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Clinical Otolaryngology : Official... Sep 2020Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are important for clinical guidance and evidence-based practice.
OBJECTIVE OF REVIEW
To quantify the evidence of treatment effectiveness on the outcome measure Voice Handicap Index with the 30-items (VHI-30) from existing randomised controlled/clinical trials (RCT) of voice therapy using the statistical approach of a network meta-analysis (NMA) with a random effects model.
TYPE OF REVIEW
Meta-analysis.
SEARCH STRATEGY
We searched in MEDLINE (PubMed, 1950 to 2019), Embase (1974 to 2019) and Science Citation Index (1994 to 2019) using five key terms. The inclusion criteria were reports of randomised controlled/clinical trials (RCTs) published in English or German which evaluated the effectiveness of a specific voice therapy treatment using VHI-30 as an outcome measure in adult participants with non-organic or organic voice disorders. Studies were excluded if participants had been diagnosed with neurological motor speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological or instrumental (eg voice amplification) treatments were considered.
EVALUATION METHOD
The primary outcome variable was VHI-30 with a score from 0 to 120. The pre-post treatment change in VHI-30 scores was an average score of 13 points related to various VHI-30 test-retest results.
RESULTS
We retrieved 464 publications (ie with duplicates) and included 13 RCTs, which evaluated nine interventions, in the final analysis. The most effective intervention with a significant and clinically relevant effect was Stretch-and-Flow Phonation (SFP) (mean pre-post difference -28.37, 95% confidence interval [CI], -43.05 to-13.68). Resonant Voice (RV), the Comprehensive Voice Rehabilitation Program (CVRP) and Vocal Function Exercises (VFE) also demonstrated significant improvements.
CONCLUSIONS
Of the nine voice interventions identified with the present NMA, SFP, RVT, CVRP, and VFE effectively improved VHI-30 scores from pre- to post-treatment. SFP proved to be the most significant and clinically relevant treatment. Further contributions of high-quality intervention studies are needed to support evidence-based practice in vocology.
Topics: Disabled Persons; Dysphonia; Humans; Network Meta-Analysis; Phonation; Treatment Outcome; Voice Quality; Voice Training
PubMed: 32534474
DOI: 10.1111/coa.13596 -
Journal of Clinical Medicine May 2023Vocal fold polyps (VFP) are a common cause of voice disorders and laryngeal discomfort. They are usually treated by behavioral voice therapy (VT) or phonosurgery, or a...
BACKGROUND
Vocal fold polyps (VFP) are a common cause of voice disorders and laryngeal discomfort. They are usually treated by behavioral voice therapy (VT) or phonosurgery, or a combination (CT) of both. However, the superiority of either of these treatments has not been clearly established.
METHODS
Three databases were searched from inception to October 2022 and a manual search was performed. All clinical trials of VFP treatment were included that reported at least auditory-perceptual judgment, aerodynamics, acoustics, and the patient-perceived handicap.
RESULTS
We identified 31 eligible studies (VT: n = 47-194; phonosurgery: n = 404-1039; CT: n = 237-350). All treatment approaches were highly effective, with large effect sizes ( > 0.8) and significant improvements in almost all voice parameters (-values < 0.05). Phonosurgery reduced roughness and NHR, and the emotional and functional subscales of the VHI-30 were the most compared to behavioral voice therapy and combined treatment (-values < 0.001). Combined treatment improved hoarseness, jitter, shimmer, MPT, and the physical subscale of the VHI-30 more than phonosurgery and behavioral voice therapy (-values < 0.001).
CONCLUSIONS
All three treatment approaches were effective in eliminating vocal fold polyps or their negative sequelae, with phonosurgery and combined treatment providing the greatest improvement. These results may inform future treatment decisions for patients with vocal fold polyps.
PubMed: 37240557
DOI: 10.3390/jcm12103451 -
Aging & Mental Health 2016Dementia is a progressive condition, affecting increasing numbers of people, characterised by cognitive decline. The current systematic review aimed to evaluate research... (Review)
Review
OBJECTIVES
Dementia is a progressive condition, affecting increasing numbers of people, characterised by cognitive decline. The current systematic review aimed to evaluate research pertaining to the impact of arts and health interventions on cognition in people with dementia.
