedics, Copenhagen University, Copenhagen S, Denmark
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Nanjundaswamy RKB, Jayakumar T. Comparison of Two Multiparameter Acoustic Voice Outcome Indices in the Treatment of Hyperfunctional Voice Disorders: Dysphonia Severity Index and Acoustic Voice Quality Index. J Voice 2024:S0892-1997(24)00174-7. [PMID: 38906742 DOI: 10.1016/j.jvoice.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The Dysphonia Severity Index (DSI) and Acoustic Voice Quality Index (AVQI) are the two widely used multiparameter acoustic instrumented indices that estimate dysphonia severity and track treatment outcomes. This study compared the performance of these two indices in identifying voice quality changes with eclectic voice therapy in individuals with hyperfunctional voice disorders (HFVD). METHOD Twenty individuals with HFVD including eight males and 13 females in the age range of 20-55 years received an eclectic voice therapy program named the Comprehensive Voice Habilitation Program. All the participants attended 15 sessions of voice therapy. DSI and AVQI measures were obtained at the baseline, immediate post therapy, 15 days post therapy (follow-up 1), and 60 days post therapy (follow-up 2). Repeated measures analysis of variance was performed to verify whether there were any differences between the time points for dependent variables DSI and AVQI. The effect sizes obtained for the DSI and AVQI measures were also noted. RESULTS A significant difference was obtained between the baseline and post therapy, follow-up 1 and follow-up 2 for AVQI measure with a very large effect size, ηp2 = 0.451. In contrast, DSI showed a significant difference only between the baseline and follow-up 1 with effect size, ηp2 = 0.187. CONCLUSIONS The results of this study confirmed that both DSI and AVQI were effective in tracking the changes in the severity of dysphonia. However, when compared, AVQI appeared to be more sensitive than DSI in potentially reflecting the effect of eclectic voice therapy in HFVD.
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Affiliation(s)
| | - Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
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Nanjundaswamy RKB, Jayakumar T. Eclectic Voice Therapy Program in Hyperfunctional Voice Disorders: Evidence from Multidimensional Vocal Profiling. J Voice 2024:S0892-1997(24)00146-2. [PMID: 38806326 DOI: 10.1016/j.jvoice.2024.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Hyperfunctional voice disorder (HFVD) is a disorder of multifactorial origin. It can be speculated that an eclectic voice therapy program that uses combinatory approaches could bring about better efficiency of voice in these individuals. Nevertheless, very less attempts have been made to examine the efficacy of eclectic voice therapy using multidimensional voice outcome measures in the treatment of HFVD. METHOD Ten individuals with HFVD in the age range of 20-55years attended Comprehensive Voice Habilitation Program (CVHP), an eclectic voice therapy approach for 15 sessions spread across 3weeks. A stroboscopy examination was performed at the baseline and post-therapy to track the changes in laryngeal functions. Further, perceptual voice analysis, Acoustic Voice Quality Index (AVQI), and Voice Handicap Index in Kannada (VHI-K) were obtained at the baseline, post-therapy, and two follow-ups to report the therapy outcomes. Related samples Friedman's Two-way Analysis of Variance by Ranks and Wilcoxon Signed Rank Test were used to note the pre-post and follow-up changes in voice outcomes. RESULTS Stroboscopy findings revealed significant improvement in movement patterns of the vocal folds and a reduction in ventricular hyperadduction. Perceptual ratings and AVQI scores decreased in post-therapy and follow-up evaluations indicating a decrease in dysphonia severity over time. In addition, a significant decrease in VHI-K scores indicated the alleviation of self-perceived disability/handicap. CONCLUSION The current study provided preliminary evidence to support the efficacy of eclectic voice therapy in HFVD by documenting significant changes in the voice-related outcome measures.
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Affiliation(s)
| | - Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
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Boominathan P, Mahalingam S, Arunachalam R, Venkatesh L. An eclectic Voice Therapy Program for the Treatment of Hyperfunctional Voice Disorders (HFVD). J Voice 2023; 37:969.e1-969.e21. [PMID: 34261583 DOI: 10.1016/j.jvoice.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE An eclectic voice therapy program includes sequenced and structured set of exercises combining direct and indirect intervention methods. Tailor-made exercise prescription with specific cultural adaptations are needed to provide a holistic change to voice quality.1 This study detailed the construction of an exercise prescription for participants with hyperfunctional voice disorder [HFVD] in the Indian context. METHOD The exercise program was developed based on literature related to vocal therapy approaches and delivery methods. Adaptations were introduced to a selected set of exercises. Five voice experts verified the exercises and their prescription for content and feasibility of use in the Indian context. Modification suggested by the experts were included for framing the final version of the exercise program. This structured therapy program was planned for 6 weeks (30 minutes duration/session offered individually twice per week, with a gap of two days between sessions in a week) with the goals to improve voice quality, flexibility, and endurance while speaking. Five participants with HFVD partook in the study for pilot testing. Stroboscopy, perceptual voice analysis, Dysphonia Severity Index (DSI) and Vocal Fatigue Index in Tamil (VFI-T) were used to report the therapy outcomes. Participants' report on the learning process and generalization of the program were documented. Wilcoxon-signed rank test was used to test the pre-post outcome measures. RESULTS An eclectic voice therapy program, i.e., Comprehensive Voice Habilitation Program [CVHP] was constructed and it included vocal hygiene instructions, warm-up & cool-down, easy onset, resonant voice, and carry over exercises. Participants completed the program in 14-18 sessions (over 7 to 9 weeks of therapy). All participants showed significant changes in vocal fold movement patterns, reduction in ventricular hyperadduction, overall grade of voice quality, DSI and VFI-T. Participants reported that pictorial illustrations, feedback, and monitoring sheets were useful in learning the exercises. CONCLUSION CVHP showed significant change in the voice-related outcome measures and was a viable program for treating HFVD.
