Influence Of Tele Therapy On Individuals With Hyperfunctional Voice Disorders.

Not yet recruiting

Conditions: Dysphonia,

Registration Number: CTRI/2022/11/047256

Lead Sponsor: Ananya

Brief Summary: Voice therapy appears to be an effective treatment for various hyper-functional voice disorders, particularly early vocal nodules and muscular tension dysphonia (Holmberg et al., 2003). Vocal nodules have been linked to hyper-functional/phonotraumatic voice usage in literature. Muscle Tension Dysphonia (MTD) is also caused by vocal misuse/abuse, psychiatric illnesses, and underlying organic lesions, Behavioral voice therapy strategies focus on changing certain vocal behaviors and have been shown to help people with vocal nodules improve their voice quality. However, most individuals with voice disorders were reported to drop out and fail to sustain voice therapy sessions at a higher rate. Portone et al. (2008) observed 38% of patients never returned for voice evaluation recommended by the Otolaryngologist, and 47% of patients never reported voice therapy after the voice evaluation. , when these authors studied the reasons for the dropouts, they identified distance to travel for voice therapy, especially individuals who reside in rural areas or remote areas, are not able to take time off from their work, insurance denials, and lack of confidence about voice therapy were the main reasons for the dropout. In recent years telepractice/telerehabilitation has been an effective method in delivering speech therapy for whom face-to-face contact is impossible.The majority of the studies reported positive perceptions of participants about telerehabilitation.  However, this method may not reveal similar results for all types of disability. Hence, there is a need to understand the feasibility and efficacy of voice rehabilitation delivered through telepractice for individuals with voice disorders.

*Summary of the review*

Different studies were conducted to check the influence and feasibility of telepractice differently. Some of the studies compared pre-and post-therapy assessment measures, and some compared the results of tele practice with conventional mode of therapy. Most of the studies have targeted patients with Parkinsonâ€™s diseas/e. Some studies shed light on vocal nodules, muscle tension dysphonia, hyper-functional voice disorders, edema, and unilateral vocal fold paralysis. Most of the studies delivered voice therapy using Skype video calling. However, all the existing studies have reported positive participant perception irrespective of the mode of delivery.

*Research gap*

Minimal evidence exists regarding the feasibility of tele practice delivered using smartphones. To date, minimal data exists to understand the feasibility and influence of voice therapy delivered through tele practice for individuals with voice disorders in India.

**Need for the study**

Dysphonia can impact oneâ€™s professional and social life. Speech therapy services in India are available in very few centers, and people from rural and remote areas face the challenge of getting such services. Hence, there is a need to explore the influence of telerehabilitation for SLPs for providing therapy services over tele mode, focusing on delivering exceptional care for the medically underserved population.

*Purpose/Aim:*

To investigate the influence of the tele voice therapy program using smartphones on vocal parameters of individuals with hyper-functional voice disorders.

**Objectives:**

**1.**      To investigate the changes in vocal parameters pre and post teletherapy.

**2.**      To investigate the feasibility and participantsâ€™ perception of voice therapy delivered through tele practice.

**Statistical analysis**

Descriptive statistics will be used to summarise and describe the collected data. For continuous variables, paired t-test will be used to find the change between the mentioned two points. Wilcoxon signed rank will be used for those not following normal distribution to see the shift between the said two points

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 18

Inclusion Criteria

All the participants referred by Otolaryngologists, who are diagnosed with early vocal nodule and muscle tension dysphonia and are referred for voice therapy, those who cannot attend face-to-face therapy due to distance or occupation related constraints.

Exclusion Criteria

Individuals diagnosed with other vocal pathologies related to hyperfunctional voice disorders(vocal polyps, vocal cysts), Having associated problems like.
resonance, articulation, allergic rhinitis, respiratory disorders, hearing loss, psychiatric and neurologic conditions, Participants underwent vocal fold surgery, Have had attended voice therapy previously, Have had no access to smartphones/ internet facility.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1. Auditory perceptual analysis of voice- GRBAS perceptual scale	Outcome measured will be measured at baseline and post intervention
2. Acoustic analysis	Outcome measured will be measured at baseline and post intervention
3. Maximum Phonation Duration	Outcome measured will be measured at baseline and post intervention
4. Quality of life	Outcome measured will be measured at baseline and post intervention

Secondary Outcome Measures

Name	Time	Method
Not Applicable	Not Applicable

Trial Locations

Locations (1): Kasturba Hospital, Manipal,
🇮🇳
Udupi, KARNATAKA, India
Kasturba Hospital, Manipal,
🇮🇳Udupi, KARNATAKA, India
Ananya
Principal investigator
7022737235
ananya.mcoahsma1@learner.manipal.edu