A Systematic Review of Voice Therapy: What “Effectiveness” Really Implies

Publication date: Available online 15 November 2016
Source:Journal of Voice
Author(s): Maude Desjardins, Lucinda Halstead, Melissa Cooke, Heather Shaw Bonilha
IntroductionBehavioral voice therapy guided by a speech-language pathologist is recommended as the main treatment approach for many kinds of voice disorders. Encouraging evidence regard of good outcomes from voice therapy has been found in two previous reviews on broad patient populations. However, no definitive conclusion on the effectiveness of direct voice therapy can be drawn from these reviews due to limitations of the included studies.AimsTo review recent literature on voice therapy; to provide clinicians with a list of evidence-based voice therapy techniques; to incorporate the therapy components in a physiologically based model; to assess the limitations and progress achieved in the recent research on voice therapy.MethodsA literature search was conducted using three electronic databases: PubMed, Scopus, and CINAHL. A similar strategy was used in all three databases to highlight the concepts of “therapy” and “voice disorders.” Only randomized controlled trials were included in the review.ResultsFifteen papers met the inclusion criteria, covering five categories of voice disorders (functional, Parkinson induced, GERD induced, presbyphonia, unilateral vocal fold paresis) and seven specific behavioral voice therapy approaches. Statistically significant improvements were found postintervention on at least one outcome variable in all but one study. Clinical significance of the results was rarely discussed. Discrepancies in reported outcome measures were found across studies, making comparisons between interventions challenging.ConclusionBehavioral voice therapy generally leads to significant improvements in voice outcomes, but further research considering clinical meaningfulness of the results are needed to establish what is really meant by the term “effectiveness” when it comes to voice therapy.



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Resonant metalenses for flexural waves in plates

The dispersion curves of a cluster of closely spaced rods supported by a thin plate are characterised by subwavelength bandgaps and slow group velocities induced by local resonance effects. A recent analytical study [Williams, Roux, Rupin, and Kuperman (2015). Phys. Rev. B 91, 104307], has shown how the slow velocity branch depends, amongst other parameters, on the height of the rods that make up the cluster. Such metamaterial, offering easy-to-tune spatial velocity gradients, is a perfect candidate for building gradient index lenses such as Luneburg, Maxwell, and 90° rotating. Here theoretical results are combined with numerical simulations to design and test metalenses for flexural waves. The lenses are obtained by tuning the height of the cluster of rods such that they provide the required refractive index profile. Snapshots and videos from three-dimensional numerical simulations in a narrow band centered at ∼4 kHz are used to analyse the performances of three types of gradient index metalens (Luneburg, Maxwell, and 90° rotating).

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The relationship between perceptual disturbances in dysarthric speech and automatic speech recognition performance

State-of-the-art automatic speech recognition (ASR) engines perform well on healthy speech; however recent studies show that their performance on dysarthric speech is highly variable. This is because of the acoustic variability associated with the different dysarthria subtypes. This paper aims to develop a better understanding of how perceptual disturbances in dysarthric speech relate to ASR performance. Accurate ratings of a representative set of 32 dysarthric speakers along different perceptual dimensions are obtained and the performance of a representative ASR algorithm on the same set of speakers is analyzed. This work explores the relationship between these ratings and ASR performance and reveals that ASR performance can be predicted from perceptual disturbances in dysarthric speech with articulatory precision contributing the most to the prediction followed by prosody.

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Hearing loss in children with otitis media with effusion: a systematic review.

Hearing loss in children with otitis media with effusion: a systematic review.

Int J Audiol. 2016 Nov 14;:1-12

Authors: Cai T, McPherson B

Abstract
OBJECTIVES: Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities.
DESIGN: A systematic and descriptive review.
STUDY SAMPLE: Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms.
RESULTS: The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired.
CONCLUSIONS: OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

PMID: 27841699 [PubMed - as supplied by publisher]

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Hearing loss in children with otitis media with effusion: a systematic review.

Hearing loss in children with otitis media with effusion: a systematic review.

Int J Audiol. 2016 Nov 14;:1-12

Authors: Cai T, McPherson B

Abstract
OBJECTIVES: Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities.
DESIGN: A systematic and descriptive review.
STUDY SAMPLE: Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms.
RESULTS: The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired.
CONCLUSIONS: OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

PMID: 27841699 [PubMed - as supplied by publisher]

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Molecular Impairment Mechanisms of Novel OPA1 Mutations Predicted by Molecular Modeling in Patients With Autosomal Dominant Optic Atrophy and Auditory Neuropathy Spectrum Disorder.