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Affiliation(s)
- Prakash Boominathan
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India.
| | - Shenbagavalli Mahalingam
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Ravikumar Arunachalam
- SRM Institute of Science & Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
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Daşdöğen Ü, Awan SN, Bottalico P, Iglesias A, Getchell N, Abbott KV. The Influence of Multisensory Input On Voice Perception and Production Using Immersive Virtual Reality. J Voice 2023:S0892-1997(23)00235-7. [PMID: 37739864 DOI: 10.1016/j.jvoice.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVES The purpose was to examine the influence of auditory vs visual vs combined audiovisual input on perception and production of one's own voice, using immersive virtual reality technology. METHODS Thirty-one vocally healthy men and women were investigated under 18 sensory input conditions, using immersive virtual reality technology. Conditions included two auditory rooms with varying reverberation times, two visual rooms with varying volumes, and the combination of audiovisual conditions. All conditions were repeated with and without background noise. Speech tasks included counting, sustained vowel phonation, an all-voiced sentence from the Consensus Auditory-Perceptual Evaluation of Voice, and the first sentence from the Rainbow Passage, randomly ordered. Perception outcome measures were participants' self-reported perceptions of their vocal loudness, vocal effort, and vocal comfort in speech. Production outcome measures were sound pressure level (SPL) and spectral moments (spectral mean and standard deviation in Hz, skewness, and kurtosis). Statistical analyses used self-reported vocal effort, vocal loudness, and vocal comfort in percent (0 = "not at all," 100 = extremely), SPL in dB, and spectral moments in Hz. The reference level was a baseline audiovisual deprivation condition. RESULTS Results suggested (i) increased self-perceived vocal loudness and effort, and decreased comfort, with increasing room volume, speaker-to-listener distance, audiovisual input, and background noise, and (ii) increased SPL and fluctuations in spectral moments across conditions. CONCLUSIONS Not only auditory, but also visual and audiovisual input influenced voice perception and production in ways that have not been previously documented. Findings contribute to the basic science understanding the role of visual, audiovisual and auditory input in voice perception and production, and also to models of voice training and therapy. The findings also set the foundation for the use of virtual reality in voice and speech training, as a potentially power solution to the generalization problem.
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Affiliation(s)
- Ümit Daşdöğen
- Mount Sinai Health System, Department of Otolaryngology, New York, NY.
| | - Shaheen N Awan
- University of Central Florida, Communication Sciences and Disorders, Orlando, FL
| | - Pasquale Bottalico
- University of Illinois Urbana-Champaign, Department of Speech and Hearing Science, Champaign, IL
| | - Aquiles Iglesias
- University of Delaware, Communication Sciences and Disorders, Newark, DE
| | - Nancy Getchell
- University of Delaware, Kinesiology & Applied Physiology, Newark, DE
| | - Katherine Verdolini Abbott
- Mount Sinai Health System, Department of Otolaryngology, New York, NY; University of Illinois Urbana-Champaign, Department of Speech and Hearing Science, Champaign, IL
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Abur D, Hillman RE, Stepp CE. Auditory-Motor Function Pre- and Post-Therapy in Hyperfunctional Voice Disorders: A Case Series. J Voice 2023:S0892-1997(23)00264-3. [PMID: 37716889 DOI: 10.1016/j.jvoice.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE/HYPOTHESIS Behavioral voice therapy is the most common treatment for hyperfunctional voice disorders (HVDs) but has limited long-term effectiveness since the comprehensive mechanisms underlying HVDs remain unclear. Recent work has implicated disordered sensorimotor integration during speech in some speakers with HVDs and suggests that auditory processing is a key factor to consider in HVD assessment and therapy. The purpose of this case-series study was to assess whether current voice therapy approaches for HVDs resulted in improvements to auditory-motor function. STUDY DESIGN Longitudinal (pre-post) study. METHOD Pre and postvoice therapy for HVDs, 11 speakers underwent an assessment of auditory-motor function via auditory discrimination of vocal pitch, responses to unanticipated auditory perturbations, and responses to predictable auditory perturbations of vocal pitch. RESULTS At the post-therapy session, 10 out of 11 participants demonstrated voice therapy success (via self-reported voice problems and/or auditory-perceptual judgements of voice by a clinician) and eight of the 11 participants demonstrated improvements in at least one measure of auditory discrimination and/or auditory-motor control. Specifically, three speakers demonstrated improvements in auditory discrimination, five speakers demonstrated improved (within typical cutoffs) responses to predictable perturbations, and two speakers demonstrated improvements in both auditory discrimination and auditory-motor measures. CONCLUSIONS Together, these findings support that voice therapy in individuals with HVDs may impact auditory-motor control and highlight the potential benefit of systematically addressing auditory function in voice therapy and assessment for HVDs.
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Affiliation(s)
- Defne Abur
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA; Department of Computational Linguistics, Center for Language and Cognition Groningen, University of Groningen, Groningen, the Netherlands; Research School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, the Netherlands.
| | - Robert E Hillman
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA; MGH Institute of Health Professions, Boston, MA
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA; Department of Biomedical Engineering, Boston University, Boston, MA; Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA
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Stager SV, Bielamowicz SA. Long-Term Voice Change in Presbylarynges Patients With and Without Intervention. J Voice 2023:S0892-1997(23)00030-9. [PMID: 36882333 DOI: 10.1016/j.jvoice.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE To explore long-term patient experience of treated and untreated presbylarynges patients two or more years after their previous clinic visit by their responses to a probe about the changes in voice (better, stable, or worse) and standardized rating scales either by phone or from clinic records. Congruences of rating differences between visits and probe responses were assessed. METHODS Thirty-seven participated prospectively and seven retrospectively. Better, stable, or worse probe responses and treatment follow-through were obtained. Self-rating scales, completed verbally or obtained from charts, were compared to the previous visit so differences between visits could be converted to be congruent with probe responses. RESULTS After a mean of 4.6 years, 44% (63% untreated) reported stable, 36% (38% untreated) worse, and 20% (89% untreated) better. Significantly greater proportions of untreated reported better/stable probe responses while treated reported worse (χ2; P = 0.038). Significantly better means for all ratings were found at follow-up for those with better probe responses, but mean ratings were not significantly worse for those with worse probe response. No significant congruences of rating differences between visits and probe responses were found. In untreated reporting stable probe response, a significantly greater proportion of those with previous clinic ratings within normal limits (WNL) maintained ratings WNL at follow-up (z-statistic; P = 0.0007). CONCLUSIONS Ratings WNL at the initial evaluation, especially voice-related quality of life and effort, were found to still be WNL after several years. Little congruence was found between rating differences and probe responses, especially for worse, suggesting need for developing more sensitive rating scales.
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Affiliation(s)
- Sheila V Stager
- Voice Treatment Center, Department of Surgery, Division of Otolaryngology, The George Washington University School of Medicine, Washington, DC 20037.
