A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols Purpose Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant ... Research Article
Research Article  |   June 01, 2015
A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols
 
Author Affiliations & Notes
  • Mara R. Kapsner-Smith
    National Center for Voice and Speech, University of Utah, Salt Lake City
    University of Washington, Seattle
  • Eric J. Hunter
    National Center for Voice and Speech, University of Utah, Salt Lake City
    Michigan State University, East Lansing
  • Kimberly Kirkham
    National Center for Voice and Speech, University of Utah, Salt Lake City
  • Karin Cox
    National Center for Voice and Speech, University of Utah, Salt Lake City
  • Ingo R. Titze
    National Center for Voice and Speech, University of Utah, Salt Lake City
    University of Iowa, Iowa City
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Mara R. Kapsner-Smith: mkapsner@uw.edu
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Bruce Gerratt
    Associate Editor: Bruce Gerratt×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   June 01, 2015
A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 535-549. doi:10.1044/2015_JSLHR-S-13-0231
History: Received September 9, 2013 , Revised April 7, 2014 , Accepted December 28, 2014
 
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 535-549. doi:10.1044/2015_JSLHR-S-13-0231
History: Received September 9, 2013; Revised April 7, 2014; Accepted December 28, 2014

Purpose Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions.

Method Twenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group.

Results Voice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings.

Conclusions VFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study.

Acknowledgments
This work was supported by the National Institute on Deafness and other Communication Disorders, Grant DC004224. Additional support was received from the National Center for Research Resources and the National Center for Advancing Translational Sciences through Grant 8UL1TR000105 (formerly UL1RR025764). Lynn Maxfield provided assistance in data collection and Russell Banks in data analysis. Greg Stoddard assisted with statistical analysis.
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