title: The behavioural treatment of muscle tension voice disorders: A systematic review.
abstract: OBJECTIVE
  A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders (MTVD).
  
  
  METHODS
  A search of 12 electronic databases and reference lists for studies published between the years 1990-2014 was conducted using the PRISMA guidelines. Inclusion and exclusion criteria included type of publication, participant characteristics, intervention, outcome measures and report of outcomes. Methodological quality rating scales and confidence in diagnostic scale supported the literature evaluation.
  
  
  RESULTS
  Seven papers met the inclusion criteria. Significant improvement on at least one outcome measure was reported for all studies. Effect sizes were small-to-large. Methodological qualities of research were varied. No study explicitly reported treatment fidelity and cumulative intervention intensity could only be calculated for two out of seven studies. Outcome measures were used inconsistently and less than half of the measures had reported reliability values. Confidence in the accuracy of subject diagnosis on average was rated as low. Specific "active ingredients" for therapeutic change were not identified.
  
  
  CONCLUSIONS
  Voice therapy for the treatment of MTVD is associated with positive treatment outcomes; however, there is an obvious need for systematic and high quality research designs to expand the evidence base for the behavioural treatment of MTVD.
authors.affiliation: The Voice Research Laboratory, Discipline of Speech Pathology, The University of Sydney , Sydney , Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Eastwood
authors.forename: Catherine
authors.initials: C
authors.lastname: Madill
authors.forename: Patricia
authors.initials: P
authors.lastname: Mccabe
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology*; D009129:Muscle Tonus; D020127:Recovery of Function; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training
keywords: Intervention; systematic review; voice disorder