Related Articles

Molecular Impairment Mechanisms of Novel OPA1 Mutations Predicted by Molecular Modeling in Patients With Autosomal Dominant Optic Atrophy and Auditory Neuropathy Spectrum Disorder.

Otol Neurotol. 2016 Apr;37(4):394-402

Authors: Namba K, Mutai H, Takiguchi Y, Yagi H, Okuyama T, Oba S, Yamagishi R, Kaneko H, Shintani T, Kaga K, Matsunaga T

Abstract
HYPOTHESIS: Different missense mutations of the optic atrophy 1 gene (OPA1) identified in optic atrophy patients with auditory neuropathy spectrum disorder (ANSD) induce functional impairment through different molecular mechanisms.
BACKGROUND: OPA1 is the gene responsible for autosomal dominant optic atrophy (ADOA), but some of its mutations are also associated with ANSD. OPA1 is a member of the GTPase family of proteins and plays a key role in the maintenance of mitochondrial activities that are dependent on dimer formation of the protein. There are many reports of OPA1 mutations, but the molecular mechanisms of their functional impairments are unclear.
METHODS: The sequences of coding regions in OPA1 were analyzed from blood samples of ADOA patients with ANSD. Molecular modeling of the protein's ability to form dimers and its GTP-binding ability were conducted to study the effects of structural changes in OPA1 caused by two identified mutations and their resultant effects on protein function.
RESULTS: Two heterozygous mutations, p.T414P (c.1240A>C) and p.T540P (c.1618A>C), located in the GTPase and middle domains of OPA1, respectively, were identified in two patients. Molecular modeling indicated decreased dimer formation caused by destabilization of the association structure of the p.T414P mutant, and decreased GTP-binding caused by destabilization of the binding site structure in the p.T540P mutant.
CONCLUSION: These two different conformational changes might result in decreased GTPase activities that trigger ADOA associated with ANSD, and are likely to be associated with mild clinical features. Molecular modeling would provide useful information in clinical practice.

PMID: 26905822 [PubMed - indexed for MEDLINE]

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Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension.

Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension.

Acta Otolaryngol. 2016 Nov 14;:1-3

Authors: Tan J, Deng Y, Zhang T, Wang M

Abstract
CONCLUSIONS: Patients with BPPV comorbid with hypertension (h-BPPV) tend to receive a delayed diagnosis of BPPV. Comorbidity with hypertension did not influence the efficacy of the repositioning maneuver; however, comorbidity with hypertension was associated with an increased recurrence rate of BPPV.
OBJECTIVES: To determine the clinical characteristics and outcomes of h-BPPV, as well as the clinical differences between h-BPPV and idiopathic BPPV (i-BPPV).
METHODS: The authors reviewed the medical records of 41 consecutive patients with h-BPPV (the h-BPPV group) from March to December 2014 and 47 patients with i-BPPV (the i-BPPV group) during the same period.
RESULTS: There were no significant differences in age, sex ratio, or the affected side between the h-BPPV and i-BPPV groups. The proportion of patients reporting an initial episode of positional vertigo was significantly lower in the h-BPPV group (51.22% vs 74.47%; p = .024). Patients in the h-BPPV group reported a longer median episode duration than did those in the i-BPPV group (60 days vs 15 days; p = .017). The results of treatment using repositioning maneuvers were similar between the two groups. At follow-up, 13 patients in the h-BPPV group were diagnosed with recurrent BPPV compared with six in the i-BPPV group (p = .031).

PMID: 27841099 [PubMed - as supplied by publisher]

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Hearing loss in children with otitis media with effusion: a systematic review.

Hearing loss in children with otitis media with effusion: a systematic review.

Int J Audiol. 2016 Nov 14;:1-12

Authors: Cai T, McPherson B

Abstract
OBJECTIVES: Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities.
DESIGN: A systematic and descriptive review.
STUDY SAMPLE: Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms.
RESULTS: The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired.
CONCLUSIONS: OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

PMID: 27841699 [PubMed - as supplied by publisher]

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Hearing loss in children with otitis media with effusion: a systematic review.

Hearing loss in children with otitis media with effusion: a systematic review.

Int J Audiol. 2016 Nov 14;:1-12

Authors: Cai T, McPherson B

Abstract
OBJECTIVES: Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities.
DESIGN: A systematic and descriptive review.
STUDY SAMPLE: Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms.
RESULTS: The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired.
CONCLUSIONS: OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

PMID: 27841699 [PubMed - as supplied by publisher]

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Hearing loss in children with otitis media with effusion: a systematic review

.


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Hearing loss in children with otitis media with effusion: a systematic review

.


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Hearing loss in children with otitis media with effusion: a systematic review

.


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