| | - Steven A Bielamowicz
- Voice Treatment Center, Department of Surgery, Division of Otolaryngology, The George Washington University School of Medicine, Washington, DC 20037
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Ali I, Hussain RT, Wagay FA, Ahmad R. Muscle Tension Dysphonia: Experience from a Conflict Zone. Indian J Otolaryngol Head Neck Surg 2022; 74:2082-2087. [PMID: 36452805 PMCID: PMC9702440 DOI: 10.1007/s12070-020-02007-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022] Open
Abstract
We sought to explore the frequency of stress among OPD attending Kashmiri public diagnosed as muscle tension dysphonia (MTD) and determine the subjective consequences of voice therapy in management of muscle tension dysphonia. 72 subjects that attended to ENT and HNS OPD with change of voice were prospectively evaluated and also underwent an extensive otolaryngological examination. Patients identified as MTD were provided a questionnaire which was split into 3 parts: First part dealt with the identification of the subject (age, geography, gender, profession) and also provided evaluation of perceived anxiety using Perceived Stress Scale-10. In the next part the individuals needed to assess their vocal quality based on parameters of GRBAS 4-point score scale before and also after the treatment. In the final component the subjects also needed to answer the VHI-10 (Voice Handicap Index) and also the outcome was compared with those acquired at the assessment before the beginning of the treatment. The mean age of the cohort was 30.31 ± 07.43 (age range, 12-71) and every subject was an indigenous Kashmiri. As expected, vast majority of subjects were females (43 patients). In the pooled information set, women had numerically higher PSS-10 scores than males. For women, the typical stress score was M = 18.6 and for men the average stress score was M = 16.65. In a healthy population, the typical PSS stress score is described to be 13.7 (SD = 6.6) for women and 12.1 (SD = 5.9) for men. At the Wilcoxon test for paired data, we observed a significant difference between the VHI pretreatment (mean = 19.7) and VHI post-treatment, that's at time of the research (mean = 9.73; P = 0.017). The grade (G) was assessed in terms of improvement of the vocal quality as opposed with before treatment and also the individuals demonstrated a high level of satisfaction (mean = 0.65). When looking at roughness (R) as well as breathiness (B), the individuals remember that their speech is seldom rough (mean = 0.62) and also less breathy (median = 0.44). Patients likewise noted improvement in other variables of GRBAS scale. Stress is persistent, pervasive and nearly unavoidable in contemporary life. The decades old perplexing and mind baffling pandemonium hovering around the Kashmiri population has had a tremendous impression on the psychological development of people in this region. A careful conclusion is the fact that emotional stress might play a major role in the upkeep of MTD. MTD has to be approached in a multidisciplinary environment in which closer cooperation between a laryngologist, a speech language pathologist and also a psychologist is likely.
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Affiliation(s)
- Ihsan Ali
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Raj Tajamul Hussain
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Fayaz Ahmad Wagay
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Rauf Ahmad
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
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Desjardins M, Apfelbach C, Rubino M, Verdolini Abbott K. Integrative Review and Framework of Suggested Mechanisms in Primary Muscle Tension Dysphonia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1867-1893. [PMID: 35446683 PMCID: PMC9559660 DOI: 10.1044/2022_jslhr-21-00575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/14/2021] [Accepted: 01/12/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE Despite the high prevalence of primary muscle tension dysphonia (MTD-1), its underlying mechanisms and their interrelationships have yet to be fully identified. The objectives of this integrative review were (a) to describe and classify the suggested underlying mechanisms for MTD-1, (b) to appraise the empirical evidence supporting each of the proposed mechanisms, and (c) to summarize the information in an integrative model. METHOD PubMed, Scopus, and CINAHL were searched for all publications pertaining to muscle tension dysphonia. Papers were retained if they included theoretical or empirical data pertaining to underlying mechanisms of MTD-1. A total of 921 papers initially qualified for screening, of which 100 remained for consideration in this review. Underlying mechanisms of MTD-1 were extracted using a consensus approach. RESULTS Seven broad categories of putative mechanisms involved in MTD-1 were identified: psychosocial, autonomic, sensorimotor, respiratory, postural, inflammatory, and neuromuscular. These categories were further divided into 19 subcategories detailed in the body of this review article. Based on the reviewed evidence, our proposed integrative model presents MTD-1 as an idiosyncratic motor adaptation to physiological perturbation or perceived threat. Under this model, physiologically or psychologically aversive stimuli can instigate a series of motor adaptations at multiple levels of the nervous system, ultimately disturbing muscle activation patterns and their biomechanical outcomes. Importantly, these adaptations appear to have the potential to become chronic even after threatening stimuli are withdrawn. CONCLUSIONS The proposed model highlights the importance of personalized rehabilitation in MTD-1 treatment. Limitations of the literature are discussed to provide guidance for future research aimed at improving our understanding of MTD-1. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19586065.
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Affiliation(s)
- Maude Desjardins
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | | | - Marianna Rubino
- Department of Communication Sciences & Disorders, University of Delaware, Newark
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Nasrin S, Ali D, Jamshid J, Hamed G, Bashir R, Hamide G. The effects of Cricothyroid Visor Maneuver (CVM) therapy on the voice characteristics of patients with muscular tension dysphonia: A Case Series Study. J Voice 2022:S0892-1997(22)00056-X. [PMID: 35321794 DOI: 10.1016/j.jvoice.2022.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the effects of a novel manual therapy, the Cricothyroid visor maneuver (CVM) therapy, on acoustic, auditory perceptual and self-assessment ratings in Muscle tension dysphonia (MTD) patients. STUDY DESIGN This was a retrospective study of 6 clinical cases. MATERIALS AND METHOD The study comprised 6 Persian speakers with MTD (2 men and 4 women) and mean age 38.50 ± 5.32 years. All patients underwent therapy between April and June 2021. Therapy was provided in five 30-minute sessions. This study used of acoustic measurement including smoothed cepstral peak prominence (CPPs), Dysphonia Severity Index (DSI), self-assessment scales include vocal tract discomfort scale (VTD), voice related quality of life (V-RQOL) and Consensus Auditory- Perceptual Evaluation of Voice (CAPE-V) for auditory perceptual assessment in pre- and post-CVM sessions. RESULTS In the present study the CPPs and DSI increased while only CPPs significantly changed in pre and post therapy (P < 0.05). Also, having done the therapy the total severity of dysphonia (CAPE-V) and VTD significantly decreased (P < 0.05) and V-RQOL significantly increased (P < 0.05). CONCLUSIONS These results suggest that CVM can be an effective method for promote significant improvements in acoustic measurements, auditory perceptual and self-assessment scales in patients with MTD.
