A Systematic Review of Speech-Language Pathology Interventions for Presbyphonia Using the Rehabilitation Treatment Specification System

Saccente-Kennedy, Brian; Gillies, Fiona; Desjardins, Maude; Van Stan, Jarrad; Govender, Roganie

doi:10.1016/j.jvoice.2023.12.010

Journal of Voice

2024

DOI: 10.1016/j.jvoice.2023.12.010

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A Systematic Review of Speech-Language Pathology Interventions for Presbyphonia Using the Rehabilitation Treatment Specification System

Brian Saccente-Kennedy,

Fiona Gillies,

Maude Desjardins

et al.

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2024

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Cited by 4 publications

References 90 publications

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Endoscopic Distance and its Impact on Quantified Age‐related Vocal Fold Atrophy Measures

Aboueisha,

Sauder,

Jaleel

et al. 2024

The Laryngoscope

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IntroductionThe bowing index (BI) and normalized glottal gap area (NGGA) are used to quantify vocal fold morphology in ARVA; however, the influence of the distance between the flexible laryngoscope lens and the target area is not known. The goal is to test whether the endoscopic distance impacts vocal fold morphology measurements in patients with ARVA during flexible video laryngostroboscopy (VLS).MethodPatients with ARVA who underwent VLS were included. Images were classified into near (close to the petiole of the epiglottis) and far (below nasopharynx, with tongue base and entire epiglottis visible) conditions. BI was calculated using a mobile application, and NGGA was measured using ImageJ.ResultsThis study included 23 patients; the mean age was 77 ± 7 years. Mean BI measured at the near distance was higher than far distances with a mean difference of 1.94 (95% CI: 0.92–2.96, p = 0.001). NGGA showed difference with changed distance −0.24 (95% CI: −0.48 to 0.01, p < 0.05).When stratifying patients into two groups based on median BI measurement, there was a statistically significant difference between near and far conditions, with increased BI in the near condition for patients above the median (p < 0.05), but no difference between the near and far condition for patients with BI below the median.ConclusionThe BI and NGGA were impacted by the endoscopic distance during flexible VLS. BI was significantly higher in the near condition compared with the far condition. The difference in BI between the near and far conditions was more pronounced when the vocal fold bowing was greater. These findings call for heightened awareness of measurement discrepancies secondary to the endoscopic distance during flexible laryngostroboscopy.Level of EvidenceLevel 2 Laryngoscope, 2024

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Endoscopic Distance and its Impact on Quantified Age‐related Vocal Fold Atrophy Measures

Aboueisha,

Sauder,

Jaleel

et al. 2024

The Laryngoscope

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Systematic Review: Singing-Based Interventions to Improve Physical Functions Related to Aging Voice in Older Adults

Yuen,

2024

J Speech Lang Hear Res

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Purpose: This systematic review aimed to evaluate the effects of singing as an intervention for aging voice. Method: Quantitative studies of interventions for older adults with any medical condition that involves singing as training were reviewed, measured by respiration, phonation, and posture, which are the physical functions related to the aging voice. English and Chinese studies published until April 2024 were searched using 31 electronic databases, and seven studies were included. The included articles were assessed according to the Grading of Recommendations, Assessment, Development, and Evaluations rubric. Results: Seven studies were included. These studies reported outcome measures that were related to respiratory functions only. For the intervention effect, statistically significant improvements were observed in five of the included studies, among which three studies had large effect sizes. The overall level of evidence of the included studies was not high, with three studies having moderate levels and the rest having lower levels. The intervention activities included trainings other than singing. These non-singing training items may have caused co-intervention bias in the study results. Conclusions: This systematic review suggests that singing as an intervention for older adults with respiratory and cognitive problems could improve respiration and respiratory–phonatory control. However, none of the included studies covers the other two of the physical functions related to aging voice (phonatory and postural functions). The overall level of evidence of the included studies was not high either. There is a need for more research evidence in singing-based intervention specifically for patient with aging voice.

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Floating Ball Voice Therapy: Preliminary Effects on Outcomes and Predicting Individual Patient Differences in Generalization

Van Stan,

Hillman,

Krusemark

et al. 2024

J Speech Lang Hear Res

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Purpose: Floating ball voice therapy (FBVT) is a voice-controlled virtual environment based on a common treatment component across multiple evidence-based therapies: improved vocal efficiency (target) via practicing voicing with modified resonance and airflow (ingredient). This study preliminarily tested FBVT's effects on outcomes and the potential for its novel variability metrics to predict individual patient generalization. Method: Ten patients with nonphonotraumatic vocal hyperfunction (NPVH) practiced FBVT for 10 days. Outcomes were assessed by a vocal efficiency ratio, a validated NPVH index, the patient-reported Voice-Related Quality of Life (V-RQOL), and forced-choice auditory judgments of overall severity. Exploration in early practice (Day 1) was estimated by how the patient's two-dimensional variability (mean airflow and intensity) related to error (difference between the patient-produced and normative vocal efficiency ratio). Generalization from the game to spontaneous speech was evaluated using the validated NPVH index. Results: Ten days of FBVT were associated with improved vocal efficiency (Cohen's d = 1.3), NPVH index ( d = −1.1), V-RQOL total score ( d = 0.9), and overall severity (odds ratio = 2.5). Patients who generalized on Day 10 exhibited airflow/intensity exploration that was more aligned with the error gradient on Day 1 ( d = 0.6–1.2). Conclusions: A relatively small dosage of FBVT (i.e., 10 practice sessions) was associated with multiple improved voice therapy outcomes. The FBVT variability metrics on Practice Day 1 demonstrated strong potential to predict which patients generalized to connected speech. Future work can more thoroughly evaluate effects on outcomes and characterizing the quality of vocal exploration with a larger patient population. Supplemental Material: https://doi.org/10.23641/asha.27040873

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A Systematic Review of Speech-Language Pathology Interventions for Presbyphonia Using the Rehabilitation Treatment Specification System

Cited by 4 publications

References 90 publications

Endoscopic Distance and its Impact on Quantified Age‐related Vocal Fold Atrophy Measures

Endoscopic Distance and its Impact on Quantified Age‐related Vocal Fold Atrophy Measures

Systematic Review: Singing-Based Interventions to Improve Physical Functions Related to Aging Voice in Older Adults

Floating Ball Voice Therapy: Preliminary Effects on Outcomes and Predicting Individual Patient Differences in Generalization

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