Twelve-month clinical follow-up study of voice patients' recovery using the Voice Activity and Participation Profile (VAPP).
OBJECTIVE
To study the effects of voice treatment including brief voice therapy for 12 months in two groups of voice patients: organic and functional.


METHODS
A clinical prospective follow-up study with repeated measurements in five phases: medical session, first voice therapy session, last voice therapy session, and 6 months and 12 months after voice therapy. The mean number of voice therapy sessions was 3.4. The main outcome measures were the Voice Activity and Participation Profile (VAPP) and the Symptom Questionnaire. Of consenting patients (n=141) with chronic voice disorders, 46 dropped out during follow-up. Ninety-five patients formed the study group. Forty-one of them received only voice therapy, but the rest of them received combined treatment (medication, amplifiers, and voice massage), but also experienced life events affecting voice. Patients with any laryngeal pathology formed the organic group (n=47), others had a functional voice disorder.


RESULTS
Using the improvement criterion that the change of the VAPP score should exceed standard error of measurement, the percentage of individual patients achieving improvement was 47% in the mild, 59% in the moderate, and 75% in the severe disorder groups. Effect size for VAPP total score was 0.89. The positive effect continued to progress after the therapy ended. Patients with functional or organic voice disorder improved almost equally, although minor findings indicate that functional patients benefited more.


CONCLUSIONS
Voice treatment had a progressive effect for 1 year in half of our patients. No statistical difference was found between the functional and organic patient groups.
Department of Eye, Ear and Oral Diseases, Department of Otorhinolaryngology, Tampere University and Tampere University Hospital, Tampere, Finland. leenamaija.kleemola@pshp.fi
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L
Kleemola
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Helminen
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Rorarius
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Sihvo
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Isotalo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012648:Self Care; D013070:Speech Therapy / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014832:Voice Disorders / Q000523:psychology* / Q000628:therapy*; D055815:Young Adult