Laryngeal Manual Therapies for Behavioral Dysphonia: A Systematic Review and Meta-analysis

Ribeiro, Vanessa Veis; Pedrosa, Vanessa; Silvério, Kelly Cristina Alves; Behlau, Mara

doi:10.1016/j.jvoice.2017.06.019

Cited by 22 publications

(15 citation statements)

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“…No difference was found between the values of F 0 obtained by the Shure SM58 and the Karsect HT-9 microphones. This outcome, along with previous studies (1,(23)(24)(25) , states that F 0 is one of the most consistent and robust acoustic parameters, despite of different recording conditions. The same outcome was observed for Jitter, a perturbation measurement, and GNE, a noise measurement.…”

Section: Discussionsupporting

confidence: 83%

Análise acústica da voz: comparação entre dois tipos de microfones

Krik

Ribeiro

Siqueira

et al. 2019

Audiol., Commun. Res.

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RESUMO Objetivo Comparar os valores das medidas acústicas da voz, extraídas de gravações vocais realizadas com dois tipos de microfones. Métodos Participaram da pesquisa 103 pessoas do sexo feminino, com idades entre 18 e 54 anos. Foram coletadas amostras da vogal sustentada /e/, captadas por dois microfones, simultaneamente: Shure SM58 e Karsect HT-9. Foi realizada a análise acústica das vozes, com a extração de valores de frequência fundamental (F0), variação da frequência (Jitter) e variação de amplitude dos segmentos fundamentais da voz (Shimmer) e proporção Glottal to Noise Excitation (GNE). Resultados Houve diferenças entre os microfones apenas na medida de Shimmer, com predomínio de valores mais altos captados pelo Karsect HT-9. Porém, os resultados de ambos os microfones estiveram dentro dos padrões de normalidade do software utilizado. Conclusão Os resultados da análise acústica extraídos a partir da gravação de voz realizada com os microfones Shure SM58 e Karsect HT-9 foram semelhantes, concluindo-se que ambos os microfones podem ser utilizados para gravação do sinal sonoro na análise acústica.

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Section: Discussionsupporting

confidence: 83%

Análise acústica da voz: comparação entre dois tipos de microfones

Krik

Ribeiro

Siqueira

et al. 2019

Audiol., Commun. Res.

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“…36,38,43 Over the last two decades, attempts were undertaken to attain consensus and recommendations for voice measurements of laryngeal imaging (eg stroboscopy), 3,4,8,65 Third, several voice therapy approaches were not included in the present meta-analysis with regard to those that were analysed in previous systematic reviews on voice therapy. [35][36][37][38][39][40][41][42][43][44][45] This was due to the fact that currently no high-quality studies were available for those approaches, or studies used voice treatment outcome measures other than VHI, or omitted essential statistical data for a meta-analysis.…”

Section: Representativeness Of the Current Metaanalysismentioning

confidence: 99%

“…The present paper focuses on studies reporting the effectiveness of voice therapy as the primary intervention approach. In surveying the different systematic reviews of voice therapy effectiveness, 35‐45 only three researcher groups performed a meta‐analysis on different treatment approaches (ie Vocal Function Exercises, Laryngeal Manual Therapy, and indirect and combined voice therapy) 36,42,43 …”

Section: Introductionmentioning

confidence: 99%

“…In surveying the different systematic reviews of voice therapy effectiveness, [35][36][37][38][39][40][41][42][43][44][45] only three researcher groups performed a meta-analysis on different treatment approaches (ie Vocal Function Exercises, Laryngeal Manual Therapy, and indirect and combined voice therapy). 36,42,43 There exist several barriers for conducting a meta-analysis of voice therapy effectiveness. First, there is a lack of consistency of outcome measurements across studies to evaluate a treatment effect.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of voice therapy on voice‐related handicap: A network meta‐analysis

Latoszek

Neumann

2020

Clinical Otolaryngology

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Background Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are important for clinical guidance and evidence‐based practice. Objective of review To quantify the evidence of treatment effectiveness on the outcome measure Voice Handicap Index with the 30‐items (VHI‐30) from existing randomised controlled/clinical trials (RCT) of voice therapy using the statistical approach of a network meta‐analysis (NMA) with a random effects model. Type of review Meta‐analysis. Search strategy We searched in MEDLINE (PubMed, 1950 to 2019), Embase (1974 to 2019) and Science Citation Index (1994 to 2019) using five key terms. The inclusion criteria were reports of randomised controlled/clinical trials (RCTs) published in English or German which evaluated the effectiveness of a specific voice therapy treatment using VHI‐30 as an outcome measure in adult participants with non‐organic or organic voice disorders. Studies were excluded if participants had been diagnosed with neurological motor speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological or instrumental (eg voice amplification) treatments were considered. Evaluation method The primary outcome variable was VHI‐30 with a score from 0 to 120. The pre‐post treatment change in VHI‐30 scores was an average score of 13 points related to various VHI‐30 test‐retest results. Results We retrieved 464 publications (ie with duplicates) and included 13 RCTs, which evaluated nine interventions, in the final analysis. The most effective intervention with a significant and clinically relevant effect was Stretch‐and‐Flow Phonation (SFP) (mean pre‐post difference −28.37, 95% confidence interval [CI], −43.05 to‐13.68). Resonant Voice (RV), the Comprehensive Voice Rehabilitation Program (CVRP) and Vocal Function Exercises (VFE) also demonstrated significant improvements. Conclusions Of the nine voice interventions identified with the present NMA, SFP, RVT, CVRP, and VFE effectively improved VHI‐30 scores from pre‐ to post‐treatment. SFP proved to be the most significant and clinically relevant treatment. Further contributions of high‐quality intervention studies are needed to support evidence‐based practice in vocology.

