Changes in the daily phonotrauma index following the use of voice therapy as the sole treatment for phonotraumatic vocal hyperfunction in females

Jarrad H. Van Stan, Andrew J. Ortiz, Katherine L. Marks, Laura E. Toles, Daryush D. Mehta, James A. Burns, Tiffiny Hron, Tara Stadelman-Cohen, Carol Krusemark, Jason Muise, Annie B. Fox, Charles Nudelman, Steven Zeitels, Robert E. Hillman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: The aim of this study was to use the Daily Phonotrauma Index (DPI) to quantify group-based changes in the daily voice use of patients with phonotraumatic vocal hyperfunction (PVH) after receiving voice therapy as the sole treatment. This is part of an ongoing effort to validate an updated theoretical framework for PVH. Method: A custom-designed ambulatory voice monitor was used to collect 1 week of pre-and posttreatment data from 52 female patients with PVH. Normative weeklong data were also obtained from 52 matched controls. Each week was represented by the DPI, which is a combination of neck-surface acceleration magnitude skewness and the standard deviation of the difference between the first and second harmonic magnitudes. Results: Compared to pretreatment, the DPI statistically decreased towards normal in the patient group after treatment (Cohen’s d = −0.25). The posttreatment patient group’s DPI was still significantly higher than the control group (d = 0.68). Conclusions: The DPI showed the pattern of improved ambulatory voice use in a group of patients with PVH following voice therapy that was predicted by the updated theoretical framework. Per the prediction, voice therapy was associated with a decreased potential for phonotrauma in daily voice use, but the posttreatment patient group data were still significantly different from the normative control group data. This posttreatment difference is interpreted as reflecting the impact on voice use of the persistence of phonotrauma-induced structural changes to the vocal folds. Further validation of the DPI is needed to better understand its potential clinical use.

Original languageEnglish (US)
Pages (from-to)3446-3455
Number of pages10
JournalJournal of Speech, Language, and Hearing Research
Volume64
Issue number9
DOIs
StatePublished - Sep 2021
Externally publishedYes

ASJC Scopus subject areas

  • Language and Linguistics
  • Linguistics and Language
  • Speech and Hearing

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