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Affiliation(s)
- Shahouzaie Nasrin
- Department of Speech therapy, school of paramedical sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dehqan Ali
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Jamali Jamshid
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ghaemi Hamed
- Assistant Professor, Bahar Institute of Higher Education, Mashhad, Iran
| | - Rasoulian Bashir
- Assistant professor of the otorhinolaryngology, head and neck surgery, Sinus and Sagittal Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ghaemi Hamide
- Department of Speech therapy, school of paramedical sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
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D'haeseleer E, Huvenne W, Vermeersch H, Meerschman I, Imke K, Servayge L, Versavel O, Van Lierde K. Long-term voice quality outcome after thyroidectomy without laryngeal nerve injury: a prospective 10 year follow up study. JOURNAL OF COMMUNICATION DISORDERS 2021; 91:106109. [PMID: 34034037 DOI: 10.1016/j.jcomdis.2021.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/16/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE This study investigates the long-term voice outcome of thyroidectomy up to 10 years after the surgery using a longitudinal prospective study design. METHODS Eighteen participants (6 men and 12 women, mean age: 54 years) who underwent a thyroidectomy between September 2006 and May 2007 were included in this study. A voice assessment protocol consisting of subjective (videolaryngostroboscopic evaluation, auditory- perceptual evaluation, patients' self-report) and objective voice assessments (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was used to evaluate the participants' pre- and postoperative voice. Voice measurements were compared before and one week, six weeks, three months and 10 years after the surgery. RESULTS No significant differences over time in auditory-perceptual and objective voice parameters were found, except for shimmer. Only in the first postoperative condition, significantly more patients reported vocal complaints. A progressive amelioration of the vocal folds' movement patterns was observed in the postoperative conditions. CONCLUSION The findings of this small longitudinal prospective study suggest that thyroidectomy without laryngeal nerve injury does not cause a permanent deterioration of the laryngeal aspect or function, vocal fold behavior and the self-perceived, perceptual and objective vocal quality. The increase of the shimmer 10 years post-thyroidectomy may be related to vocal aging.
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Affiliation(s)
- Evelien D'haeseleer
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Belgium.
| | - Wouter Huvenne
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Iris Meerschman
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kissel Imke
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Lena Servayge
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Orphee Versavel
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa.
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van Leer E, Lewis B, Porcaro N. Effect of an iOS App on Voice Therapy Adherence and Motivation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:210-227. [PMID: 33476177 PMCID: PMC8740599 DOI: 10.1044/2020_ajslp-19-00213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 12/17/2019] [Accepted: 09/28/2020] [Indexed: 05/22/2023]
Abstract
Purpose Patients commonly report difficulties adhering to voice therapy. An iOS app was developed in our lab that assists practice via reminder notifications, instructional recordings, and cepstral peak prominence analysis results. The purpose of this study was to assess the effect of such homework support modality on adherence behavior and associated motivation in a comparison of app support and written homework instructions and to assess the usability and utility of the app. Method Thirty-four individuals exhibiting adducted hyperfunction were randomized to receive either written homework instructions or the app when practicing resonant voice exercises for 3 weeks. All patients digitally audio-recorded all home practice, provided self-reported estimates of generalization, and completed weekly motivation scales. Results App support significantly increased practice frequency but did not affect self-reported generalization or motivation. Practice was significantly predicted by System Usability Scale scores. Utility of reminders and instructions were good, but cepstral peak prominence feedback was considered useful to only a subset of participants. Conclusion Interactive mobile therapy support can significantly increase practice of resonant voice homework without influencing motivation.
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Affiliation(s)
- Eva van Leer
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta
| | - Brittney Lewis
- Autonomous Reanimation and Evacuation Program, The Geneva Foundation, San Antonio, TX
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Mansuri B, Torabinezhad F, Jamshidi AA, Dabirmoghadam P, Vasaghi-Gharamaleki B, Ghelichi L. Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect. J Voice 2020; 34:657-666. [DOI: 10.1016/j.jvoice.2019.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/09/2019] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
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14
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Lowell SY, Colton RH, Kelley RT, Auld M, Schmitz H. Isolated and Combined Respiratory Training for Muscle Tension Dysphonia: Preliminary Findings. J Voice 2020; 36:361-382. [PMID: 32682682 DOI: 10.1016/j.jvoice.2020.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to determine the feasibility of altering speech breathing patterns and dysphonia severity through training increased levels of lung volume use during speech. It was hypothesized that respiratory-based training would increase lung volume levels during speech as well as improve acoustic voice measures, and that the addition of laryngeal-based treatment would further improve voice acoustics by treatment completion. METHOD A multiple baseline, single subject design was replicated over six participants with primary muscle tension dysphonia as a preliminary investigation of novel respiratory treatment methods. Following four baseline probes (1-4), two phases of treatment were implemented over 6 weeks. Respiratory lung volume-based training (RLVT) and subsequent performance was probed at sessions 5 to 7 and laryngeal-based training was added to the RLVT and probed at sessions 8 to 10. Visual biofeedback was used during RLVT to assist the motor learning process. Respiratory outcome measures of lung volume initiation, termination and excursion were objectively measured using respiratory plethysmography (InductoTrace), and cepstral and spectral-based acoustic measures were also determined at each time point. RESULTS All participants showed improvement in one or more respiratory measures as well as reduced acoustic dysphonia severity following phase 1 of RLVT alone. Two participants achieved further marked improvement in acoustic voice measures after laryngeal-based training was added in phase 2 of treatment, but this was generally also accompanied by further improvement or stabilization of respiratory measures. CONCLUSION Results from this preliminary study support the feasibility of RLVT for improving speech breathing behavior, and suggest that RLVT alone can improve objectively measured dysphonia severity.
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Affiliation(s)
- Soren Y Lowell
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York.
| | - Raymond H Colton
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York
| | - Richard T Kelley
- Department of Otolaryngology & Communication Sciences, SUNY Upstate Medical University, Syracuse, New York
| | - Madeline Auld
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York
| | - Hanna Schmitz
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York
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15
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Narasimhan SV, Rashmi R. Multiparameter Voice Assessment in Dysphonics: Correlation Between Objective and Perceptual Parameters. J Voice 2020; 36:335-343. [PMID: 32651100 DOI: 10.1016/j.jvoice.2020.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Perceptual assessment and objective measures of voice provide a quantifiable tool for determining the degree of glottal closure, thus helping to distinguish dysphonic voices from normal voices. The correlation between the perceptual and objective parameters of voice in dysphonic can enable the voice pathologist to be more effective in differentiating the normal voices from dysphonic voices. However, only a few studies have investigated the correlation between these measures. OBJECTIVE To document the differences in the perceptual and objective parameters of voice in participants with dysphonia and normal controls and to investigate the correlation between the perceptual and objective parameters of voice among participants with dysphonia. STUDY DESIGN This investigation deployed standard group comparison and a retrospective study. METHODS Two groups of participants were included in the study. Participants in group 1 were diagnosed as having a voice disorder secondary to organic pathologies and group 2 participants had a clinically normal voice. Phonation samples of all the participants were collected and perceptual analysis was carried out using the GRBAS rating scale. As part of the objective measures, acoustic and cepstral measures were extracted from the phonation samples. RESULTS The analysis of the results revealed significant differences in perceptual ratings between the normal (control) and dysphonic groups. The mean values of all the objective measures of voice presented significant differences between participants of both groups. The perceptual ratings of grade, breathiness, and roughness showed better correlations with the cepstral measures than with the time-based acoustic measures. CONCLUSIONS Further foraging research on the correlation between perceptual and objective measures of voice in various degrees of dysphonia will improve reliability while discriminating and quantifying hoarse, harsh and breathy voices from modal voices.
