Christopher R Watts1, Amy Hamilton2, Laura Toles2, Lesley Childs2, Ted Mau2. 1. Department of Communication Sciences and Disorders, Texas Christian University, Fort Worth. 2. Clinical Center for Voice Care, Dept. of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
Abstract
OBJECTIVES: To investigate the effect of stretch-and-flow voice therapy on vocal function and handicap. STUDY DESIGN: Randomized controlled trial. METHODS:Participants with primary muscle tension dysphonia were randomly assigned to experimental or control groups. Experimental participants received vocal hygiene education followed by 6 weeks of stretch-and-flow voice therapy. Control participants received vocal hygiene education only. Outcome variables consisted of a measure of vocal handicap (Voice Handicap Index [VHI]), maximum phonation time, s/z ratio, and acoustic measures. All measures were obtained at baseline prior to treatment and within 2 weeks posttreatment or at the end of the control period. The pre- to posttreatment measurement change (delta Δ) was applied to statistical analyses. RESULTS: A multivariate analysis of variance revealed significant group differences in pre-to-post changes on measures of VHI, maximum phonation time, and cepstral peak prominence (CPP) in connected speech and vowels (P = 0.003, 0.013, 0.025, and 0.017 respectively), with a significant reduction of VHI (Cohen's d = 1.6), increase in maximum phonation time (Cohen's d = 1.2), increase of CPP in connected speech (Cohen's d = 1.2), and increase of CPP in vowels (Cohen's d = 1.1) in the experimental group compared to the control group. CONCLUSIONS: This preliminary small sample randomized controlled trial found significantly greater improvement in vocal handicap, maximum phonation time, and acoustic measures of vocal function after participants received stretch-and-flow voice therapy compared to participants receiving vocal hygiene education alone. Additional research incorporating larger samples will be needed to confirm and further investigate these findings. LEVEL OF EVIDENCE: 1b.
RCT Entities:
OBJECTIVES: To investigate the effect of stretch-and-flow voice therapy on vocal function and handicap. STUDY DESIGN: Randomized controlled trial. METHODS:Participants with primary muscle tension dysphonia were randomly assigned to experimental or control groups. Experimental participants received vocal hygiene education followed by 6 weeks of stretch-and-flow voice therapy. Control participants received vocal hygiene education only. Outcome variables consisted of a measure of vocal handicap (Voice Handicap Index [VHI]), maximum phonation time, s/z ratio, and acoustic measures. All measures were obtained at baseline prior to treatment and within 2 weeks posttreatment or at the end of the control period. The pre- to posttreatment measurement change (delta Δ) was applied to statistical analyses. RESULTS: A multivariate analysis of variance revealed significant group differences in pre-to-post changes on measures of VHI, maximum phonation time, and cepstral peak prominence (CPP) in connected speech and vowels (P = 0.003, 0.013, 0.025, and 0.017 respectively), with a significant reduction of VHI (Cohen's d = 1.6), increase in maximum phonation time (Cohen's d = 1.2), increase of CPP in connected speech (Cohen's d = 1.2), and increase of CPP in vowels (Cohen's d = 1.1) in the experimental group compared to the control group. CONCLUSIONS: This preliminary small sample randomized controlled trial found significantly greater improvement in vocal handicap, maximum phonation time, and acoustic measures of vocal function after participants received stretch-and-flow voice therapy compared to participants receiving vocal hygiene education alone. Additional research incorporating larger samples will be needed to confirm and further investigate these findings. LEVEL OF EVIDENCE: 1b.
Authors: Jarrad H Van Stan; John Whyte; Joseph R Duffy; Julie Barkmeier-Kraemer; Patricia Doyle; Shirley Gherson; Lisa Kelchner; Jason Muise; Brian Petty; Nelson Roy; Joseph Stemple; Susan Thibeault; Carol Jorgensen Tolejano Journal: Am J Speech Lang Pathol Date: 2021-08-31 Impact factor: 2.408
Authors: Pedro Clarós; Iwona Porebska; Astrid Clarós-Pujol; Carmen Pujol; Andrés Clarós; Francisco López-Muñoz; Konrad Kaczmarek Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-05-01 Impact factor: 6.223