Improving Voice Production for Adults With Age-related Dysphonia

Study Overview
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Brief Summary
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The objectives for this research are to determine the mechanisms by which specific therapy tasks improve voice in age-related dysphonia, and the conditions that limit the extent of improvement. The central hypothesis is that targeted therapy tasks will improve voice, and that severity will determine the extent of improvement.

Official Title
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Improving Voice Production for Adults With Age-related Dysphonia

Conditions
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Presbylarynx, Age-Related Dysphonia

Intervention / Treatment
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* Behavioral: Voice therapy: respiratory
* Behavioral: Voice therapy: glottal closure
* Behavioral: Voice therapy: loud
* Behavioral: Voice therapy: Semiocclusion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults in age range who volunteer Can understand and complete directions presented in English People with voice disorder associated with advancing age will be included, including bowing, incomplete closure, mild edema, erythema, signs of laryngopharyngeal reflux. Exclusion Criteria: Laryngeal differences not related to aging (e.g., vocal fold paralysis, moderate-severe edema, lesions, leukoplakia, dysplasia, Parkinson disease) Known history of stroke, brain injury, or other neurological disorder

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: All participants receive every intervention in randomized order
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Participants<br>All participants will undergo each treatment. | Behavioral: Voice therapy: respiratory<br>* Abdominal voice onset<br>Behavioral: Voice therapy: glottal closure<br>* Pulling/pushing task<br>Behavioral: Voice therapy: loud<br>* Assertive task<br>Behavioral: Voice therapy: Semiocclusion<br>* Semi-occluded vocal tract<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relative glottal gap from laryngeal high-speed videoendoscopy |  | End of year 3 | 
| Perceived voice quality | Participants will score the construct of overall voice quality using a technique called sort and rate in which listeners move icons representing each sound along a line. They align the icons so that best voices are on one side and worst voices are on the other. The distance between the icons represents how much better or worse one sound is than the other. There are no units to the scale. Rankings from all listeners are combined using the statistical technique of multidimensional scaling. The result is a ranked value for each sound file (i.e., voice production) that shows how different they are. There is no highest or lowest value. | End of year 3 | 
| Acoustic measure of voice quality (Cepstral Peak Prominence) |  | End of year 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Open quotient from laryngeal high-speed videoendoscopy |  | End of year 3 | 
| Speed index from laryngeal high-speed videoendoscopy |  | End of year 3 | 
| Maximum area declination ratefrom laryngeal high-speed videoendoscopy |  | End of year 3 | 
| Fundamental frequency standard deviation from laryngeal high-speed videoendoscopy |  | End of year 3 |