title: Intensive versus traditional voice therapy for vocal nodules: perceptual, physiological, acoustic and aerodynamic changes.
abstract: OBJECTIVE
  To investigate the perceptual, physiological, acoustic, and aerodynamic outcomes of patients with vocal nodules following intensive voice treatment compared with traditional voice treatment.
  
  
  METHODS
  Pragmatic randomized clinical trial.
  
  
  METHODS
  Fifty-three women diagnosed with bilateral vocal nodules participated in the study. Voice recordings, stroboscopic recordings, acoustic, and aerodynamic assessments were made before voice treatment, after vocal hygiene education, and immediately postvoice treatment. All participants completed one session of vocal hygiene and eight sessions of direct voice therapy, however the delivery of the treatment between the two groups differed in treatment intensity.
  
  
  RESULTS
  Physiological improvements were observed after vocal hygiene alone, whereas physiological, perceptual, and acoustic parameters all improved to some degree in both treatment groups immediately posttreatment. There were no differences in the extent of change observed between the two groups at any point following treatment.
  
  
  CONCLUSIONS
  The investigation provided initial evidence that individuals with vocal nodules are able to recover voice function, vocal health, and vocal communication through intensive voice treatment. The results suggest comparable positive perceptual, physiological, and acoustic outcomes from intensive voice therapy compared with traditional voice therapy. Further investigation is required to determine the long-term effects of intensive treatment.
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Division of Speech Pathology, Brisbane, Queensland, Australia. Electronic address: sherry.fu@uqconnect.edu.au.
authors.forename: Sherry
authors.initials: S
authors.lastname: Fu
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Division of Speech Pathology, Brisbane, Queensland, Australia.
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Theodoros
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Division of Speech Pathology, Brisbane, Queensland, Australia; Centre for Functioning and Health Research, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D010699:Phonation / Q000502:physiology*; D011312:Pressure; D013061:Speech Acoustics; D013067:Speech Perception / Q000502:physiology*; D049489:Stroboscopy; D014827:Vocal Cords / Q000503:physiopathology*; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Acoustic; Aerodynamic; Perception; Physiology; Vocal nodules; Voice treatment