Rehabilitation Treatment Specification System: Content and Criterion Validity Across Evidence-Based Voice Therapies for Muscle Tension Dysphonia.

Purpose: Systematically improving voice therapy outcomes is challenging as the clinician actions (i.e., active ingredients) responsible for improved patient functioning (i.

Effect of Clinical Expertise on Efficacy of Vocal Function Exercises in Individuals With Typical Voice.

Objectives/hypothesis: To determine the effect of clinical expertise on efficacy of Vocal Function Exercises (VFEs) as measured by change in percent of maximum phonation time goal attained. The hypothesis was that clinical expertise would result in greater increases in percent of maximum phonation time goal attained.

Study Design: Randomized controlled trial.

Mobile device accessibility with 3D printed devices for individuals with physical disabilities.

Purpose: Disparities may disproportionately exist for those with disabilities when using mobile devices, which are critical for independence in activities such as socialization and leisure. Prior 3D printing studies in rehabilitation have not focused on mobile device access to everyday preferred activities.

Methods: This study examined user satisfaction, self-rated performance and satisfaction with daily activities while using the mobile device, and the feasibility of customized 3D printed assistive devices.

The Effect of Maximum Phonation Time Goal on Efficacy of Vocal Function Exercises.

Objectives/ Hypothesis: To determine the effect of maximum phonation time goal on efficacy of Vocal Function Exercises (VFEs) as measured by percent of maximum phonation time goal attained. The hypothesis was that provision of a maximum phonation time goal would result in greater increases in percent of maximum phonation time goal attained.

Study Design: Randomized controlled trial.

Variability in Voice Characteristics of Female Speakers With Phonotraumatic Vocal Fold Lesions.

Objective: To examine the variability of lesion characteristics and vocal function in female speakers with phonotraumatic vocal fold lesions (PVFLs).

Study Design: Prospective Cohort Study METHODS: Thirty adult female speakers with PVFL who were participating in voice therapy were recruited to complete a multidimensional voice analysis at four time points across 1 month. Analysis comprised self-ratings of effort and vocal function, expert ratings of videostroboscopy and audio recordings, and instrumental evaluation by selected aerodynamic and acoustic parameters.

Developing and Testing a Smartphone Application to Enhance Adherence to Voice Therapy: A Pilot Study.

The present study aimed to develop a smartphone application (app) that addressed identified barriers to success in voice therapy; accessibility, and poor adherence to home practice. The study objectives were (1) to investigate if app use enhanced adherence to the home practice of voice therapy and (2) to test app usability. Maximizing the effectiveness of voice therapy is vital as voice disorders are detrimental to personal and professional quality of life.

Vocal Function Exercises With and Without Maximally Sustained Phonation: A Randomized Controlled Trial of Individuals With Normal Voice.

Objectives: To determine the effect of maximally sustained phonation on efficacy of Vocal Function Exercises as measured by percent of maximum phonation time goal attained. The hypothesis was that maximally sustained phonation would result in greater improvements in percent of maximum phonation time goal attained.

Study Design: Randomized controlled trial.

The Immediate Impact of Targeted Exercises on Voice Characteristics in Female Speakers With Phonotraumatic Vocal Fold Lesions.

Objective: To examine the immediate impact of 30 minutes of targeted voice exercises on measures of vocal function and lesion characteristics in female speakers with phonotraumatic vocal fold lesions (PVFLs).

Study Design: Prospective cohort study.

Method: Twenty-nine (n = 29) female subjects with PVFLs completed a 30 minutes targeted voice exercise protocol and a multidimensional voice analysis was conducted immediately pre and post-exercise.

The Impact of a Vocal Loading Task on Voice Characteristics of Female Speakers With Benign Vocal Fold Lesions.

Objectives: To examine the effect of a vocal loading task on measures of vocal structure and function in females with benign vocal fold lesions (BVFLs) and determine if change is observed in voice and lesion characteristics.

Study Design: Prospective cohort study.

Methods: Twenty-eight (n = 28) female subjects with phonotraumatic BVFLs completed a vocal loading task of 30 minutes of reading aloud at 75-85 dBA.

