Rodríguez-Parra María J, Adrián Jose A, Casado Juan C
Department of Personality, Psychological Evaluation and Treatment, University of Granada, Granada, Spain.
J Commun Disord. 2011 Nov-Dec;44(6):615-30. doi: 10.1016/j.jcomdis.2011.07.003. Epub 2011 Aug 5.
This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation.
Forty-two participants with voice disorders were randomly assigned to one of two groups. Participants in group 1 received voice-therapy and participants in group 2 received a vocal-hygiene program. Vocal function was assessed before and after treatment.
MANOVA analysis Pillai's trace test shows significant pre-post immediate differences between treatments in favor of direct-intervention. Repeated-measures ANOVAs display significant within subjects main effect for follow-up period in the 8 measures considered. Interaction effects of group×time are also found in five out of the eight continuous variables analyzed (3 aerodynamics-acoustic and 2 self-rating), indicating differences between both treatments. Qualitative dimensions (perceptual, laryngoscopic and spectrographic assessments) also support voice-therapy superiority.
Results of this study suggest superiority of a voice-therapy (direct treatment) approach over a vocal-hygiene program (indirect treatment). This advantage is on the majority of the 8 continuous variables analyzed (aerodynamics, acoustic, and self-rating), including qualitative perceptual, laryngoscopic and spectrographic voice-dimensions. The stability of changes is extended during a post-treatment follow-up period.
(1) The reader should distinguish the advantage using one type of treatment or another in clinical contexts. (2) The reader must know the most important direct techniques used in clinical treatment of voice disorders.
本研究使用有限的多维评估方案，评估两种不同的嗓音治疗方案对一组异质性发声障碍患者的有效性，以及治疗后长期随访期间治疗进展的稳定性。
42名嗓音障碍参与者被随机分配到两组中的一组。第1组参与者接受嗓音治疗，第2组参与者接受嗓音卫生计划。在治疗前后评估嗓音功能。
多变量方差分析的 Pillai 迹检验显示，治疗前后存在显著差异，支持直接干预。重复测量方差分析显示，在所考虑的8项测量中，随访期内受试者内部存在显著主效应。在分析的8个连续变量中的5个（3个空气动力学-声学变量和2个自我评估变量）中也发现了组×时间的交互作用，表明两种治疗方法存在差异。定性维度（感知、喉镜和频谱评估）也支持嗓音治疗的优越性。
本研究结果表明，嗓音治疗（直接治疗）方法优于嗓音卫生计划（间接治疗）。这种优势体现在所分析的8个连续变量中的大多数（空气动力学、声学和自我评估）上，包括定性的感知、喉镜和频谱嗓音维度。治疗后随访期间变化的稳定性得到延长。
（1）读者应在临床环境中区分使用一种治疗方法或另一种治疗方法的优势。（2）读者必须了解嗓音障碍临床治疗中使用的最重要的直接技术。
