title: The Effectiveness of the Comprehensive Voice Rehabilitation Program Compared With the Vocal Function Exercises Method in Behavioral Dysphonia: A Randomized Clinical Trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of the Comprehensive Voice Rehabilitation Program (CVRP) compared with Vocal Function Exercises (VFEs) to treat functional dysphonia.
  
  
  METHODS
  This is a randomized blinded clinical trial.
  
  
  METHODS
  Eighty voice professionals presented with voice complaints for more than 6 months with a functional dysphonia diagnosis. Subjects were randomized into two voice treatment groups: CVRP and VFE. The rehabilitation program consisted of six voice treatment sessions and three assessment sessions performed before, immediately after, and 1 month after treatment. The outcome measures were self-assessment protocols (Voice-Related Quality of Life [V-RQOL] and Voice Handicap Index [VHI]), perceptual evaluation of vocal quality, and a visual examination of the larynx, both blinded.
  
  
  RESULTS
  The randomization process produced comparable groups in terms of age, gender, signs, and symptoms. Both groups had positive outcome measures. The CVRP effect size was 1.09 for the V-RQOL, 1.17 for the VHI, 0.79 for vocal perceptual evaluation, and 1.01 for larynx visual examination. The VFE effect size was 0.86 for the V-RQOL, 0.62 for the VHI, 0.48 for the vocal perceptual evaluation, and 0.51 for larynx visual examination. Only 10% of the patients were lost over the study.
  
  
  CONCLUSIONS
  Both treatment programs were effective. The probability of a patient improving because of the CVRP treatment was similar to that of the VFE treatment.
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil; Departamento de Medicina, Centro de Estudos da Voz, São Paulo, Brazil. Electronic address: vpedrosavieira@yahoo.com.br.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pedrosa
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil.
authors.forename: Antônio
authors.initials: A
authors.lastname: Pontes
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil; Departamento de Medicina, Centro de Estudos da Voz, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Pontes
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil; Departamento de Medicina, Centro de Estudos da Voz, São Paulo, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil.
authors.forename: Stella Maria
authors.initials: SM
authors.lastname: Peccin
mesh_terms: D000293:Adolescent; D000328:Adult; D001307:Auditory Perception; D001938:Brazil; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007600:Judgment; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D013066:Speech-Language Pathology / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Randomized clinical trial; Speech therapy; Vocal quality; Voice; Voice disorders; Voice quality; Voice treatment