The Effects of Adding Expiratory Muscle Strength Training in Voice Therapy

University of Miami

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Conditions

Dysphonia Unilateral Vocal Cord Paralysis

Interventions

Standard of care voice therapyOTHER

Exercises will include improved breath coordination, sustained humming and vowels, vocal glides, resonant voice therapy, and relaxation techniques to the neck and shoulder

Expiratory muscle strength training (EMST)OTHER

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.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Locations (1)

University of Miami

Miami, Florida, United States

Outcomes

Primary Outcomes

Maximum expiratory pressure

Maximum expiratory pressure, in cm of H2O, will be measured to evaluate how much pressure a participant can blow into a respiratory pressure meter.

Time frame: 16 weeks

Amplitude

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.

Time frame: 16 weeks

Secondary Outcomes

Fundamental frequency

Fundamental frequency, measured in herz, will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab.

Time frame: 16 weeks

Dynamic pitch range

Dynamic pitch range will be measured using Voice Range Profile on Kay Pentax Computerized Speech Lab.

Time frame: 16 weeks

Cepstral Peak Prominence (CPP)

Cepstral Peak Prominence will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab.

Time frame: 16 weeks

Cepstral spectral index of dysphonia (CSID)

Cepstral spectral index of dysphonia, will be obtained using the Analysis of Dysphonia in Speech and Voice on Kay Pentax Computerized Speech Lab.

Time frame: 16 weeks

Voice Handicap Index

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.

Data from ClinicalTrials.gov

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