Comparing voice-therapy and vocal-hygiene treatments in dysphonia
using a limited multidimensional evaluation protocol
Publicado en Journal of Communication Disorders
María J. Rodríguez-Parra, Department of Personality, Psychological Evaluation and Treatment, University of Granada, Granada, Spain
Jose A. Adrián, Department of Personality, Psychological Evaluation and Treatment, University of Malaga, Malaga, Spain
Juan C. Casado Department of Otorhinolaryngology, Costa del Sol Hospital, Marbella, Malaga, Spain
Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation.
Method: Forty-two participants with voice disorders were randomly assigned to one of two groups. Participants in group 1 received voice-therapy and participants in group 2 received a vocal-hygiene program. Vocal function was assessed before and after treatment.
Results: MANOVA analysis Pillai’s trace test shows significant pre–post immediate differences between treatments in favor of direct-intervention. Repeated-measures ANOVAs display significant within subjects main effect for follow-up period in the 8 measures considered. Interaction effects of group × time are also found in five out of the eight continuous variables analyzed (3 aerodynamics-acoustic and 2 self-rating), indicating differences between both treatments. Qualitative dimensions (perceptual, laryngoscopic and spectrographic assessments) also support voice-therapy superiority.
Conclusions: Results of this study suggest superiority of a voice-therapy (direct treatment) approach over a vocal-hygiene program (indirect treatment). This advantage is on the majority of the 8 continuous variables analyzed (aerodynamics, acoustic, and self-rating), including qualitative perceptual, laryngoscopic and spectrographic voice-dimensions. The stability of changes is extended during a post-treatment follow-up period.
Learning outcomes: (1) The reader should distinguish the advantage using one type of treatment or another in clinical contexts. (2) The reader must know the most important direct techniques used in clinical treatment of voice disorders.
► We used a shortened multidimensional protocol to evaluate clinical progress in the voice disorders.
► We evaluated two different treatment programs of the voice disorders in different stages.
► The results suggested superiority of a voice-therapy approach over vocal-hygiene program.
► The stability of changes was extended during a post-treatment follow-up period.
Keywords: Voice-therapy; Vocal-hygiene; Dysphonia; Effectiveness; Multidimensional protocol