SUMMARY
Objective
Voice therapy is the primary treatment modality for voice rehabilitation. Specific
patient-ability factors beyond patient-characteristic factors (eg, disorder diagnosis,
age, etc.), that influence individual patient responses to voice treatment remain
largely unknown. The goal of the current study was to determine the relationship between
patient-perceived improvements in both the sound and feel of voice during stimulability
assessment and voice therapy outcomes.
Study Design
Prospective Cohort study.
Methods
This study was a single-arm, single-center, prospective study. Fifty patients with
primary muscle tension dysphonia and benign vocal fold lesions were enrolled. Patients
read the first four sentences of the Rainbow Passage and were asked if they experienced
a change in the feel or sound of their voice following the stimulability prompt. Patients
then completed four sessions of conversation training therapy (CTT) voice therapy
and followed up one-week and three-months after their last therapy session, for a
total of six time-points. Demographic data were collected at baseline, and voice handicap
index 10 (VHI-10) scores were collected at each follow-up time-point. The primary
exposure variables were CTT intervention and patient perception of voice change to
stimulability probes. The primary outcome was change in VHI-10 score.
Results
On average, VHI-10 scores improved for all participants following CTT treatment. All
participants heard a change in the sound of voice with stimulability prompts. Descriptively,
patients who reported a positive change in the feel of their voice after stimulability
testing recovered faster (ie, experienced a sharper decline in VHI-10) compared to
those who did not note a change in feel of voice during stimulability testing. However,
the rate of change over time was not significantly different between groups.
Conclusion
Patient self-perception of a change in the sound and feel of voice in response to
stimulability probes during initial evaluation is an important factor in treatment
outcomes. Patients who perceive an improved feel of their voice production after stimulability
probes may respond to voice therapy more quickly.
Key Words
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References
- Lessac-Madsen resonant voice therapy: case study.in: Stemple J Hapner E Voice Therapy: Clinical Studies. 4th ed. Plural Publishing, San Diego2013
- Treatment efficacy: voice disorders.J Speech Lang Hear Res. 1998; 41: S101-S116
- Lessac-Madsen Resonant Voice Therapy.Plural Publishing, San Diego, CA2008
- Efficacy of vocal function exercises as a method of improving voice production.J Voice. 1994; 8: 271-278
- Efficacy of the accent method of voice therapy.Folia Phoniatr Logopedics. 1998; 50: 146-164
- A critical view of the yawn-sigh as a voice therapy technique.J Voice. 1993; 7: 75-80
- A randomized controlled trial of stretch-and-flow voice therapy for muscle tension dysphonia.Laryngoscope. 2015; 125: 1420-1425
- A systematic review of voice therapy: what "Effectiveness" really implies.J Voice. 2017; 31: 392.e313-392.e332
- Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements.J Voice. 2007; 21: 415-425
Stemple JC. Case scenario: which voice therapy approach should I use? 2017; Available at:https://www.medbridgeeducation.com/blog/2017/09/case-scenario-which-voice-therapy-approach-should-i-use/?utm_content=Case%20Scenario%3A%20Which%20Voice%20Therapy%20Approach%20Should%20I%20Use%3F&utm_source= medbridgeed&utm_medium=email&utm_campaign=medbridgeed. Access Jan 21, 2021
- Plasticity of voice quality: a prognostic factor for outcome of voice therapy?.J Voice. 2001; 15: 251-256
- Assessing stimulability in toddlers.J Commun Disord. 1996; 29: 279-297
- Stimulability: a useful clinical tool.J Commun Disord. 1996; 29: 237-253
- Creating a mastery experience during the voice evaluation.J Voice. 2012; 26: 665.e661-665.e667
- Immediate effect of stimulability assessment on acoustic, aerodynamic, and patient-perceptual measures of voice.J Voice. 2015; 30: 507
- Self-efficacy: toward a unifying theory of behavioral change.Perceptual Motor Skills. 2002; 94: 1056
- Interactions between auditory and somatosensory feedback for voice F0 control.Exp Brain Res. 2008; 187: 613-621
- Respiratory afferent activity in the superior laryngeal nerves.Respir Physiol. 1984; 58: 41-50
- Effects of laryngeal topical anesthesia on voice fundamental frequency perturbation.J Speech Hear Res. 1980; 23: 274-283
- Influences of laryngeal afferent inputs on intralaryngeal muscle activity during vocalization in the cat.Neurosci Res. 1997; 27: 85-92
- Effects of a professional solo singer education on auditory and kinesthetic feedback–a longitudinal study of singers' pitch control.J Voice. 2004; 18: 236-241
- Efficacy of conversation training therapy for patients with benign vocal fold lesions and uscle tension dysphonia compared to historical matched control patients.J Speech Lang Hear Res. 2019; 62: 4062-4079
- The development of conversation training therapy: a concept paper.J Voice. 2016; 30: 563-573
- Conversation training therapy: let's talk it through.Semin Speech Lang. 2021; 42: 32-40
- Normative values for the voice handicap index-10.J Voice. 2012; 26: 462-465
- Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.Am J Speech-Lang Pathol. 2009; 18: 124-132
- Quantifying dysphonia severity using a spectral/cepstral-based acoustic index: comparisons with auditory-perceptual judgements from the CAPE-V.Clin Linguist Phon. 2010; 24: 742-758
- A global measure of perceived stress.J Health Soc Behav. 1983; 24: 385-396
- The role of self-regulation in voice therapy.J Voice. 2013; 27 (390.e391–390.e311)
- Vocal control: is it susceptible to the negative effects of self-regulatory depletion?.J Voice. 2016; 30: 21-31
- Optimizing motor learning in speech interventions.in: C S J C Vocal Rehabilitation for Medical Speech Language Pathology. Pro-Ed, Austin, TX2004: 403-446
- Vocology The Science and Practice of Voice Habilitation.National Center for Voice and Speech, Clearfield, Utah, 2012
- Motor Control and Learning: A behavioral Emphasis.4th ed. Human Kinetics, Champaign, IL2005
- Transfer effect of speech-sound learning on auditory-motor processing of perceived vocal pitch errors.Sci Rep. 2015; 5: 13134
- Vocal congruence: the voice and the self measured by interoceptive awareness.J Voice. 2021; 35: 324.e315-324.e328
Article info
Publication history
Published online: March 10, 2023
Accepted:
February 7,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