METHOD
A literature search was conducted utilising PsychInfo, Cochrane Reviews, Web of Science, Medline and British Humanities Index databases. Seventeen studies were included in the review, including those related to literary, performing and visual arts.
RESULTS
The review highlighted this as an emerging area of research with the literature consisting largely of small-scale studies with methodological limitations including lack of control groups and often poorly defined samples. All the studies suggested, however, that arts-based activities had a positive impact on cognitive processes, in particular on attention, stimulation of memories, enhanced communication and engagement with creative activities.
CONCLUSION
The existent literature suggests that arts activities are helpful interventions within dementia care. A consensus has yet to emerge, however, about the direction for future research including the challenge of measurement and the importance of methodological flexibility. It is suggested that further research address some of these limitations by examining whether the impact of interventions vary depending on cognitive ability and to continue to assess how arts interventions can be of use across the stages of dementia.
Topics: Art Therapy; Cognition; Communication; Community Health Services; Dementia; Humans; Literature; Mental Health; Narration; Singing
PubMed: 25683767
DOI: 10.1080/13607863.2015.1011080 -
Journal of Speech, Language, and... Jul 2021Purpose Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and... (Meta-Analysis)
Meta-Analysis
Purpose Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and assess the different factors affecting their quality. Method In September 2017, 15 databases were searched to include all randomized controlled trials. A new search was done in May 2019 to include all other study design articles, which include all the new-era VPs subtypes. Network meta-analysis (NMA) was applied to all 27 outcomes, besides NMA overall and partial order setting was done by using Hasse scatter plots. values were used in NMA, where the best VPs are approaching one and the least approaches zero. Meta-analysis was done for the rest of the outcomes. Results Two hundred one articles were eligible for inclusion in our study ( = 11,918). Provox-2 was significantly the most efficient and safest device concerning the most patient preference (odds ratio [] = 33.88 [0.65, 1762.24]; = .92), the least dislodgement (risk ratio [RR] = 0.27 [0.13, 0.57]; = .79), the least airflow resistance (RR = 0.42 [0.08, 2.11]; = .84), the least granulation formation (RR = 0.73 [0.02, 26.32]; = .60), and the least VPs' inaccurate size (RR = 0.77 (0.23, 2.61); = .66). Heat and moisture exchanger addition showed a significant increase in maximum phonation time and breathing experience, with values (1 and .59), respectively. While heat and moisture exchanger addition showed a significant decline in stoma cleaning frequency, coughing frequency, forced expectoration, sputum production, sleeping problems, and loosening of adhesive, with values (.99, .72, .69, .96, 1, and 0.96), respectively, Groningen low resistance and Nijdam were considered the worst devices with both overall mean value of .44. Conclusions Provox-2 is considered the best choice as being the most preferable for patients, with the least airflow resistance, dislodgment, granulation formation, and prosthesis inaccurate size. Groningen low resistance and Nijdam were considered the worst devices according to our analysis. Supplemental Material https://doi.org/10.23641/asha.14802903.
Topics: Humans; Laryngectomy; Larynx, Artificial; Network Meta-Analysis; Voice; Voice Training
PubMed: 34185575
DOI: 10.1044/2021_JSLHR-20-00597 -
International Journal of Pediatric... Jun 2020The anatomical, physiological, and phenotypic characteristics of children with Down Syndrome results in deviated acoustic and aerodynamic measures in their voice. These...
PURPOSE
The anatomical, physiological, and phenotypic characteristics of children with Down Syndrome results in deviated acoustic and aerodynamic measures in their voice. These deviant vocal presentations may negatively affect the quality of life of children with Down syndrome. The present study aimed to systematically review the available literature on acoustic and aerodynamic voice characteristics of children with Down syndrome.
METHOD
A systematic review of studies on acoustic and aerodynamic measures of voice in children with Down Syndrome (using PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct) was carried out. Keywords based on Population-Investigation-Outcome were used to develop search strings. Two authors screened titles and abstracts independently, and appropriate studies were analyzed in detail for data extraction.
