Effect of a short-term intensive voice therapy (Meerschman et al., 2019)

Purpose: The aim of this study was to compare the effectof a short-term intensive voice therapy (IVT) with a long-term traditional voice therapy (TVT) on the vocal quality, vocal capacities, psychosocial impact, vocal tract discomfort, laryngological anatomy/physiology, and session attendance of patients with dysphonia. An additional comparison was made between an individual IVT (IVT-I) and a group IVT (IVT-G).Method: A longitudinal, prospective controlled trial was used. Forty-six adults diagnosed with dysphonia were assigned to 1 of the 3 treatment groups. The IVT groups practiced with a frequency of 1 hr 20 min a day and a duration of 2 weeks. The TVT group practiced with a frequency of two 30-min sessions a week and a duration of 6 months. Both therapy programs were content-identical and guided by the same voice therapist. A multidimensional voice assessment consisting of both objective (maximum performance task, aerodynamic measurements, voice range profile, acoustic analysis, multiparametric voice quality indices) and subjective (subject’s self-report, auditory-perceptual evaluation, flexible videolaryngostroboscopy) outcomes was used to evaluate the participants’ voice.Results: IVT made an equal progress in only 2 weeks and 12 hr of therapy compared with TVT that needed 6 months and 24 hr of therapy. IVT-I and IVT-G showed comparable results. Session attendance was clearly higher in IVT compared with TVT. Long-term follow-up results (1 year) were positive for the 3 groups, except for the self-reported psychosocial impact that increased in the IVT-I group.Conclusions: Short-term IVT is at least equally effective in treating patients with dysphonia as long-term TVT. Group treatment seemed as effective as individual treatment. Attendance and cost-effectiveness are important advantages of IVT. A potential drawback might be an insufficient psychosocial progress. The golden mean between intensive and traditional treatment might therefore be an achievable, effective, and efficient solution for everyday clinical practice.Supplemental Material S1. Baseline voice-related symptoms, risk factors, vocal abuse, vocal load and lifestyle habits in the IVT-I, IVT-G, and TVT groups. Supplemental Material S2. Evolution of the secondary outcome parameters pre- to post-therapy in the IVT-I, IVT-G, and TVT groups.Meerschman, I., Claeys, S., Bettens, K., Bruneel, L., D'haeseleer, E., Van Lierde, K. (2019). Massed versus spaced practice in vocology: Effect of a short-term intensive voice therapy versus a long-term traditional voice therapy. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2018_JSLHR-S-18-0013

研究目的：本研究的目的是比较短期强化语音治疗（IVT）与长期传统语音治疗（TVT）对嗓音质量、嗓音能力、心理社会影响、声带不适、喉部解剖生理学以及嗓音障碍患者治疗出席率的影响。此外，还对个体IVT（IVT-I）与团体IVT（IVT-G）进行了比较。研究方法：采用纵向的前瞻性对照试验。将诊断为嗓音障碍的46名成年人分配到3个治疗组的其中之一。IVT组每日练习1小时20分钟，持续2周。TVT组每周进行两次30分钟的会话，持续6个月。两种治疗方案内容相同，并由同一语音治疗师指导。使用多维度嗓音评估，包括客观指标（最大表现任务、气动测量、嗓音范围分析、声学分析、多参数嗓音质量指数）和主观指标（患者自我报告、听觉感知评估、灵活的声带镜检查）的结果来评估参与者嗓音。研究结果：与需要6个月和24小时治疗的TVT相比，IVT仅用2周和12小时的疗法就取得了相同的进展。IVT-I和IVT-G显示出可比的结果。与TVT相比，IVT的治疗出席率明显更高。长期随访结果（1年）显示，除IVT-I组的自我报告心理社会影响增加外，3组均呈积极结果。结论：短期IVT在治疗嗓音障碍患者方面至少与长期TVT同样有效。团体治疗似乎与个体治疗一样有效。出席率和成本效益是IVT的重要优势。潜在缺点可能是心理社会进步不足。因此，在强化治疗与传统治疗之间寻求最佳平衡，可能是临床实践中可实现的、有效且高效的治疗方案。补充材料S1：IVT-I、IVT-G和TVT组的基线嗓音相关症状、风险因素、嗓音滥用、嗓音负荷和生活习惯。补充材料S2：IVT-I、IVT-G和TVT组治疗前后次要结果参数的变化。Meerschman, I., Claeys, S., Bettens, K., Bruneel, L., D'haeseleer, E., Van Lierde, K. (2019). 语音学中集中练习与分散练习的比较：短期强化语音治疗与长期传统语音治疗的效果。言语、语言和听力研究杂志。在线提前发布。https://doi.org/10.1044/2018_JSLHR-S-18-0013