The Effect of a Voice Therapy Program Based on the Taxonomy of Vocal Therapy in Women with Behavioral Dysphonia

J Voice. 2019 Mar;33(2):256.e1-256.e16. doi: 10.1016/j.jvoice.2017.10.019. Epub 2018 Feb 1.

Abstract

Objective: This study aims to propose and analyze the effect of a voice therapy program (VTP) in women with behavioral dysphonia.

Materials and methods: This is a controlled, blinded, and nonrandomized cohort study. Participants of this study were 22 women with behavioral dysphonia divided into two groups: G1, 11 women with behavioral dysphonia who received the VTP, and G2, 11 women with behavioral dysphonia who did not receive any intervention. Before and after 6 weeks, the outcome variables evaluated in both groups were auditory-perceptual evaluation of the global degree of vocal quality (vowel /a/ and counting), instrumental acoustic parameters, Voice-Related Quality of Life, vocal and larynx symptoms, and musculoskeletal pain. The statistical analysis used the Wilcoxon, chi-square, and Mann-Whitney tests (P < 0.05).

Results: After 6 weeks, we observed a significantly higher improvement in the general degree of vocal deviation in vowels, a reduced F0 and symptom of "fatigue while talking" in G1, and an increased "shoulder" pain intensity in G2. Both groups showed improvement in the socioemotional domain of Voice-Related Quality of Life. In addition, the comparison between the groups showed a significantly greater reduction in fundamental frequency and the "voice loss" symptom in G1 compared with G2.

Conclusions: The VTP using semioccluded vocal tract exercises obtained a positive effect on voice quality, symptoms, and musculoskeletal pain in women with behavioral dysphonia. The proposal, based on the taxonomy of voice therapy, seems to have promoted a phonatory balance, muscle relaxation, and improvement in the vocal resistance of this population.

Keywords: Behavioral dysphonia; Voice; Voice disorders; Voice therapy; Voice training.

MeSH terms

  • Acoustics
  • Adult
  • Auditory Perception
  • Case-Control Studies
  • Dysphonia / diagnosis
  • Dysphonia / physiopathology
  • Dysphonia / psychology
  • Dysphonia / therapy*
  • Emotions*
  • Female
  • Humans
  • Judgment
  • Musculoskeletal Pain / physiopathology
  • Musculoskeletal Pain / psychology
  • Musculoskeletal Pain / therapy
  • Pain Measurement
  • Phonation*
  • Quality of Life
  • Speech Production Measurement
  • Surveys and Questionnaires
  • Terminology as Topic*
  • Time Factors
  • Treatment Outcome
  • Voice Quality*
  • Voice Training*