Dysphonia, Unilateral Vocal Cord Paralysis
Conditions
Brief summary
Evaluate if adding expiratory muscle strength training to traditional voice therapy for individuals with dysphonia due to glottal insufficiency improves maximal expiratory pressure, acoustic and aerodynamic measures (i.e. amplitude, maximum phonation time, peak expiratory flow), and voice related quality of life.
Interventions
OTHERStandard of care voice therapy
Exercises will include improved breath coordination, sustained humming and vowels, vocal glides, resonant voice therapy, and relaxation techniques to the neck and shoulder
EMST150 used at 75% of their maximum expiratory pressure. Participants will be directed to perform 5 sets of 5 breaths, 5 days per week, for 5 weeks, at the pressure threshold established in therapy. Maximum expiratory pressure will then be determined at the beginning of each therapy session and recalibration of the device will be performed if indicated.
Sponsors
University of Miami
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals with glottic insufficiency. * Adequate cognition evidenced by score of 24 or higher on the Mini-Mental State Examination (MMSE) survey to determine if the subject has the mental capacity to participate in therapy * Completed voice combination evaluation with speech pathologists and otolaryngologist. * Individuals 18 years of age or older
Exclusion criteria
* Adults unable to consent * Non English or Spanish speakers * Pregnant women * Prisoners * Individuals with significant uncontrolled chronic and progressive respiratory diseases including COPD, interstitial lung disease, and cystic fibrosis. * Individuals with uncontrolled blood pressure. * Individuals with significant GI disease and/or gastroesophageal surgery with the exception of well-controlled GERD. * Individuals with a history of abdominal hernia. * Individuals with difficulty complying due to neuropsychological dysfunction (e.g., severe depression, psychosis). * Individuals with other neurological disorders and/or neuromuscular disease other than Parkinson's Disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum expiratory pressure | 16 weeks | Maximum expiratory pressure, in cm of H2O, will be measured to evaluate how much pressure a participant can blow into a respiratory pressure meter. |
| Amplitude | 16 weeks | Amplitude of voice, in decibels, will be measured using Voice Range Profile on Kay Pentax CSL and will be compared to gender matched normative values for normal and loud volumes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cepstral Peak Prominence (CPP) | 16 weeks | Cepstral Peak Prominence will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab. |
| Cepstral spectral index of dysphonia (CSID) | 16 weeks | Cepstral spectral index of dysphonia, will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab. |
| Fundamental frequency | 16 weeks | Fundamental frequency, measured in herz, will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab. |
| Maximum phonation time | 16 weeks | The patient will be asked to inhale deeply and sustain the vowel /a/ at a comfortable loudness level for a many seconds as possible. |
| Peak expiratory flow rate | 16 weeks | Peak expiratory flow rate, measured in units of liters per minute, will be measured for purposes of measuring cough function. |
| Voice Handicap Index | 16 weeks | This is quality of life assessment tool quantifying perception of the impact of their vocal disorder on various aspects of lifestyle. It is 30-questions in length and is divided into 3 subscales including emotional, physical, and functional, divided into 10 questions each. Each question scored from 0-4. Total score range from 0-120. Higher score indicates increased handicap. |
| Dynamic pitch range | 16 weeks | Dynamic pitch range will be measured using Voice Range Profile on Kay Pentax Computerized Speech Lab. |
Countries
United States
Outcome results
None listed