Comparison of Voice Therapy Outcomes: Clinic vs Telehealth

Brandon LaBarge; F Jeffrey Lorenz; Arin Ayala; Tonya S King; John P Gniady

doi:10.1016/j.jvoice.2023.03.014

Comparison of Voice Therapy Outcomes: Clinic vs Telehealth

J Voice. 2023 May 6:S0892-1997(23)00107-8. doi: 10.1016/j.jvoice.2023.03.014. Online ahead of print.

Authors

Brandon LaBarge¹, F Jeffrey Lorenz², Arin Ayala¹, Tonya S King³, John P Gniady⁴

Affiliations

¹ Department of Otolaryngology, Penn State College of Medicine, Hershey, Pennsylvania.
² College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania.
³ Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
⁴ Department of Otolaryngology, Penn State College of Medicine, Hershey, Pennsylvania. Electronic address: JGniady@pennstatehealth.psu.edu.

PMID: 37150699
DOI: 10.1016/j.jvoice.2023.03.014

Abstract

Background: Voice therapy provides patients with valuable exercises and techniques to optimize vocal behaviors and improve their ability to communicate effectively and efficiently. These sessions were typically held by speech-language pathologists (SLPs) in clinic. During the COVID-19 pandemic, SLPs were provisionally able to provide billable voice therapy services in telehealth format. There is a lack of existing research studies comparing outcomes based on the format of voice therapy.

Methods: A retrospective chart review was performed on 101 patients who underwent voice therapy at a large academic institution in order to compare outcomes between clinic, telehealth, and mixed voice therapy formats. Demographics, dysphonia etiology, duration of symptoms, number of therapy sessions, and pre- and postvoice therapy scores using reflux symptom index (RSI), voice handicap index (VHI-10), consensus auditory-perceptual evaluation of voice (CAPE-V), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scoring were collected. Statistical comparisons were performed using Fisher's exact test and analysis of covariance.

Results: There were no statistically significant differences in pre- to postvoice therapy RSI, VHI-10, CAPE-V, or GRBAS scores based on format of voice therapy, after adjustment for number of therapy sessions received. There were no differences in these outcomes when comparing voice therapy by etiology of dysphonia.

Conclusions: Overall, these data support the effectiveness of the telehealth voice therapy format. It is a promising platform for greater patient access to therapy. All formats of voice therapy were effective in improving key measures of voice perception.

Keywords: Dysphonia; Laryngology; Speech; Telehealth; Voice therapy.