Development of Comprehensive Voice Habilitation Program CVHP for hyper functional voice disorder and evaluation by randomized controlled trial

Abstract

Voice therapy is the primary mode of treatment for voice disorders Tailor made exercise programs with specific cultural adaptations are needed to provide a holistic change to voice quality The study aimed to develop and evaluate the efficacy of a structured eclectic voice therapy regimen Comprehensive Voice Habilitation Program with a standard technique Vocal Function Exercises in participants with hyperfunctional voice disorders In Phase 1 the exercise program was developed based on literature related to vocal therapy approaches and delivery methods Five voice experts verified and suggested modifications to derive the final version Adaptations were introduced to a selected set of exercises and included vocal hygiene instructions warm up and cool down easy onset resonant voice and carry over exercises This was piloted on five participants with HFVD and showed positive changes in voice related outcome measures In Phase 2 a RCT was conducted on sixty participants to compare multidimensional voice assessment outcomes before and immediately post CVHP and VFE 30 in each group No significant differences in baseline indicated the homogeneity of the samples included Post therapy significant difference was found in closure pattern reduction in ventricular hyperadduction cepstral peak prominence in vowel dynamic range in speaking overall grade asthenia and strain in GRBAS scale and factor I physical discomfort in VFI T between both the groups The eclectic approach showed significant changes post therapy compared to VFE CVHP a structured and sequenced exercise prescription was found to be a viable program for treating HFVD newline