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Affiliation(s)
- S V Narasimhan
- Department of Speech & Language Pathology, JSS Institute of Speech & Hearing, Mysore, Karnataka, India
| | - Rajesh Rashmi
- II MASLP, Samvaad Institute of Speech & Hearing, Bangalore, Karnataka, India.
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Lovato A, Bonora C, Genovese E, Amato C, Maiolino L, de Filippis C. A panel of jitter/shimmer may identify functional dysphonia at risk of failure after speech therapy. Am J Otolaryngol 2020; 41:102455. [PMID: 32475619 DOI: 10.1016/j.amjoto.2020.102455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND There are no reliable outcome predictors for functional dysphonia (FD) patients. OBJECTIVES To investigate if any clinical or phoniatric characteristics could identify FD patients at risk of negative outcome after speech therapy. METHODS We retrospectively reviewed the results of 78 FD patients treated with the proprioceptive elastic method. Before and one-month after therapy, patients underwent endoscopy, acoustic analysis with Multi-Dimensional Voice Program, and Voice Handicap Index-10 questionnaire (VHI-10). Negative outcome was the persistence of VHI-10 ≥ 13. RESULTS 26 FD patients had negative outcome (i.e. VHI-10 ≥ 13) after speech therapy. At univariate analysis, clinical variables (i.e. sex, age, comorbidities, dysphonia duration, and professional voice use) were not associated with the outcome. Elevated Jitter% (Jitt; p = 0.03), Shimmer% (Shim; statistical trend, p = 0.06), and Noise to Harmonics Ratio (statistical trend, p = 0.06) were found in patients with poor results. At multivariate analysis, higher Jitt was an independent negative prognostic factor (p = 0.02), while a statically trend was identified for Shim (p = 0.06). A panel of Jitt >1.5 and Shim >5.1 showed an acceptable discriminatory power (AUC [ROC] = 0.76) according to Hosmer and Lemeshow scale. CONCLUSION A panel of two acoustic analysis parameters could help in identifying FD patients at risk of speech therapy failure. Further studies in these patients are needed to evaluate the most efficient treatment protocol.
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Affiliation(s)
- Andrea Lovato
- Department of Neuroscience DNS, University of Padova, Audiology Unit at Treviso Hospital, Treviso, Italy.
| | - Chiara Bonora
- Department of Neuroscience DNS, University of Padova, Audiology Unit at Treviso Hospital, Treviso, Italy
| | - Elisabetta Genovese
- Department of Diagnostic, Clinical and Public Health, University of Modena and Reggio Emilia, Audiology Unit, Modena, Italy
| | - Chiara Amato
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, ENT Section, Catania, Italy
| | - Luigi Maiolino
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, ENT Section, Catania, Italy
| | - Cosimo de Filippis
- Department of Neuroscience DNS, University of Padova, Audiology Unit at Treviso Hospital, Treviso, Italy
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Positive Effects of Manual Circumlaryngeal Therapy in the Treatment of Muscle Tension Dysphonia (MTD): Long Term Treatment Outcomes. J Voice 2019; 33:866-871. [DOI: 10.1016/j.jvoice.2018.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 11/20/2022]
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18
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A Comparison of Voice Activity and Participation Profiles Among Etiological Groups. J Voice 2019; 33:804.e5-804.e12. [DOI: 10.1016/j.jvoice.2018.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/26/2018] [Indexed: 11/21/2022]
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19
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Do Standard Instrumental Acoustic, Perceptual, and Subjective Voice Outcomes Indicate Therapy Success in Patients With Functional Dysphonia? J Voice 2019; 33:317-324. [DOI: 10.1016/j.jvoice.2017.11.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 11/23/2022]
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20
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Meerschman I, Claeys S, Bettens K, Bruneel L, D'haeseleer E, Van Lierde K. Massed Versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Therapy Versus a Long-Term Traditional Voice Therapy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:611-630. [PMID: 30950739 DOI: 10.1044/2018_jslhr-s-18-0013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of this study was to compare the effect of a short-term intensive voice therapy (IVT) with a long-term traditional voice therapy (TVT) on the vocal quality, vocal capacities, psychosocial impact, vocal tract discomfort, laryngological anatomy/physiology, and session attendance of patients with dysphonia. An additional comparison was made between an individual IVT (IVT-I) and a group IVT (IVT-G). Method A longitudinal, prospective controlled trial was used. Forty-six adults diagnosed with dysphonia were assigned to 1 of the 3 treatment groups. The IVT groups practiced with a frequency of 1 hr 20 min a day and a duration of 2 weeks. The TVT group practiced with a frequency of two 30-min sessions a week and a duration of 6 months. Both therapy programs were content-identical and guided by the same voice therapist. A multidimensional voice assessment consisting of both objective (maximum performance task, aerodynamic measurements, voice range profile, acoustic analysis, multiparametric voice quality indices) and subjective (subject's self-report, auditory-perceptual evaluation, flexible videolaryngostroboscopy) outcomes was used to evaluate the participants' voice. Results IVT made an equal progress in only 2 weeks and 12 hr of therapy compared with TVT that needed 6 months and 24 hr of therapy. IVT-I and IVT-G showed comparable results. Session attendance was clearly higher in IVT compared with TVT. Long-term follow-up results (1 year) were positive for the 3 groups, except for the self-reported psychosocial impact that increased in the IVT-I group. Conclusions Short-term IVT is at least equally effective in treating patients with dysphonia as long-term TVT. Group treatment seemed as effective as individual treatment. Attendance and cost-effectiveness are important advantages of IVT. A potential drawback might be an insufficient psychosocial progress. The golden mean between intensive and traditional treatment might therefore be an achievable, effective, and efficient solution for everyday clinical practice. Supplemental Material https://doi.org/10.23641/asha.7761872.