RESULTS
Out of the 1432 studies, two studies met the inclusion criteria. Different acoustic and aerodynamic measures were employed, such as fundamental frequency, intensity, phonation time, jitter, shimmer and ESGP, MAFR, and LAR.
CONCLUSION
Overall, there was a lack of standardized criteria for the evaluation of acoustic and aerodynamic characteristics in the Down syndrome population. Acoustically, there was no significant difference between children with DS and typically developing children. However, aerodynamic studies suggest that there is a significant impairment of glottal valving in children with Down syndrome.
Topics: Child; Down Syndrome; Glottis; Humans; Phonation; Speech Acoustics; Voice Quality
PubMed: 32087479
DOI: 10.1016/j.ijporl.2020.109946 -
Voice rehabilitation for laryngeal cancer after radiotherapy: a systematic review and meta-analysis.European Archives of... Jun 2019We aimed to determine whether voice rehabilitation after radiotherapy improves the quality of life (QOL), voice function, and self-rated voice function in patients with... (Meta-Analysis)
Meta-Analysis
PURPOSE
We aimed to determine whether voice rehabilitation after radiotherapy improves the quality of life (QOL), voice function, and self-rated voice function in patients with laryngeal cancer.
METHODS
We searched CENTRAL, MEDLINE, EMBASE, PEDro, and World Health Organization International Clinical Trials Registry Platform for randomized controlled trials published between inception and October 2018. The primary outcome was QOL, adverse events and mortality. Secondary outcomes included voice function and self-rated voice function. The quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation approach.
RESULTS
Three trials (enrolling 122 patients) compared voice rehabilitation to usual care or no intervention after radiotherapy. Voice rehabilitation did not significantly improve any QOL scores. Data on adverse events and mortality were not available in any of the trials. Voice rehabilitation did not improve any voice function scores, such as jitter (mean difference: - 0.48 [- 1.27 to 0.32]), shimmer (mean difference: - 0.04 [- 0.27 to 0.19]), maximum phonation time (mean difference: 1.54 [- 1.13 to 4.22]), and the grade, roughness, breathiness, asthenia, and strain scale (mean difference: - 0.39 [- 2.59 to 1.80]). Voice rehabilitation also did not improve the voice handicap index, which was used as a self-rated voice function score (mean difference: 5.54 [- 2.07 to 13.16]). The certainty of the evidence was graded as low for primary and secondary outcomes.
CONCLUSION
Voice rehabilitation for patients with laryngeal cancer after radiotherapy might not improve QOL, voice function, and self-rated voice function. Pre-specified voice rehabilitation programs may not be necessary for all patients with laryngeal cancer after radiotherapy.
Topics: Humans; Laryngeal Neoplasms; Quality of Life; Radiation Injuries; Recovery of Function; Self Report; Treatment Outcome; Voice; Voice Disorders; Voice Training
PubMed: 31055641
DOI: 10.1007/s00405-019-05452-2 -
Complementary Therapies in Medicine Aug 2016To investigate the effect of group singing on health related quality of life (HRQoL) for adult, amateur singers with chronic health conditions. (Review)
Review
OBJECTIVE
To investigate the effect of group singing on health related quality of life (HRQoL) for adult, amateur singers with chronic health conditions.
METHODS
A literature search for experimental and observational studies and qualitative studies published before February 2014 was undertaken using the following databases: ASSIA (Proquest), CINAHL (Ebsco), EMBASE (OVID), HMIC (OVID), MEDLINE (OVID), MEDLINE in Process (OVID), OpenGrey, PsycINFO (OVID) and PubMed for Epub ahead of print studies. Social Science searches included: Web of Science, Proquest, and Scopus (Elsevier). The records were screened independently by two reviewers. Studies were critiqued using Critical Appraisal Skills Programme tools.
RESULTS
The literature search identified 573 papers, from which 18 were included (5 quantitative, 5 qualitative, 8 mixed-methods studies). These included a variety of patient populations including chronic respiratory disease, neurological conditions and mental health. The quantitative studies lacked consistency: two of the seven controlled studies demonstrated additional HRQoL benefits with singing compared to controls, while three of six uncontrolled studies showed improved HRQoL. Qualitative methods were recorded in variable depth. The qualitative data presented a range of benefits of group singing including increased confidence, increased mood and social support. Few negative effects of singing were reported.