Voice Therapy According to the Rehabilitation Treatment Specification System: Expert Consensus Ingredients and Targets.

Purpose Clinical trials have demonstrated that standardized voice treatment programs are effective for some patients, but identifying the unique individual treatment ingredients specifically responsible for observed improvements remains elusive. To address this problem, the authors used a taxonomy of voice therapy, the Rehabilitation Treatment Specification System (RTSS), and a Delphi process to develop the RTSS-Voice (expert consensus categories of measurable and unique voice treatment ingredients and targets). Method Initial targets and ingredients were derived from a taxonomy of voice therapy.

Quantitative Assessment of Learning and Retention in Virtual Vocal Function Exercises.

Purpose Successful voice therapy requires the patient to learn new vocal behaviors, but little is currently known regarding how vocal motor skills are improved and retained. To quantitatively characterize the motor learning process in a clinically meaningful context, a virtual task was developed based on the Vocal Function Exercises. In the virtual task, subjects control a computational model of a ball floating on a column of airflow via modifications to mean airflow (L/s) and intensity (dB-C) to keep the ball within a target range representing a normative ratio (dB × s/L).

Rehabilitation Treatment Specification System: Methodology to Identify and Describe Unique Targets and Ingredients.

Although significant advances have been made in measuring the outcomes of rehabilitation interventions, comparably less progress has been made in measuring the treatment processes that lead to improved outcomes. A recently developed framework called the Rehabilitation Treatment Specification System (RTSS) has potential to identify which clinician actions (ie, ingredients) actively improve specific patient functions (ie, targets). However, the RTSS does not provide methodology for standardly identifying specific unique targets or ingredients.

Does a Systematic Vocal Exercise Program Enhance the Physiologic Range of Voice Production in Classical Singing Graduate-Level Students?

Purpose The purpose of this study was to assess the effects of vocal function exercises (VFEs) on the physiologic range of the operatic voice. The primary outcome measure was total voice range profile (VRP) area. Method Forty graduate-level opera majors were randomly assigned to experimental (training with VFE + vocal hygiene) and control (vocal hygiene only) groups.

Efficacy of Voice Therapy in Improving Vocal Function in Adults Irradiated for Laryngeal Cancers: A Pilot Study.

Background: Radiation therapy (XRT) for laryngeal cancers causes acute and chronic vocal dysfunction. Although these deleterious effects of XRT are well-established, there is a dearth of research with respect to effective voice rehabilitation following XRT for laryngeal cancers.

Objective: To obtain preliminary data on the efficacy of voice rehabilitation, using vocal function exercises (VFEs) in improving vocal function in adults irradiated for laryngeal cancer.

Limbic and cortical control of phonation for speech in response to a public speech preparation stressor.

Knowledge on brain networks subserving vocalization in vocally healthy individuals under various task conditions is scarce but paramount to understand voice disorders. The aims of our study were to determine (1) the effect of social-evaluative stress on the central neural control of phonation underlying speech production; and (2) the neural signature, personality profile, and aerodynamic vocal function in relation to salivary cortisol responses. Thirteen vocally healthy females underwent an event-related sparse-sampling fMRI protocol consisting of voiced and whispered sentence productions with and without exposure to the social-evaluative stressor public speaking anticipation.

Descriptive Analysis of the Interactive Patterning of the Vocalization Subsystems in Healthy Participants: A Dynamic Systems Perspective.

Purpose Normative data for many objective voice measures are routinely used in clinical voice assessment; however, normative data reflect vocal output, but not vocalization process. The underlying physiologic processes of healthy phonation have been shown to be nonlinear and thus are likely different across individuals. Dynamic systems theory postulates that performance behaviors emerge from the nonlinear interplay of multiple physiologic components and that certain patterns are preferred and loosely governed by the interactions of physiology, task, and environment.

Biobehavioral Measures of Presbylaryngeus.

Objective: The objective of this observational study was to assess the relationship between established aging biobehavioral measures and voice decline in normally aging adults.

Study Design: Cross-sectional study.

Methods: Participants 60-85 years of age were divided into two age and sex-matched groups, based on the presence or absence of presbylaryngeus.