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Affiliation(s)
- Iris Meerschman
- Department of Rehabilitation Sciences, Research group: Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Sofie Claeys
- Department of Otorhinolaryngology, Ghent University, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Research group: Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Research group: Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, Research group: Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Research group: Speech, Language and Hearing Sciences, Ghent University, Belgium
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
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de Oliveira Lemos I, da Cunha Pereira G, Druck SantAnna G, Cassol M. Effects of a Voice Therapy Program for Patients with Muscle Tension Dysphonia. Folia Phoniatr Logop 2018; 69:239-245. [DOI: 10.1159/000487942] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/23/2018] [Indexed: 11/19/2022] Open
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22
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Meerschman I, Van Lierde K, Van Puyvelde C, Bostyn A, Claeys S, D'haeseleer E. Massed versus spaced practice in vocology: effect of a short-term intensive voice training versus a longer-term traditional voice training. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:393-404. [PMID: 29205707 DOI: 10.1111/1460-6984.12358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. AIMS The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy non-professional voice users. METHODS & PROCEDURES A pre-/post-test randomized control group design with follow-up measurements was used. Twenty healthy female non-professional voice users with a mean age of 21.7 years (range = 20-24 years) were randomly assigned into a short-term IVT group (n = 10) or a longer-term TVT group (n = 10). Both groups received an identical 6-h lasting voice training. Only the distribution of practice varied between the groups: 2 h a day for 3 consecutive days for the IVT group versus two 30-min sessions a week for 6 weeks for the TVT group. In both groups, a voice assessment protocol consisting of subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, acoustic analysis, voice range profile, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and post-training and at 6 weeks follow-up. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post-hoc pairwise comparisons with Bonferroni corrections. OUTCOMES & RESULTS No significant time-by-group interactions were found for any of the outcome measures, indicating no significant differences in evolution over time between the groups. Significant time effects were found for maximum phonation time, lowest intensity, lowest frequency, highest frequency and dysphonia severity index, all improving over time in both groups. More in-depth within-group analyses indicate a preference for the IVT group regarding the evolution of maximum phonation time, lowest frequency and dysphonia severity index, and a preference for the TVT group regarding the evolution of lowest intensity. CONCLUSIONS & IMPLICATIONS Short-term IVT may be equally, or even more, effective in training vocally healthy non-professional voice users compared with longer-term TVT.
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Affiliation(s)
- Iris Meerschman
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Caro Van Puyvelde
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Astrid Bostyn
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Sofie Claeys
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
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López JM, Catena A, Montes A, Castillo ME. Effectiveness of a Short Voice Training Program for Teachers: A Preliminary Study. J Voice 2017; 31:697-706. [DOI: 10.1016/j.jvoice.2017.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 01/28/2017] [Accepted: 01/30/2017] [Indexed: 11/25/2022]
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24
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Kryshtopava M, Van Lierde K, Meerschman I, D'Haeseleer E, Vandemaele P, Vingerhoets G, Claeys S. Brain Activity During Phonation in Women With Muscle Tension Dysphonia: An fMRI Study. J Voice 2017; 31:675-690. [DOI: 10.1016/j.jvoice.2017.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 11/26/2022]
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25
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Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA. Laryngopharyngeal Reflux and Voice Disorders: A Multifactorial Model of Etiology and Pathophysiology. J Voice 2017; 31:733-752. [DOI: 10.1016/j.jvoice.2017.03.015] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 12/14/2022]
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Maryn Y, Morsomme D, De Bodt M. Measuring the Dysphonia Severity Index (DSI) in the Program Praat. J Voice 2017; 31:644.e29-644.e40. [DOI: 10.1016/j.jvoice.2017.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 01/02/2017] [Accepted: 01/04/2017] [Indexed: 11/28/2022]
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27
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Misono S, Marmor S, Roy N, Mau T, Cohen SM. Multi-institutional Study of Voice Disorders and Voice Therapy Referral: Report from the CHEER Network. Otolaryngol Head Neck Surg 2017; 155:33-41. [PMID: 27371624 DOI: 10.1177/0194599816639244] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/25/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess perspectives of patients with voice problems and identify factors associated with the likelihood of referral to voice therapy via the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. STUDY DESIGN Prospectively enrolled cross-sectional study of CHEER patients seen for a voice problem (dysphonia). SETTING The CHEER network of community and academic sites. METHODS Patient-reported demographic information, nature and severity of voice problems, clinical diagnoses, and proposed treatment plans were collected. The relationship between patient factors and voice therapy referral was investigated. RESULTS Patients (N = 249) were identified over 12 months from 10 sites comprising 30 otolaryngology physicians. The majority were women (68%) and white (82%). Most patients reported a recurrent voice problem (72%) and symptom duration >4 weeks (89%). The most commonly reported voice-related diagnoses were vocal strain, reflux, and benign vocal fold lesions. Sixty-seven percent of enrolled patients reported receiving a recommendation for voice therapy. After adjusting for sociodemographic and other factors, diagnoses including vocal strain/excessive tension and vocal fold paralysis and academic practice type were associated with increased likelihood of reporting a referral for voice therapy. CONCLUSIONS The CHEER network successfully enrolled a representative sample of patients with dysphonia. Common diagnoses were vocal strain, reflux, and benign vocal fold lesions; commonly reported treatment recommendations included speech/voice therapy and antireflux medication. Recommendation for speech/voice therapy was associated with academic practice type.
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Affiliation(s)
- Stephanie Misono
- Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Schelomo Marmor
- Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA
| | - Ted Mau
- Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Seth M Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA
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Lee SJ, Lim SE, Choi HS. Responsiveness of the Korean Version of the Voice Activity and Participation Profile (K-VAPP) after Surgical Intervention. COMMUNICATION SCIENCES AND DISORDERS-CSD 2017. [DOI: 10.12963/csd.17407] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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29
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Spectral Measures of Hoarseness in Persons with Hyperfunctional Voice Disorder. J Voice 2017; 31:57-61. [DOI: 10.1016/j.jvoice.2016.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 11/23/2022]
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30
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Encouragement to Increase the Use of Psychosocial Skills in the Diagnosis and Therapy of Patients With Functional Dysphonia. J Voice 2017; 31:132.e1-132.e7. [DOI: 10.1016/j.jvoice.2015.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/25/2015] [Indexed: 11/15/2022]
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31
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Carding P, Bos-Clark M, Fu S, Gillivan-Murphy P, Jones S, Walton C. Evaluating the efficacy of voice therapy for functional, organic and neurological voice disorders. Clin Otolaryngol 2016; 42:201-217. [DOI: 10.1111/coa.12765] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- P. Carding
- Speech Pathology; Australian National Catholic University; Brisbane Qld Australia
| | - M. Bos-Clark
- Royal Devon and Exeter NHS Trust and University of ST Mark and St John; Plymouth UK
| | - S. Fu
- Department of Audiology and Speech Pathology; MacKay Medical College; New Taipei City Taiwan
| | | | - S.M. Jones
- University Hospital of South Manchester; Manchester UK
| | - C. Walton
- Speech Pathology; Australian National Catholic University; Brisbane Qld Australia
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Gartner-Schmidt J, Gherson S, Hapner ER, Muckala J, Roth D, Schneider S, Gillespie AI. The Development of Conversation Training Therapy: A Concept Paper. J Voice 2016; 30:563-73. [DOI: 10.1016/j.jvoice.2015.06.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/16/2015] [Indexed: 11/17/2022]
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Moore J, Greenberg C, Thibeault SL. Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population. J Voice 2016; 31:41-47. [PMID: 26952321 DOI: 10.1016/j.jvoice.2016.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI). STUDY DESIGN Prospective, survey study. METHODS Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database with voice, concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. The VHI was sent to patients 6 months post clinic visit to determine change in voice handicap from baseline. General health was screened using the 12-item Short Form Health Survey, using physical component summary and mental component summary scores. Predictor variables included treatment (medical and/or behavioral); dysphonia sub-diagnosis; grade, roughness, breathiness, asthenia, and strain rating; age; sex; socioeconomic factors; smoking history; and comorbidity score. RESULTS Two hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned 6-month surveys. The VHI was significantly correlated with mental component summary scores. Patients with a higher grade in baseline grade, roughness, breathiness, asthenia, and strain score were more likely to receive voice intervention (P = 0.04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher educational level in both univariate (P < 0.01, P = 0.04) and multivariate analyses (P < 0.01, P = 0.02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI score. CONCLUSIONS Our results suggest that it is important to consider baseline self-perceived voice impact measures and educational level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted.
