title: Multidimensional Assessment of the Effectiveness of Group Voice Therapy.
abstract: OBJECTIVE
  Group voice therapy has been successfully used in patients with dysphonia, but there is little objectively documented evidence of its effects on voice quality and the self-perception of voice fatigue. The aim of this study was to investigate the effectiveness of group therapy in patients with functional dysphonia and minor anatomic vocal fold pathologies linked by appearance and history to voice use in an objective and multidimensional manner.
  
  
  METHODS
  This is a prospective longitudinal study.
  
  
  METHODS
  Before and after treatment, 34 adult women underwent perceptual voice assessments using the grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) scale, Evaluation Vocale Assistée (EVA) system aerodynamic and acoustic assessments, and maximum phonation time measurements, and made subjective evaluations using the Voice Handicap Index. The pretreatment baseline values of the participants were obtained by means of two examinations separated by an interval of 1 week. The parameters belonging to each main dimension were clustered by means of Z-transformation, and the corresponding Z-scores were analyzed.
  
  
  RESULTS
  Group therapy was associated with a statistically significant improvement in the perceptual (P = 0.008), acoustic (P = 0.040), aerodynamic (P = 0.009 and <0.001), and self-evaluation parameters (P = 0.011).
  
  
  CONCLUSIONS
  Our findings provide evidence that group voice therapy can be associated with improvements in perceptual, acoustic, aerodynamic, and self-evaluated parameters in some patients with dysphonia. Controlled, randomized studies are needed in follow-up. This method of treatment may be a means of reducing the costs and waiting lists associated with rehabilitative treatment, and enhancing patients' motivation and compliance.
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: giovanna.cantarella@policlinico.mi.it.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cantarella
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Torretta
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferruta
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Annaclara
authors.initials: A
authors.lastname: Ciabatta
authors.affiliation: Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Manfredi
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
authors.affiliation: Dept. of Neurosciences, University of Leuven and Federal Agency for Occupational Risks, Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dejonckere
mesh_terms: D000162:Acoustics; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006126:Group Processes; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010699:Phonation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D013061:Speech Acoustics; D013068:Speech Production Measurement; D013997:Time Factors; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Dysphonia; Group voice therapy; Multidimensional assessment; Voice; Voice fatigue