Applicability of the vocal tract discomfort (VTD) scale in evaluating the effects of voice therapy of occupational voice disorders.

Department of Audiology and Phoniatrics, Nofer Institute of Occupational Medicine, Łódź.
Medycyna pracy (Impact Factor: 0.32). 01/2012; 63(2):141-52.
Source: PubMed

ABSTRACT Occupational voice disorders are characterized by rich symptomatology, which is dominated by symptoms by the vocal tract discomfort. Therefore, in the management it is important to consider these subjective complaints. The aim of the study was to assess the usefulness of using the vocal tract discomfort scale (VTD) in evaluating the effects of rehabilitation concerning occupational dysphonia.
The study included 55 teachers (mean age: 47.2) with occupational dysphonia diagnosed by means of videostroboscopy. The test battery covered also: voice self-assessment according to voice handicap index (VHI), perceptual GRBAS scale and the new VTD scale. Each subject underwent intensive rehabilitation, including voice training and voice hygiene education. The post-therapy examination was conducted using the above-mentioned methods.
Comparing the results obtained in the preliminary and the control test a significant post-therapy improvement (p = 0.000) was discovered in relation to the general outcome of the symptoms in the VTD scale-- assessed both as for the frequency subscale (24.7 points vs. 10 points) and the severity subscale (25.5 points vs. 10 points). A positive significant effect of the treatment was also observed in the voice VHI disability index (p < 0.05) and in perceptual voice evaluation, using the GRBAS scale (p < 0.05). In addition, the study revealed a high coefficient of correlation (r) between the subscales of the VTD, both in the preliminary examination (r = 0.934) and the control one (r = 0.935).
The vocal tract discomfort scale (VTD) seems to be a valuable tool, useful in monitoring the progress in the treatment of occupational voice disorders.

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    ABSTRACT: Diagnostic and therapeutic procedures of occupational dysphonia play a major role in voice self-assessment, which is one of the elements of a comprehensive evaluation of voice disorders. The aim of the study was to assess the applicability of the Vocal Tract Discomfort (VTD) scale to monitor the effectiveness of voice rehabilitation and compare the VTD results with objective and instrumental methods of phoniatric diagnosis. The study included 55 teachers (mean age, 47.2) with occupational dysphonia. A comprehensive diagnosis took into account self-assessment by VTD scale, phoniatric examination, including laryngovideostroboscopy (LVSS) and objective measurements of the aerodynamic parameter - the maximum phonation time (MPT). After 4 months of intense rehabilitation, post-therapy examination was performed using the methods specified above. After the treatment, a significant improvement was obtained in the subjective symptoms measured on a VTD scale - assessed both for the frequency (p = 0.000) and the severity (p = 0.000) subscales. Positive effects of the therapy were also observed for the parameters evaluated in the phoniatric study (p < 0.01) and laryngovideostroboscopy (p < 0.01). After voice therapy, there was also an improvement in the objective parameter MCF, which was about 5 seconds longer. Studies have shown that the VTD scale is characterized by high reliability - Cronbach's alpha coefficient in the preliminary test was as follows: for the frequency subscale symptoms - 0.826, and severity - 0.845; similarly high reliability was achieved in the control test, 0.908 and 0.923, respectively. Vocal Tract Discomfort scale can be a valuable tool for assessing voice, and can also be used to monitor the effectiveness of therapy of the occupational dysphonia.
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May 20, 2014