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Affiliation(s)
- Jaime Moore
- Department of Surgery and Communication Sciences and Disorders, 5107 Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave., Madison, Wisconsin 53705-2275
| | - Caprice Greenberg
- Department of Surgery and School of Medicine and Public Health, 7375 Clinical Science Center, K6/148, University of Wisconsin-Madison, 600 Highland Ave., Madison, Wisconsin 53792
| | - Susan L Thibeault
- Department of Surgery, 5107 Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave., Madison, Wisconsin 53705-2275..
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De Bodt M, Patteeuw T, Versele A. Temporal Variables in Voice Therapy. J Voice 2015; 29:611-7. [DOI: 10.1016/j.jvoice.2014.12.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/02/2014] [Indexed: 11/30/2022]
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Cohen SM, Dinan MA, Kim J, Roy N. Otolaryngology utilization of speech-language pathology services for voice disorders. Laryngoscope 2015; 126:906-12. [DOI: 10.1002/lary.25574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Seth M. Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery; Duke University Medical Center; Durham North Carolina
| | | | - Jaewhan Kim
- Division of Public Health & Study Design and Biostatistics Center; University of Utah; Salt Lake City Utah
| | - Nelson Roy
- Department of Communication Sciences and Disorders, Division of Otolaryngology-Head & Neck Surgery (Adjunct); University of Utah, Salt Lake City; Utah U.S.A
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Eastwood C, Madill C, Mccabe P. The behavioural treatment of muscle tension voice disorders: A systematic review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 17:287-303. [PMID: 25953458 DOI: 10.3109/17549507.2015.1024169] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders (MTVD). METHOD A search of 12 electronic databases and reference lists for studies published between the years 1990-2014 was conducted using the PRISMA guidelines. Inclusion and exclusion criteria included type of publication, participant characteristics, intervention, outcome measures and report of outcomes. Methodological quality rating scales and confidence in diagnostic scale supported the literature evaluation. RESULT Seven papers met the inclusion criteria. Significant improvement on at least one outcome measure was reported for all studies. Effect sizes were small-to-large. Methodological qualities of research were varied. No study explicitly reported treatment fidelity and cumulative intervention intensity could only be calculated for two out of seven studies. Outcome measures were used inconsistently and less than half of the measures had reported reliability values. Confidence in the accuracy of subject diagnosis on average was rated as low. Specific "active ingredients" for therapeutic change were not identified. CONCLUSION Voice therapy for the treatment of MTVD is associated with positive treatment outcomes; however, there is an obvious need for systematic and high quality research designs to expand the evidence base for the behavioural treatment of MTVD.
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Affiliation(s)
- Clare Eastwood
- The Voice Research Laboratory, Discipline of Speech Pathology, The University of Sydney , Sydney , Australia
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Couch S, Zieba D, Van der Linde J, Van der Merwe A. Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2015; 62:E1-7. [PMID: 26304213 PMCID: PMC5843152 DOI: 10.4102/sajcd.v62i1.95] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/12/2014] [Accepted: 08/24/2014] [Indexed: 11/29/2022] Open
Abstract
Background As a professional voice user, it is imperative that a speech-language pathologist's (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. Objectives To determine the effect of service delivery on the perceptual and acoustic features of voice. Method A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. Results A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Conclusion Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.
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Is More Intensive Better? Client and Service Provider Outcomes for Intensive Versus Standard Therapy Schedules for Functional Voice Disorders. J Voice 2014; 28:652.e31-652.e43. [DOI: 10.1016/j.jvoice.2014.02.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/14/2014] [Indexed: 12/22/2022]
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Behlau M, Pontes P, Vieira VP, Yamasaki R, Madazio G. Presentation of the Comprehensive Vocal Rehabilitation Program for the treatment of behavioral dysphonia. Codas 2013; 25:492-6. [DOI: 10.1590/s2317-17822013000500015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 09/18/2013] [Indexed: 11/22/2022] Open
Abstract
Voice rehabilitation is the main treatment option in cases of behavioral dysphonia, and it has the purpose of enhancing the quality of vocal production and voice-related life aspects. Several efforts have been made to offer a clinical practice that is based on evidence, including the development of specific therapeutic protocols as an option for clinical and scientific improvement. It is necessary to define the focus/objective of the dysphonia treatment, type of approach, and duration in order to establish the intervention criteria. This paper describes the organization of a program of behavioral dysphonia treatment, based on an approach that has been used for over twenty years, named Comprehensive Vocal Rehabilitation Program, and also to present its concepts, theory, and practical fundamentals. The program has an eclectic approach and associates body work, glottal source, resonance, and breathing coordination in addition to knowledge about vocal hygiene and communicative behavior. The initial proposal suggests a minimum time of intervention of six therapeutic sessions that can be adapted according to the patient' s learning curve and development. The goal is to offer a rational and structured therapeutic approach that can be reproduced in other scenarios.
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Affiliation(s)
- Mara Behlau
- Centro de Estudos da Voz, Brazil; Universidade Federal de Sao Paulo, Brazil
| | - Paulo Pontes
- Universidade Federal de Sao Paulo, Brazil; Instituto da Laringe, Brazil
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Ribeiro MB, Gama ACC, Bassi IB, Teixeira LC. Parâmetros vocais, laríngeos e de autopercepção de professoras disfônicas: análise após tratamento fonoaudiológico. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013000300016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: analisar os resultados das avaliações vocais, laríngeas e de autopercepção após tratamento fonoaudiológico em um grupo de professoras disfônicas. MÉTODO: trata-se de estudo retrospectivo com revisão de 42 prontuários de mulheres portadoras de disfonia comportamental, com coleta de dados referente à análise perceptivo-auditiva, acústica, de avaliação laríngea e de protocolo de autopercepção vocal (PPAV) nas situações pré e pós-fonoterapia. As professoras foram atendidas por estudantes do curso de Fonoaudiologia supervisionados por um único profissional. Foram utilizadas terapia direta com a realização de técnicas vocais e indireta com orientação sobre cuidados com a saúde vocal. RESULTADOS: com relação à análise perceptivo-auditiva, 73,8% das vozes foram descritas como melhores após a fonoterapia. Os parâmetros que mais se modificaram foram o grau da disfonia (G) e a rugosidade (R). No que concerne à análise acústica, os parâmetros que melhoraram significantemente após o tratamento foram o jitter, quociente de perturbação de frequência, shimmer e quociente de perturbação de amplitude. A avaliação laríngea demonstrou que 43% das pacientes apresentaram melhora no exame após o tratamento fonoaudiológico; 38% dos exames não sofreram alteração com o tratamento e 19% pioraram no momento da alta. A partir do PPAV, constatou-se melhora estatisticamente significante para todos os domínios no momento pós-fonoterapia, sendo que a maior diferença entre as médias pré e pós-tratamento foi referente ao parâmetro "efeitos no trabalho". CONCLUSÃO: observou-se melhora dos parâmetros perceptivo-auditivos de grau geral da disfonia e rugosidade, nas medidas acústicas de jitter e shimmer, bem como melhora da imagem laríngea e impacto positivo da voz na qualidade de vida das professoras avaliadas após o tratamento fonoaudiológico.
