title: Efficacy of intensive phonatory-respiratory treatment (LSVT) for presbyphonia: two case reports.
abstract: OBJECTIVE
  Research evidence has shown that neither traditional voice therapy nor surgery was efficacious in managing age-related dysphonia, specifically for more severe cases with pronounced fold atrophy or larger glottal gaps. The purpose of this study was to examine the efficacy of intensive respiratory-phonatory treatment (Lee Silverman voice treatment [LSVT]) for glottal incompetence associated with presbyphonia.
  
  
  METHODS
  Nonrandomized prospective study.
  
  
  METHODS
  Two subjects with age-related vocal fold bowing received 4 weeks of the LSVT. Strobolaryngoscopic examination, phonatory function measurement, acoustical analyses, and perceptual judgments of voice were obtained at baseline and 2 weeks posttreatment. Additional acoustic measures of phonatory function, including vocal intensity, maximum phonation time, and pitch range, were also obtained during 16 treatment sessions.
  
  
  RESULTS
  Both subjects exhibited significant improvements in glottal closure, phonatory function, acoustic features, and perceptual ratings of voice after treatment. Significant changes of phonatory function measures were noticed relatively early and remained steady throughout the course of treatment.
  
  
  CONCLUSIONS
  These findings provide solid evidence that speakers with age-related vocal fold bowing and dysphonia may improve glottal competence and related vocal function with neither laryngeal trauma nor maladaptive laryngeal hyperfunction after the LSVT.
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas, Denton, Texas. Electronic address: flu@unt.edu.
authors.forename: Fang-Ling
authors.initials: FL
authors.lastname: Lu
authors.forename: Shannon
authors.initials: S
authors.lastname: Presley
authors.forename: Becky
authors.initials: B
authors.lastname: Lammers
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011446:Prospective Studies; D013061:Speech Acoustics; D016896:Treatment Outcome; D014832:Voice Disorders / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality
keywords: Glottal incompetence; LSVT; Presbyphonia; Treatment efficacy