Voice Therapy With a Semi-occluded Vocal Tract

Not Applicable

Completed

Conditions: Voice Disorders

Interventions: Behavioral: Straw phonation in air
Behavioral: straw phonation in water
Behavioral: /u/ phonation

Registration Number: NCT06137131

Lead Sponsor: University Ghent

Brief Summary: 1. The first objective of this research is to investigate the immediate effects of three semi-occluded vocal tract (SOVT) exercises (straw phonation in air, straw phonation in 2cm water, and straw phonation in 5cm water) on (supra)glottic activity of vocally healthy participants and patients with voice disorders (dysphonia) visualized with laryngovideostroboscopy.

Participants will receive a flexible laryngovideostroboscopy, both during normal phonation and during the specific SOVT exercise. These videos will be randomly and blindly evaluated by two experts using the Voice-Vibratory Assessment with Laryngeal Imaging (VALI) rating form (Poburka et al., 2017).

Researchers will compare the effects of these SOVT exercises on the (supra)glottic activity with the effects found in a control group producing /u/ phonation, using a randomized controlled trial.

2. The second objective of this research is to investigate the short- and long-term effects of the three SOVT therapy approaches on the (supra)glottic activity, voice quality and self-report of patients with voice disorders (dysphonia).

Participants will receive a short-term intensive therapy with the specific SOVT exercise across four weeks.

Immediately after the therapy program and at 1 and 3 months follow-up, the voice of the participants will be re-evaluated.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 58

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
straw phonation in air	Straw phonation in air	Participants will be asked to phonate an /u/ vowel through a stirring straw in air with slightly pursed lips and a soft voice onset.
straw phonation in 2 cm water	straw phonation in water	Participants will be asked to phonate an /u/ vowel through a stirring straw, placed 2 cm below the water surface, with slightly pursed lips and a soft voice onset.
straw phonation in 5 cm water	straw phonation in water	Participants will be asked to phonate an /u/ vowel through a stirring straw, placed 5 cm below the water surface, with slightly pursed lips and a soft voice onset.
/u/ control condition	/u/ phonation	Participants will be asked to phonate an /u/ vowel with slightly pursed lips and a soft voice onset but without a straw.

Primary Outcome Measures

Name	Time	Method
(Supra)Glottic Activity: Amplitude of Vibration	baseline (before the intervention)	Laryngeal function determined with the Voice-Vibratory Assessment with Laryngeal Imaging (VALI) rating form (Poburka et al., 2017). Amplitude of vibration: magnitude of lateral movement of the vocal folds. This is a visual-perceptual evaluation based on the video samples of the strobovideolaryngoscopy. Raters score the magnitude of lateral movement of the vocal folds based on the graphic of the VALI form ranging from 0 to 10, this number is then multiplied by 10 to obtain a percentage. Lower percentages mean a smaller amplitude of vibration, higher percentages mean a larger amplitude of vibration.
Supraglottic Activity: Anteroposterior Compression	baseline (before the intervention)	Laryngeal function determined with the VALI form (Poburka et al, 2017). Anteroposterior supraglottic compression: constriction of the supraglottic structures in the anteroposterior dimension. This is a visual-perceptual evaluation based on the video samples of the strobovideolaryngoscopy. Raters score the supraglottic compression based on the graphic of the VALI form on a scale ranging from 0 to 5 (with the aid of concentric circles). The higher the number, the more supraglottic compression. More supraglottic compression is often seen as a negative outcome, however it might be a beneficial effect seen in SOVT phonation studied here.

Secondary Outcome Measures

Name	Time	Method
Voice Quality Index 1: Dysphonia Severity Index (DSI)	baseline (before the intervention), 1 month (immediately after the intervention), 1 month follow-up, 3 months follow-up	DSI: A higher index indicates a better voice quality. The index ranges from -5 to +5 for severely dysphonic to normal voices. A more negative index indicates a worse voice quality. Values \> +5 are possible in subjects with excellent vocal capacities. A DSI = +1.6 is the threshold separating normophonic from dysphonic persons.
Voice Quality Index 2: Acoustic Voice Quality Index (AVQI)	baseline (before the intervention), 1 month (immediately after the intervention), 1 month follow-up, 3 months follow-up	A lower AVQI indicates a better voice quality. The index ranges from 0 to 10 for normal to severely dysphonic voices. An AVQI of 2.95 is the threshold separating normophonic from dysphonic persons.
Self-report 1: Voice Handicap Index (VHI)	baseline (before the intervention), 1 month (immediately after the intervention), 1 month follow-up, 3 months follow-up	VHI: A lower index indicates less impact of the voice impairment on the quality of life. The VHI ranges from 0 to 120.
Self-report 2: Vocal Tract Discomfort Scale (VTDS)	baseline (before the intervention), 1 month (immediately after the intervention), 1 month follow-up, 3 months follow-up	VTDS: A lower index indicates less discomfort in the vocal tract. The index ranges from 0 to 96.
Self-report 3: Vocal Fatigue Index (VFI)	baseline (before the intervention), 1 month (immediately after the intervention), 1 month follow-up, 3 months follow-up	VFI: A lower index indicates less vocal fatigue. The index ranges from 0 to 76.