Treatment Of Voice Problems Research Articles

A Manual Therapy in Need of a Manual: Conceptualizing and Comparing Existing Vocal Massage Protocols and Their Use in the Treatment of Voice Problems

ABSTRACT Vocal manual therapy (VMT) is a heterogenous term used to describe a variety of touch-based approaches to voice rehabilitation and maintenance. VMT aims to use manipulation, massage, and reposturing to change how the voice sounds and feels. Since first described in 1990, there has been a proliferation in the use of VMT in the treatment of voice problems, with increasing interest in its usefulness within clinical and non-clinical voice settings. This forum article presents a narrative review of 42 studies investigating the use of VMT in a vocal health context. The aim was to identify the theoretical orientations of VMT protocols, draw links between the techniques employed in their administration, and highlight similarities and differences in use of language across VMT protocols. Relevant articles for review were identified via informal literature search using forward and backward citation screening and then described using narrative synthesis. Theoretical orientations were broad and influenced by speech pathology research as well as Finnish massage, naprapathy and yoga. 26 ostensibly different protocols were identified across the 42 studies, with considerable variation in protocol length and frequency. Language was highly varied across protocols. The forum article therefore advocates for greater shared understanding in VMT research and practice.

Preliminary Data on Prevention and Treatment of Voice Problems in Student Teachers

To assess the utility of a targeted voice hygiene (VH) program compared to VH plus voice training intervention (VH+VT) for the prevention and treatment of voice problems in student teachers. Prospective, randomized. Thirty-one student teachers with low (good) and high (poor) voice handicap index (VHI) scores in Pittsburgh and Hong Kong were randomly assigned to (1) a targeted, individually tailored VH program, (2) the VH program plus resonant VT (VH+VT), or (c) a control group. Participants assigned to intervention groups were monitored for their adherence to their programs for their first 4 weeks of student teaching. VHI data were collected again 4 weeks postintervention (both sites) and 8 weeks postintervention, following a no-contact washout period (Pittsburgh). Descriptive data analysis indicated that across both sites, for initially healthy participants, the VH program was sufficient to prevent worsening of VHI scores that occurred in all control participants over the first 4-8 weeks of student teaching. The addition of VT did not consistently enhance protective benefits over VH alone. In contrast, for participants with initially poor VHI scores, the VH program failed to produce VHI benefits over the control condition. The addition of VT was required to optimize results for that cohort. Preliminary data suggest that a minimalist, individually tailored VH program may be sufficient to prevent voice problems from teaching in healthy student teachers. However, for student teachers with existing voice problems, VT may be required to optimize results of intervention.

VoiceRelease

VoiceRelease is a progressively structured treatment system that aims to release the voice through muscle tension reduction by manual therapy, thereby facilitating healthy voice production. The VoiceRelease treatment should closely interact with functional voice training and should therefore be carried out by the speech-language therapist (SLT). The aim of this paper is not to present the treatment in detail, but to describe the benefits of using the techniques in the voice clinic and to argue that laryngeal manual therapy complements the skills of the SLT and that it in a natural and integrated way applies to the treatment of voice problems. In order to comply with the present skills of the SLT, VoiceRelease is progressively structured in four levels.

Risk Factors for Voice Problems in Teachers

In order to identify factors that are associated with voice problems and voice-related absenteeism in teachers, 1,878 questionnaires were analysed. The questionnaires inquired about personal data, voice complaints, voice-related absenteeism from work and conditions that may lead to voice complaints and absenteeism. Different factors play a role in the development and consolidation of voice problems. Physical and psycho-emotional factors appear to be the most important risk factors. Remarkably, voice load and environment seem to be less important as risk factors in the development and consolidation of voice complaints. Teachers who experienced voice problems during their training reported more voice problems during their career. The results of this study stress the importance of a multifactorial approach in the diagnosis and treatment of voice problems, whereby physical and psycho-emotional aspects should be considered as sensitive to the risk of developing voice problems. Moreover, this study shows the crucial importance of adequate voice training during the teacher training programme.

Vocal problems among teachers: a review of prevalence, causes, prevention, and treatment.

Voice disorders are thought to be one of the major occupational hazards of school teaching. The resulting symptoms can affect teachers' ability to function in the classroom and prevent them from developing effective working relationships with other staff and students. Sick leave, speech pathology management, and surgical intervention can be costly. Severe voice problems can also result in a teacher permanently leaving the classroom. Despite the significant implications of voice disorders for teachers, this review of published research demonstrates that findings concerning the prevalence of voice problems in teachers and the causes and contributing factors of those voice problems are inconclusive. Similarly, previous research on the efficacy of prevention programs and treatment of voice problems in teachers provide few firm conclusions. Further research based on sound empirical data is needed, as many past studies have relied on anecdotal or self-report data. More operational definitions of what constitutes a voice disorder and the associated contributing factors should be adopted, along with the use of more instrumental measures and careful attention to methodology and appropriate statistical analyses. Only then will we have a sound basis for the development of effective prevention and education programs for teachers.