CONCLUSION
This systematic review indicates that group singing interventions may have beneficial effects on HRQoL, anxiety, depression and mood. Studies were heterogeneous with significant methodological limitations, allowing only a weak recommendation for group singing as an intervention for adults with chronic health problems. The undertaking of larger controlled and in-depth qualitative studies is warranted.
Topics: Affect; Anxiety; Chronic Disease; Depression; Humans; Mental Health; Qualitative Research; Quality of Life; Singing; Social Support
PubMed: 27515869
DOI: 10.1016/j.ctim.2016.03.017 -
Infant Behavior & Development Jun 2024Musical interactions between babies and their primary caregivers are very frequent during the early years of life and their impact on dyadic interaction and infants'... (Review)
Review
Musical interactions between babies and their primary caregivers are very frequent during the early years of life and their impact on dyadic interaction and infants' development has garnered significant attention in recent literature. However, the difficulties that natural observations entail have meant that research often carries out methodological manipulations that have a significant impact on the phenomenon studied. In order to clarify how to investigate best natural musical interactions and the information that these can provide, we have carried out a systematic review to analyze the proposed scenarios and the variables analyzed in the studies published on such interactions between main caregivers and babies under three years old. We have screened 971 articles and yielded 27. We have found a higher prevalence in the literature of studies on singing interactions, between mothers and babies under 12 months of age. We have also been able to identify two extremes in terms of methodological structuring of natural interactions. Regarding the analysis variables, a few behaviors are repeated throughout the studies, being emotions, rhythmic behaviors and characterizations of the vocal emissions common between parents and babies. Synchrony is the dyadic variable with the most weight and also one of the preferred focuses of interest in the most recent literature that has undergone a shift of focus from characterization of musical interactions to the search for the mechanisms that underlie and make them specific.
Topics: Humans; Music; Infant; Caregivers; Mother-Child Relations; Child Development; Infant Behavior; Female; Singing
PubMed: 38422780
DOI: 10.1016/j.infbeh.2024.101928 -
Medical Problems of Performing Artists Jun 2020Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim...
BACKGROUND
Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim of this systematic review was to evaluate the effectiveness and efficacy of OMT in adult musicians.
METHODS
A systematic literature search included the electronic databases PubMed/MEDLINE, Medpilot, EBSCOhost, BioMedCentral, OSTMED-Dr, osteopathic-research.com, PEDro, hand searches, and contact to European osteopathic academies. Interventional and observational studies published between January 1999 and January 2019, of professional or amateur musicians who were either healthy or had MCD treated by OMT, were included. The quality of the randomized controlled trials (RCTs) was assessed by the Physiotherapy Evidence Database (PEDro) Scale ranging between 0 and 10 points.
RESULTS
Only 5 studies were identified investigating OMT in musicians, including 1 RCT (cross-over design), 3 clinical controlled trials, and 1 case report. The internal validity of the RCT was assessed as 6 points. OMT was reported to have a positive impact on healthy singers, improving phonation time, voice quality, and voice range. It also improved the cervical range of motion in violinists. No adverse events were observed, although only the cross-over RCT reported partly an assessment of adverse events.
CONCLUSIONS
The evidence for OMT in adult musicians is very limited. Prospective controlled clinical trials investigating OMT in musicians are required.
Topics: Adult; Health Status; Humans; Manipulation, Osteopathic; Musculoskeletal Diseases; Music; Occupational Injuries; Prospective Studies; Treatment Outcome
PubMed: 32479587
DOI: 10.21091/mppa.2020.2017 -
European Journal of Neurology Oct 2020Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech... (Meta-Analysis)
Meta-Analysis
Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta-analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage', monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31 dB, respectively, after 1 month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage' and monologue immediately after treatment (13.39, 6.66 and 3.19 dB). Positive improvement still existed after 24 months. There was no difference in the therapeutic effect between face-to-face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.
Topics: Dysarthria; Humans; Parkinson Disease; Speech Therapy; Treatment Outcome
PubMed: 32539227
DOI: 10.1111/ene.14399