Implementation of Eclectic Voice Therapy Program via Telepractice in Hyperfunctional Voice Disorders: A Preliminary Efficacy Study.

Purpose: Hyperfunctional voice disorder (HFVD) has a multifaceted origin. Individuals with HFVD work in professions that demand high vocal usage and are bound to work for longer hours with very inflexible work schedules. In consequence, it can be speculated that an eclectic voice therapy program that uses combinatory approaches delivered via telepractice could bring about better efficiency of voice in these individuals. Nevertheless, very less attempts have been made in these lines. Therefore, the present study aims to implement eclectic voice therapy via telepractice and examine the efficacy of the same in HFVD.

Method: In total, 10 individuals with HFVD in the age range of 20-55years received Comprehensive Voice Habilitation Program (CVHP), an eclectic voice therapy approach via a videoconferencing platform, Zoom Video Communications, Inc. All the participants completed 15 sessions of voice therapy spread across 3weeks. Stroboscopy examination was performed at the baseline and post therapy to track the changes in laryngeal functions. Further, Consensus Auditory Perceptual Evaluation-Voice (CAPE-V), Acoustic Voice Quality Index (AVQI), and Voice Handicap Index in Kannada (VHI-K) were obtained at the baseline, post therapy, and two follow-ups to report the therapy outcomes. Related-sample Friedman's Two-way Analysis of Variance by Ranks and Wilcoxon Signed Rank Test were used to note the pre-post and follow-up changes in voice outcomes.

Results: Significant improvement in movement patterns of the vocal folds and a reduction in ventricular hyperadduction were noted in stroboscopy. CAPE-V and AVQI scores decreased in post-therapy and follow-up evaluations indicating reduction in dysphonia severity over time. Also, decrease in VHI-K scores indicated improved psychosocial aspects and quality of life in HFVD.

Conclusion: The current study provided preliminary evidence on the possible benefits of telepractice in the delivery of CVHP in HFVD. Hence, telepractice could be recommended as an alternate treatment modality for patients with HFVD.