Evaluating the Feasibility of Acapella® Choice as a Dysphonia Treatment
Condition: Muscle Tension Dysphonia; Vocal Fold Palsy; Vocal Cord Paralysis; Presbylarynx; Dysphonia
MeSH terms: Dysphonia; Hoarseness; Vocal Cord Paralysis; Paralysis
Study type: Interventional

Summary: 
      A feasibility study to identify the immediate effect on the voices of patients with voice
      disorders (muscle tension dysphonia, vocal fold palsy or presbylaryngis) produced by
      exercising with Acapella Choice as a form of semioccluded vocal tract exercise (SOVTE).
    

Detailed description: 
      This feasibility study is the natural extension of the researchers' recently completed study
      (R&D 16/0242) which assessed how the use of an Acapella Choice (Smiths Medical) positive
      expiratory pressure (PEP) device as a semi-occluded vocal tract exercise (SOVTE) impacted
      acoustic, electroglottographic and aerodynamic measures of the voice in a group of
      normophonic volunteers. In that study, Acapella Choice was found to offer significantly
      greater oscillating intraoral pressures than techniques in current clinical practice and was
      found to have measurable benefits in terms of producing a louder and more economical voice.
      It offered the largest oscillating pressures, likened to a 'massage' of the vocal organs,
      giving it great therapeutic promise for patients with excess vocal tract tension.

      This study seeks to evaluate the immediate effects of Acapella Choice as a voice exercise in
      patients with Muscle Tension Dysphonia, Presbylaryngis and Vocal Fold Palsy, and compare this
      to the widely-used voice rehabilitation technique of phonation into a tube held under water
      (henceforward referred to as "Tube"). Patients will be recruited from four weekly Voice
      Clinics held at the Royal National Throat Nose and Ear Hospital where their diagnosis will be
      confirmed. They will be invited to attend a single experimental session during which time
      they will exercise both with Acapella Choice and with Tube. Baseline and outcome voice
      measures will be taken and a short questionnaire will be completed, eliciting perceptions of
      the two exercises and any changes which were felt to have resulted from them.

      The researchers' previous work suggests that Acapella Choice as a SOVTE may offer significant
      clinical benefits in terms of improved efficacy of therapy. It is suggested that it also
      offers patients a more convenient and user-friendly form of exercise which may well improve
      compliance and result in better outcomes.
    

Intervention name(s): Acapella Choice; Tube-in-water
Intervention type(s): Device; Device
Intervention description(s): 3 minutes of exercise consisting of blowing through the device (on setting '5') and phonating at the same time.; 3 minutes of exercise consisting of blowing through a silicone tube (10mm internal diameter) submerged in 5 cm of water whilst phonating at the same time.
Other intervention name(s): PEP; Semioccluded vocal tract exercise; Lax Vox; Resonance tube in water; Semi-occluded vocal tract exercise
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: This is a feasibility study using a 'before and after' design to test the immediate effects of exercising with Acapella Choice in comparison to the immediate effects of exercising with Tube-in-water resistance exercises (current treatment norm). Participants will be assigned groups according to their diagnosis (i.e. muscle tension group, vocal fold palsy group and presbylaryngis group). All participants will exercise with both techniques (i.e. Acapella and tube-in-water).
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: semi-occluded vocal tract exercise; positive expiratory pressure; tube phonation; Acapella; voice therapy