The maximum phonation time as marker for voice treatment efficacy: A network meta‐analysis

Latoszek, Ben Barsties v.; Schwan, Katharina; Hetjens, Svetlana

doi:10.1111/coa.14019

Cited by 19 publications

(12 citation statements)

References 42 publications

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“…Moreover, the efficiency of initial or sole VT has been less well studied than that of the other treatment modalities, and the meta-analysis could only rely on a smaller number of participants and less variability in VT. Additionally, it is still unclear which voice exercises in VFP particularly facilitate behavioral changes in voice use or improved voice function. Two recent network meta-analyses identified four VT programs as effective: stretch-and-flow phonation, resonant voice, vocal function exercises, and an eclectic VT program [53,54]. Strong, direct VT concepts for VFP might include VT expulsion [42], Seong-Tae Kim's multiple VT technique [27], vocal function exercises [41][42][43]45,46], and resonant voice [30][31][32]41,43,45,46].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis

Latoszek

Hetjens

Neumann

2023

JCM

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Background: Vocal fold polyps (VFP) are a common cause of voice disorders and laryngeal discomfort. They are usually treated by behavioral voice therapy (VT) or phonosurgery, or a combination (CT) of both. However, the superiority of either of these treatments has not been clearly established. Methods: Three databases were searched from inception to October 2022 and a manual search was performed. All clinical trials of VFP treatment were included that reported at least auditory–perceptual judgment, aerodynamics, acoustics, and the patient-perceived handicap. Results: We identified 31 eligible studies (VT: n = 47–194; phonosurgery: n = 404–1039; CT: n = 237–350). All treatment approaches were highly effective, with large effect sizes (d > 0.8) and significant improvements in almost all voice parameters (p-values < 0.05). Phonosurgery reduced roughness and NHR, and the emotional and functional subscales of the VHI-30 were the most compared to behavioral voice therapy and combined treatment (p-values < 0.001). Combined treatment improved hoarseness, jitter, shimmer, MPT, and the physical subscale of the VHI-30 more than phonosurgery and behavioral voice therapy (p-values < 0.001). Conclusions: All three treatment approaches were effective in eliminating vocal fold polyps or their negative sequelae, with phonosurgery and combined treatment providing the greatest improvement. These results may inform future treatment decisions for patients with vocal fold polyps.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis

Latoszek

Hetjens

Neumann

2023

JCM

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“…[43][44][45] Further strong direct voice therapy concepts (such as the voice therapy expulsion, the Seong-Tae Kim's multiple voice therapy technique, vocal function exercises, and resonant voice) were yielded in treating vocal fold polyps, which are mostly based on secondary (with phonotraumatic lesions) muscle tension dysphonia. 46 In the primary care of voice patients with increased laryngeal tension leading to primary hoarseness, MCT may be considered a preferred approach because positive outcomes, in some patients, can be established after a single therapy session, as shown by four of six studies in the present meta-analysis. The reason for the effectiveness of this approach may lie in the position of the larynx in many cases of MTD.…”

Section: Discussionmentioning

confidence: 99%

“…These include vocal function exercises, stretch-and-flow phonation, resonant voice, an eclectic voice therapy program from Brazil, Novafon local vibration voice therapy, and water resistance therapy. [43][44][45] Further strong direct voice therapy concepts (such as the voice therapy expulsion, the Seong-Tae Kim's multiple voice therapy technique, vocal function exercises, and resonant voice) were yielded in treating vocal fold polyps, which are mostly based on secondary (with phonotraumatic lesions) muscle tension dysphonia. 46 In the primary care of voice patients with increased laryngeal tension leading to primary hoarseness, MCT may be considered a preferred approach because positive outcomes, in some patients, can be established after a single therapy session, as shown by four of six studies in the present meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta‐analysis

Latoszek

Hetjens

2023

The Laryngoscope

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ObjectiveMuscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front‐line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics‐to‐noise ratio) and vocal function (fundamental frequency) through a systematic review with meta‐analysis.Data SourcesFour databases were searched from inception to December 2022, and a manual search was performed.Review MethodsThe PRISMA extension statement for reporting systematic reviews incorporating a meta‐analysis of health care interventions was applied, and a random effects model was used for the meta‐analyses.ResultsWe identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of −.58; 95% CI −1.00 to 0.16), shimmer in percent (mean difference of −5.66; 95% CI −8.16 to 3.17), and harmonics‐to‐noise ratio in dB (mean difference of 4.65; 95% CI 1.90–7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered.ConclusionThe efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics‐to‐noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high‐quality randomized control trials are needed to support evidence‐based practice in laryngology. Laryngoscope, 2023

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“…Both respiratory function assessment and respiratory muscle strength testing were performed after practicing once. For MPT assessment, the participants pronounced the vowel /a/ for as long as possible after single maximal inspiration, and we measured the time [ 22 ]. The feasibility of air stacking was determined by checking for air leakage due to exhalation after deep inspiration.…”

Section: Methodsmentioning

confidence: 99%

Deterioration of Cough, Respiratory, and Vocal Cord Functions in Patients with Multiple System Atrophy

Asakawa,

Ogino,

Tominaga

et al. 2023

Neurology International

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The purpose of this study was to clarify changes in cough function in patients with multiple system atrophy (MSA). Seventeen probable patients with MSA were studied. Peak cough flow (PCF), respiratory function (percentage of vital capacity, percentage of forced vital capacity, and percentage of predicted forced expiratory volume in one second), respiratory muscle strength (percentage of maximal inspiratory mouth pressure and percentage of maximal expiratory mouth pressure), and maximum phonation time (MPT) were assessed. Walking ability, disease duration, possibility of air stacking, Unified MSA Rating Scale (UMSARS), and Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III were also assessed. Data were separately analyzed for ambulatory and non-ambulatory groups categorized by Functional Ambulation Categories. PCF, respiratory function, respiratory muscle strength, and MPT were significantly lower in the non-ambulatory group than in the ambulatory group. On the other hand, no correlation between PCF and disease duration was observed. A significant number of patients in the non-ambulatory group were unable to hold their breath. The UMSARS and MDS-UPDRS Part III in the non-ambulatory group were significantly higher than in the ambulatory group. It was concluded that ambulatory dysfunction is associated with the decline of cough function and respiratory-related function in patients with MSA.

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The maximum phonation time as marker for voice treatment efficacy: A network meta‐analysis

Cited by 19 publications

References 42 publications

The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis

The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta‐analysis

Deterioration of Cough, Respiratory, and Vocal Cord Functions in Patients with Multiple System Atrophy

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