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“…Dentre as diversas abordagens terapêuticas existentes na literatura (RIBEIRO et al, 2018;DESJARDINS et al, 2017;FU, THEODOROS, WARD, 2015;GARTNER-SCHIMDT et al, 2013;HALAWA, MUÑOZ, PEREZ, 2013;RODRÍGUEZ-PARRA, ADRIÁN, CASADO, 2009;MORSOMME et al, 2010;VAN LIERDE et al, 2010;RAMING et al, 1995;ROY et al, 1997;YAMAGICHI et al, 1993), os…”

Section: Agradecimentosmentioning

confidence: 99%

Protocolo terapêutico baseado em exercícios de trato vocal semiocluído em indivíduos disfônicos: estudo clínico, randomizado e cego

Antonetti¹

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Therapeutic protocol based on semi-occluded vocal tract exercises in dysphonic subjects: a blind randomized clinical trial Introducion: The voice therapy can be divided into direct and indirect. The indirect vocal therapy (IVT) are vocal hygiene orientations and voice physiologic production orientations, making the subject aware of harmful vocal habits. The direct therapy can be composed by voice exercises, such as Vocal Function Exercises (VFE) that improve the voice production subsystems: breathing, resonance, and phonation. Another way of direct therapy is using the semi-occluded vocal exercises (SOVTE), these exercises enable better filter and source interaction by the means of acoustic impedance changes. Studies that use a SOVTE protocol are almost zero. Therefore it is believed that a SOVTE protocol can contribute to voice clinic. Objective: Verify the effect of the treatment with SOVTE protocol at self-assessment and voice quality in dysphonic subjects. Compare it with VFE and Vocal Hygiene Approach. Methodology: Randomized and blind clinical trial. Twenty-seven volunteers (12 men and 15 women) were included in this study. They aged between 18 to 50 years old, with vocal complaints about vocal fatigue, and they received the functional dysphonia diagnose. The volunteers were equally divided into three groups: Experimental Group (EG), Vocal Function Exercises Group (VFEG), and Indirect Vocal Therapy Group (IVTG). After they filled the consent form, they were assessed by the researcher at three moments: before the intervention (M1), immediately after it (M2), and one month after it (M3). The researcher used the Vocal Fatigue Index (VFI), selfassessment of the vocal economy, Vocal Handicap Index (VHI), perceptual, and acoustic analysis. For the three groups, the interventions happened twice per week (four weeks) and last 35 minutes. It was used Repeated measures ANOVA test (p<0,05) and Tukey Test. Results: There were statistically significant results in the moment factor for IFV (p<0,001), vocal economy (p=0,007), and VHI (p<0,001). In M2 there was a decrease in the IFV and VHI scores keeping to M3. The vocal economy improved in M2, whereas in M3 it decreases, tending to M1 values. Regarding perceptual analysis, for general degree and roughness in the sustained vowel (p=0,015 e p=0,029) and counting numbers (p=0,036 e p=0,039), they only show that the groups are different. In the acoustic parameter of the fundamental frequency (p<0,001), women show greater values than men and the Cepstral Peak Prominence-smoothed (p=0,019) women show a smaller value than men. Conclusion: The subjects with functional dysphonia e vocal fatigue complaints, the SOVTE protocol is effective as VFE and IVT, regarding vocal fatigue, vocal economy, and vocal impairment. All interventions groups did not have changes at voice quality in this population.

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Laryngeal Manual Therapies for Behavioral Dysphonia: A Systematic Review and Meta-analysis

Cited by 22 publications

References 41 publications

Análise acústica da voz: comparação entre dois tipos de microfones

Análise acústica da voz: comparação entre dois tipos de microfones

The effectiveness of voice therapy on voice‐related handicap: A network meta‐analysis

Protocolo terapêutico baseado em exercícios de trato vocal semiocluído em indivíduos disfônicos: estudo clínico, randomizado e cego

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