Predictive assessment of vocal efficiency (PAVE). A method for voice therapy outcome measurement

Abstract

A prospective study was carried out to examine the degree to which a standard voice assessment could discriminate between the potential benefits of two different voice therapy programmes for individual patients. The study encompassed 200 dysphonia subjects who were referred for voice therapy and had completed treatment within a prescribed two-year period. A standard assessment procedure was carried out on first attendance for each patient and guidelines were used to assign patients to different treatment programmes on the basis of the assessment results. The assessment discriminated well between patients requiring voice therapy to change physiological parameters of voice usage and patients able to self adjust voice usage, and provided an objective means of measuring outcomes.

Effects of Voice Therapy: A Systematic Review

“…Most of the patients of the control group (86%) show no significant change on any of the parameters, whereas 46% and 93%, respectively, of the indirect and combined therapy groups show positive changes in voice quality on all parameters. 43 include even a larger and more diverse group of patients suffering from dysphonia resulting from vocal misuse or abuse, with a variety of secondary pathologies including soft nodules, polyps, Reinke's edema, and fold thickening (N ¼ 200). Patients with significant disordered air usage are assigned to a therapy program to normalize the aerodynamic parameters.…”

Boot Camp: A Novel Intensive Approach to Voice Therapy

“…Available evidence suggests that this traditional model of voice therapy delivery is not overwhelmingly successful. 3,5 Long-term outcome (greater than 1 year) suggests a high rate of partial recurrences of dysphonia in 51-68% of individuals. 6,7 Treatment success immediately after voice therapy is unclear with reports ranging from 41% to 96%.…”

“…6,7 Treatment success immediately after voice therapy is unclear with reports ranging from 41% to 96%. 1,3,5,6 Moreover, these reported treatment success rates of traditional voice therapy immediately posttreatment may be an overestimate because they do not include patient dropouts, which are reported to be large because of poor adherence to treatment regimes. High-dropout rates of 16-65% [8][9][10][11] coupled with reduced success rates of traditional voice therapy, suggest the need for development of new approaches of voice therapy delivery to improve treatment success.…”

“…Voice therapy ''boot camp'' was derived from the constructs related to ''intensity'' from the fields of neurobiology, exercise physiology, motor learning, psychology, and language therapy to facilitate behavior change within short duration of time. Intensive short-term voice therapy is a unique approach of concentrated practice with a large number of clinicians (3)(4)(5)(6)(7), with a variety of voice therapy techniques, in a concentrated time frame (1-4 days with 4-7 hours of therapy per day). Therapy is tailored in large amounts to the nature of the voice disturbance and individual specific needs, thereby maximizing the patient's ability to learn and carryover targets to nonclinical environments.…”

Acoustic Analysis Before and After Voice Therapy for Laryngeal Pathology

“…17 Successful resolution of the problem was seen in only 41.5% and 35% with therapy and monitoring program, relaxing exercises respectively.…”