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Patel RR, Bless DM, Thibeault SL. Boot Camp: A Novel Intensive Approach to Voice Therapy. J Voice 2011; 25:562-9. [DOI: 10.1016/j.jvoice.2010.01.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 01/14/2010] [Indexed: 10/19/2022]
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van Leer E, Connor NP. Use of portable digital media players increases patient motivation and practice in voice therapy. J Voice 2011; 26:447-53. [PMID: 21840169 DOI: 10.1016/j.jvoice.2011.05.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 05/11/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVES/HYPOTHESES There are many documented barriers to successful adherence to voice therapy. However, methods for facilitating adherence are not well understood. The purpose of this study was to determine if patient adherence and motivation for practice could be improved by providing patients with practice support between sessions using mobile treatment videos. METHODS Thirteen voice therapy participants were provided with portable media players containing videos of voice exercises exemplified by their therapists and themselves. A randomized crossover design of two conditions was used: (1) standard of care voice therapy where participants were provided with written homework descriptions; and (2) video-enhanced voice therapy where participants received a portable digital media player with clinician and self-videos. The duration of each condition was 1 week. Self-report measures of practice frequency and aspects of motivation were obtained at the end of each session. RESULTS Practice of voice exercises was significantly greater in the video-enhanced voice therapy condition than in the standard of care "written" condition (P<0.05). Three aspects of participant motivation for practice-overall commitment to practice, importance of practice, and confidence in the ability to practice were also significantly greater after video-enhanced condition than after standard of care condition. CONCLUSION These results support the use of video examples and portable digital media players in voice therapy for individuals who are comfortable using such technology.
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Affiliation(s)
- Eva van Leer
- Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio 45267-0528, USA.
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Effectiveness of voice therapy in functional dysphonia: where are we now? Curr Opin Otolaryngol Head Neck Surg 2011; 19:160-4. [DOI: 10.1097/moo.0b013e3283448f85] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kleemola L, Helminen M, Rorarius E, Sihvo M, Isotalo E. Twelve-month clinical follow-up study of voice patients' recovery using the Voice Activity and Participation Profile (VAPP). J Voice 2010; 25:e245-54. [PMID: 21050712 DOI: 10.1016/j.jvoice.2010.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 05/17/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To study the effects of voice treatment including brief voice therapy for 12 months in two groups of voice patients: organic and functional. DESIGN AND METHODS A clinical prospective follow-up study with repeated measurements in five phases: medical session, first voice therapy session, last voice therapy session, and 6 months and 12 months after voice therapy. The mean number of voice therapy sessions was 3.4. The main outcome measures were the Voice Activity and Participation Profile (VAPP) and the Symptom Questionnaire. Of consenting patients (n=141) with chronic voice disorders, 46 dropped out during follow-up. Ninety-five patients formed the study group. Forty-one of them received only voice therapy, but the rest of them received combined treatment (medication, amplifiers, and voice massage), but also experienced life events affecting voice. Patients with any laryngeal pathology formed the organic group (n=47), others had a functional voice disorder. RESULTS Using the improvement criterion that the change of the VAPP score should exceed standard error of measurement, the percentage of individual patients achieving improvement was 47% in the mild, 59% in the moderate, and 75% in the severe disorder groups. Effect size for VAPP total score was 0.89. The positive effect continued to progress after the therapy ended. Patients with functional or organic voice disorder improved almost equally, although minor findings indicate that functional patients benefited more. CONCLUSIONS Voice treatment had a progressive effect for 1 year in half of our patients. No statistical difference was found between the functional and organic patient groups.
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Affiliation(s)
- L Kleemola
- Department of Eye, Ear and Oral Diseases, Department of Otorhinolaryngology, Tampere University and Tampere University Hospital, Tampere, Finland.
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Morsomme D, de la Bardonnie MF, Verduyckt I, Jamart J, Remacle M. Subjective evaluation of the long-term efficacy of speech therapy on dysfunctional dysphonia. J Voice 2010; 24:178-82. [DOI: 10.1016/j.jvoice.2008.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 05/14/2008] [Indexed: 10/21/2022]
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Hakkesteegt MM, Wieringa MH, Brocaar MP, Mulder PG, Feenstra L. The Interobserver and Test-Retest Variability of the Dysphonia Severity Index. Folia Phoniatr Logop 2008; 60:86-90. [DOI: 10.1159/000114650] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Roy N. Assessment and treatment of musculoskeletal tension in hyperfunctional voice disorders. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2008; 10:195-209. [PMID: 20840037 DOI: 10.1080/17549500701885577] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Poorly regulated activity of the perilaryngeal muscles affects phonatory function and contributes to a class of disorders known as hyperfunctional or musculoskeletal tension voice disorders. Recognizing the signs and symptoms of excess or dysregulated laryngeal muscle activity is critical to proper diagnosis and selection of appropriate treatment(s). Although numerous approaches exist to manage such hyperfunctional syndromes, manual circumlaryngeal techniques have recently received attention as valuable tools in both assessment and treatment. Therefore, the purpose of this article is to: (1) describe common phenomenological features of dysregulated laryngeal muscle tension, thereby facilitating its recognition, (2) highlight the role of manual circumlaryngeal techniques in assessment and management, (3) survey additional treatment approaches for laryngeal hyperfunction, and explore the evidence to support their effectiveness, and (4) identify unresolved issues and controversies surrounding tension-based voice disorders. A series of pre- and post-treatment audio examples are provided on the journal website at www.informaworld.com/ijslp .
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Bibliography. Current world literature. Laryngology and bronchoesophagology. Curr Opin Otolaryngol Head Neck Surg 2007; 15:417-24. [PMID: 17986882 DOI: 10.1097/moo.0b013e3282f3532f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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