Nanjundaswamy Ranjitha Kashyap Bannur, Jayakumar Thirunavukkarasu, Prakash Tumkur Kumaraswamy
Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
J Voice. 2024 Sep 7. doi: 10.1016/j.jvoice.2024.08.026.
Hyperfunctional voice disorder (HFVD) has a multifaceted origin. Individuals with HFVD work in professions that demand high vocal usage and are bound to work for longer hours with very inflexible work schedules. In consequence, it can be speculated that an eclectic voice therapy program that uses combinatory approaches delivered via telepractice could bring about better efficiency of voice in these individuals. Nevertheless, very less attempts have been made in these lines. Therefore, the present study aims to implement eclectic voice therapy via telepractice and examine the efficacy of the same in HFVD.
In total, 10 individuals with HFVD in the age range of 20-55years received Comprehensive Voice Habilitation Program (CVHP), an eclectic voice therapy approach via a videoconferencing platform, Zoom Video Communications, Inc. All the participants completed 15 sessions of voice therapy spread across 3weeks. Stroboscopy examination was performed at the baseline and post therapy to track the changes in laryngeal functions. Further, Consensus Auditory Perceptual Evaluation-Voice (CAPE-V), Acoustic Voice Quality Index (AVQI), and Voice Handicap Index in Kannada (VHI-K) were obtained at the baseline, post therapy, and two follow-ups to report the therapy outcomes. Related-sample Friedman's Two-way Analysis of Variance by Ranks and Wilcoxon Signed Rank Test were used to note the pre-post and follow-up changes in voice outcomes.
Significant improvement in movement patterns of the vocal folds and a reduction in ventricular hyperadduction were noted in stroboscopy. CAPE-V and AVQI scores decreased in post-therapy and follow-up evaluations indicating reduction in dysphonia severity over time. Also, decrease in VHI-K scores indicated improved psychosocial aspects and quality of life in HFVD.
The current study provided preliminary evidence on the possible benefits of telepractice in the delivery of CVHP in HFVD. Hence, telepractice could be recommended as an alternate treatment modality for patients with HFVD.
功能性嗓音障碍（HFVD）的病因是多方面的。患有HFVD的个体从事需要大量发声的职业，并且工作时间长，工作安排非常不灵活。因此，可以推测，一种采用多种方法并通过远程医疗实践提供的综合性嗓音治疗方案可能会提高这些个体的嗓音效率。然而，在这方面的尝试非常少。因此，本研究旨在通过远程医疗实践实施综合性嗓音治疗，并检验其对HFVD的疗效。
共有10名年龄在20至55岁之间的HFVD患者接受了综合性嗓音康复计划（CVHP），这是一种通过视频会议平台Zoom Video Communications, Inc.进行的综合性嗓音治疗方法。所有参与者在3周内完成了15次嗓音治疗课程。在基线和治疗后进行频闪喉镜检查，以跟踪喉部功能的变化。此外，在基线、治疗后和两次随访时获取共识听觉感知评估-嗓音（CAPE-V）、声学嗓音质量指数（AVQI）和卡纳达语嗓音障碍指数（VHI-K），以报告治疗结果。使用相关样本的Friedman双向秩方差分析和Wilcoxon符号秩检验来记录嗓音结果的治疗前后及随访变化。
频闪喉镜检查发现声带运动模式有显著改善，室带过度内收减少。治疗后和随访评估中CAPE-V和AVQI评分降低，表明随着时间推移，发音障碍严重程度降低。此外，VHI-K评分降低表明HFVD患者的心理社会方面和生活质量得到改善。
本研究为远程医疗实践在HFVD患者中实施CVHP的潜在益处提供了初步证据。因此，远程医疗实践可被推荐为HFVD患者的替代治疗方式。
