Low-Frequency TENS in Women With Behavioral Dysphonia: Preliminary Data From a Randomized Clinical Trial

Larissa Thaís Donalonso Siqueira; Ana Paula Dos Santos; Jhonatan da Silva Vitor; Daniela Hencke; Millena Maria Ramalho Matta Vieira; Angélica Emygdio Antonetti-Carvalho; Alcione Ghedini Brasolotto; Leonardo Wanderley Lopes; Kelly Cristina Alves Silverio

doi:10.1016/j.jvoice.2023.10.037

Low-Frequency TENS in Women With Behavioral Dysphonia: Preliminary Data From a Randomized Clinical Trial

J Voice. 2023 Dec 8:S0892-1997(23)00358-2. doi: 10.1016/j.jvoice.2023.10.037. Online ahead of print.

Authors

Larissa Thaís Donalonso Siqueira¹, Ana Paula Dos Santos², Jhonatan da Silva Vitor³, Daniela Hencke⁴, Millena Maria Ramalho Matta Vieira⁵, Angélica Emygdio Antonetti-Carvalho⁶, Alcione Ghedini Brasolotto⁷, Leonardo Wanderley Lopes⁸, Kelly Cristina Alves Silverio⁹

Affiliations

¹ Audiology Department at Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. Electronic address: larissa.siqueira@ufrn.br.
² Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: anapauladossantos@usp.br.
³ Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: jhonatansilvavitor@gmail.com.
⁴ Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: danielahencke@hotmail.com.
⁵ Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: millenavieira@usp.br.
⁶ Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: angelica.antonetticarvalho@gmail.com.
⁷ Pathology and Audiology Department at Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: alcionebra@uol.com.br.
⁸ Pathology and Audiology Department at Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil. Electronic address: lwlopes@hotmail.com.
⁹ Pathology and Audiology Department at Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil. Electronic address: kellysilverio@usp.br.

PMID: 38071130
DOI: 10.1016/j.jvoice.2023.10.037

Abstract

Purpose: To verify the effectiveness of low-frequency transcutaneous electrical nerve stimulation (TENS) simultaneously applied to the performance of vocal exercises in women with behavioral dysphonia.

Methods: This is a randomized, blinded clinical trial (Register Number: RBR-5k95vs). Twelve adult women with vocal nodules, randomly divided into three groups (G1: 4 participants - 12 sessions - application of placebo TENS simultaneously to the execution of vocal exercises; G2: 5 participants - 12 sessions - application of low-frequency TENS (frequency at 10 Hz, 200 μs duration phase, motor threshold, with electrodes placed on the thyroid cartilage lamina, bilaterally); and G3: 3 participants - 12 sessions - application of low-frequency TENS (same condition as G2) simultaneously to the execution of vocal exercises), participated in this study. The therapies were performed for 30 minutes in each session, twice a week. The participants were evaluated regarding vocal quality through acoustic voice analysis (fundamental frequency, Cesptral Peak Prominence-Smoothed (CPPs), alpha ratio, L1-L0, Acoustic Breathiness Index (ABI), and Acoustic Vocal Quality Index (AVQI)), vocal economy through electroglottography, and vocal self-assessment using the Voice-Related Quality of Life (V-RQOL) protocol. Assessments were performed before and immediately after voice therapy. Data were analyzed using the two-way repeated-measures ANOVA (variance analysis) test to compare assessment times and intervention groups.

Results: It was observed that G2 presented a reduction in the ABI acoustic parameter after the intervention and an increase in the values of the CPPs and L1-L0 parameter and in the scores of the physical and total V-RQOL domains. There were no differences for the other outcomes in relation to time and group.

Conclusion: Preliminary results indicate that low-frequency TENS applied alone can reduce ABI parameter values and improve voice-related quality of life in dysphonic women.

Keywords: Dysphonia; Transcutaneous electrical nerve stimulation; Voice; Voice disorders; Voice training.