Massed Versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Therapy Versus a Long-Term Traditional Voice Therapy

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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“…Patients provided continuous feedback on the treatment and asked questions that were implemented into the patient education, as well as information important to include in the anamneses. Anecdotally, improvements in EILO symptoms were observed with both approaches (phase 3 and phase 4), in line with findings from a similar study ( 38 ).…”

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“…Research in voice therapy has compared some of the following categories: service delivery models, [1][2][3][4] duration of voice therapy sessions, 5,6 number of voice therapy sessions, [6][7][8][9][10] and type of voice therapy programs. [11][12][13][14] Across these categories of inquiry, similar outcomes are shown regardless of the variations in therapy.…”

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“…Patients provided continuous feedback on the treatment and asked questions that were implemented into the patient education, as well as information important to include in the anamneses. Anecdotally, improvements in EILO symptoms were observed with both approaches (phase 3 and phase 4), in line with findings from a similar study (38).…”