Aging Voice Index (AVI): Reliability and Validity of a Voice Quality of Life Scale for Older Adults.

Changes in voice in aging adults impact their ability to use their voice to communicate in all situations and can lead to decreased quality of life (QOL). The primary objective of this study was to determine the validity and reliability of the Aging Voice Index (AVI)-a tool specifically designed for aging adults with voice disorders. A total of 92 older adults were asked to complete the Voice-Related Quality of Life Scale (VRQOL) and the AVI as well as provide their self-perceived voice severity rating of their voice problem and demographic information.

Vocal function exercises for normal voice: With and without semi-occlusion.

Purpose: This study examined the effect of varying degrees of vocal tract (VT) occlusion used during Vocal Function Exercises (VFEs) on attainment of maximum phonation time (MPT) goals in normal voice. Greater VT occlusion was expected to result in increased MPT. The overarching goal was to determine whether the semi-occluded vocal tract (SOVT) posture used during VFEs could be modified while preserving efficacy.

Vocalization Subsystem Responses to a Temporarily Induced Unilateral Vocal Fold Paralysis.

Purpose: The purpose of this study is to quantify the interactions of the 3 vocalization subsystems of respiration, phonation, and resonance before, during, and after a perturbation to the larynx (temporarily induced unilateral vocal fold paralysis) in 10 vocally healthy participants. Using dynamic systems theory as a guide, we hypothesized that data groupings would emerge revealing context-dependent patterns in the relationships of variables representing the 3 vocalization subsystems. We also hypothesized that group data would mask important individual variability important to understanding the relationships among the vocalization subsystems.

Effects of Vocal Function Exercises: A Systematic Review.

Objectives: The purpose of the present review was to systematically analyze the evidence for the effectiveness of vocal function exercises (VFEs) in improving voice production.

Methods: A systematic literature search was performed by two independent reviewers using PubMed and EBSCOHost to access relevant databases and to locate outcome studies that used VFEs as an intervention. Articles that met inclusion criteria were appraised based on the American Speech-Language and Hearing Association's levels of evidence.

Vocal function exercises for normal voice: The effects of varying dosage.

Purpose: This study examined the effect of varying dosage of vocal function exercise (VFE) home practice on attainment of pre-established maximum phonation time (MPT) goals in individuals with normal voice. High dosage VFE practice was expected to result in greatest MPT. The overarching goal of this study was to contribute to a VFE dosage-response curve, potentially including a point of observable toxicity.

Subcutaneous Neurotrophin 4 Infusion Using Osmotic Pumps or Direct Muscular Injection Enhances Aging Rat Laryngeal Muscles.

Laryngeal dysfunction in the elderly is a major cause of disability, from voice disorders to dysphagia and loss of airway protective reflexes. Few, if any, therapies exist that target age-related laryngeal muscle dysfunction. Neurotrophins are involved in muscle innervation and differentiation of neuromuscular junctions (NMJs).

A Multidimensional Study of Vocal Function Following Radiation Therapy for Laryngeal Cancers.

Background: Radiation therapy (XRT) has proven to be an effective curative modality in the treatment of laryngeal cancers. However, XRT also has deleterious effects on vocal function.

Aim: To demonstrate the multidimensional nature of deficits in vocal function as a result of radiation therapy for laryngeal cancer.

Immediate Effects of the Vocal Function Exercises Semi-Occluded Mouth Posture on Glottal Airflow Parameters: A Preliminary Study.

Objectives: The study aimed to quantify immediate alterations in the airflow glottogram between the Vocal Function Exercises semi-occluded mouth posture (/ol/ with lip buzz) and the sustained vowel /o/ in individuals with normal voices, and to determine if noted changes were in agreement with established semi-occluded vocal tract aerodynamic theory. Based on semi-occluded vocal tract aerodynamic theory, we hypothesized the following immediate changes in the flow glottogram during the /ol-buzz/ condition: a greater open quotient, a greater skewing quotient, a greater maximum flow declination rate, increased average airflow, decreased peak airflow, and increased minimum airflow.

Methods: A cohort of eight men with normal voices produced the sustained vowel /o/ and the Vocal Function Exercises semi-occluded mouth posture (/ol-buzz/).