Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
J Voice. 2024 Jul;38(4):903-910. doi: 10.1016/j.jvoice.2022.01.018. Epub 2022 Feb 25.
The aim was to compare voice outcomes over time in patients treated with Imitation Model voice therapy and Verbal Instructions Model voice therapy.
A prospective clinical trial was performed with 56 consecutive patients diagnosed with a primary or secondary functional voice disorder. Thirty-one patients were included for voice therapy following the Imitation Model and 25 patients for the Verbal Instructions Model. Assessments included a self-rated Voice Handicap Index, self-perceived hoarseness and vocal fatigue, perceptual voice evaluation by a Speech Language Pathologist, and maximum Voice Range Profiles. All assessments were completed before therapy, at end of therapy, at six-months posttherapy follow-up and 12-months posttherapy follow-up. For maximum Voice Range Profiles group differences were also compared for effects from end-of-treatment to follow-up assessments. Linear mixed models were used for analysis.
Comparison between treatment groups showed significantly larger long-term improvement from the baseline, for verbal instructions model as compared to imitation model for Voice Handicap Index total, and also the physical and emotional subscales, while there was no difference between groups for the functional subscale. Also, voice quality improved more after verbal instructions model, as compared to imitation model, at end of therapy. Results from self-rated hoarseness and vocal fatigue showed no difference between groups. There was no difference between treatment groups in the change of maximum Voice Range Profile from end-of-treatment to follow-up assessments.
The study showed that both Imitation Model voice therapy and Verbal Instructions Model voice therapy improved voice function. Compared to Imitation Model, the Verbal Instructions model showed larger long-term effect on physical and emotional aspects of voice function in everyday life. The two approaches for voice therapy might have different impacts on patients' learning.
比较模仿模型语音疗法和口头指令模型语音疗法治疗患者的语音效果随时间的变化。
对 56 例原发性或继发性功能性嗓音障碍患者进行前瞻性临床试验。31 例患者采用模仿模型进行语音治疗，25 例患者采用口头指令模型进行语音治疗。评估包括自我评估的嗓音障碍指数、自我感知的嘶哑和嗓音疲劳、言语语言病理学家进行的感知嗓音评估以及最大嗓音范围图。所有评估均在治疗前、治疗结束时、治疗后 6 个月随访和治疗后 12 个月随访时完成。对于最大嗓音范围图，还比较了从治疗结束到随访评估的组间差异。采用线性混合模型进行分析。
治疗组之间的比较显示，口头指令模型的长期改善明显大于模仿模型，无论是嗓音障碍指数总评分，还是身体和情绪子评分，而功能子评分在两组之间没有差异。此外，在治疗结束时，与模仿模型相比，口头指令模型的语音质量得到了更大的改善。自我评估的嘶哑和嗓音疲劳结果显示两组之间没有差异。从治疗结束到随访评估，最大嗓音范围图的变化在两组之间没有差异。
本研究表明，模仿模型语音疗法和口头指令模型语音疗法均能改善嗓音功能。与模仿模型相比，口头指令模型在日常生活中对嗓音功能的身体和情绪方面具有更大的长期效果。两种语音治疗方法可能对患者的学习有不同的影响。
