Effectiveness of Voice Exercises on Hoarseness: A Retrospective Analysis of Subjective and Objective Voice Outcomes
Main Article Content
Abstract
Background: Hoarseness is a common clinical complaint that negatively affects communication, professional performance, and quality of life. Voice exercise therapy has emerged as a cornerstone in the non-surgical management of dysphonia. However, studies integrating subjective and objective voice parameters remain limited.
Objective: To retrospectively evaluate the effectiveness of structured voice exercise therapy in patients with hoarseness using multidimensional voice assessment parameters.
Methods: A retrospective study was conducted on 46 patients diagnosed with dysphonia who underwent structured voice exercise therapy. Pre- and post-treatment evaluations included the Voice Handicap Index (VHI), GRBAS perceptual voice scale, Maximum Phonation Time (MPT), jitter, and shimmer measurements. Statistical analysis was performed using paired-sample t-tests.
Results: Significant improvements were observed in all evaluated parameters following therapy. Mean VHI scores decreased from 66.1 to 41.8 (p < 0.001), while GRBAS scores improved from 9.4 to 4.7 (p < 0.001). MPT values increased from 8.1 seconds to 14.2 seconds (p < 0.001). Jitter and shimmer values demonstrated significant reductions after treatment (both p < 0.001). These findings indicate clinically meaningful improvements in both subjective and objective voice quality.
Conclusion: Structured voice exercise therapy significantly improves perceptual, acoustic, and patient-reported voice outcomes in patients with hoarseness. Multidimensional assessment tools provide a comprehensive framework for evaluating therapeutic success.
Article Details
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References
2. Kim JS, Lee DW, Choi CH, Choi SH. Effects of Laryngeal Massage and Semi-occluded Vocal Tract Exercises for Patients with Hyperfunctional Dysphonia. Eon’eo cheong’gag jang’ae yeon’gu/Communication sciences & disorders. 2017;22(4):806-817. doi:10.12963/csd.17434
3. Kim JS, Choi SH, Choi CH, Lee DW. Effect of Voice Therapy for Persistent Dysphonia Following Laryngeal Microsurgery. Eon’eo cheong’gag jang’ae yeon’gu/Communication sciences & disorders. 2019;24(2):525-534. doi:10.12963/csd.19606
4. Nambu Y, Nimura Y, Mori Y, Hirano A, Iwahashi M, Higashikawa M. Treatment for Age-Related Dysphonia. The Japan Journal of Logopedics and Phoniatrics. 2019;60(1):43-51. doi:10.5112/jjlp.60.43
5. Niebudek-Bogusz E, Kotyło P, Śliwińska‐Kowalska M. Evaluation of Voice Acoustic Parameters Related to the Vocal-Loading Test in Professionally Active Teachers with Dysphonia. International Journal of Occupational Medicine and Environmental Health. 2007;20(1). doi:10.2478/v10001-007-0001-9
6. Craig J, Tomlinson CA, Stevens KL, et al. Combining voice therapy and physical therapy: A novel approach to treating muscle tension dysphonia. Journal of Communication Disorders. 2015;58:169-178. doi:10.1016/j.jcomdis.2015.05.001
7. Gillespie AI, Yabes JG, Rosen CA, Gartner‐Schmidt J. Efficacy of Conversation Training Therapy for Patients With Benign Vocal Fold Lesions and Muscle Tension Dysphonia Compared to Historical Matched Control Patients. Journal of Speech Language and Hearing Research . 2019;62(11):4062-4079. doi:10.1044/2019_jslhr-s-19-0136
8. Fulljames N, Harris SH. Voice outcome measures: Correlations with patients’ assessment of their condition and the effectiveness of voice therapy. Logopedics Phoniatrics Vocology. 2005;31(1):23-35. doi:10.1080/14015430500295749
9. Smith JD, McConville K, Tiner MK, et al. Examining Use and Effectiveness of Teletherapy for Patients with Dysphonia. Journal of Voice . Published online February 1, 2023. doi:10.1016/j.jvoice.2023.01.034
10. Bonetti A. Voice Outcomes as a Results of Voice Therapy after Lobectomy and Thyroidectomy. Acta Clinica Croatica. Published online January 1, 2020. doi:10.20471/acc.2020.59.s1.02
11. Miaśkiewicz B, Szkiełkowska A, Gos E, Panasiewicz A, Włodarczyk E, Skarżyński PH. Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients. European Archives of Oto-Rhino-Laryngology. 2018;275(11):2763-2771. doi:10.1007/s00405-018-5040-2
12. Zhang X, Liu CH, Fan Z, Qiao Z, Liu M. Efficacy of voice training on benign vocal cord lesions after surgery: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials. Medicine. 2025;104(35). doi:10.1097/md.0000000000044024
13. Ananya, Nayak S, Veerabhadrappa RC, Pillai S, Devadas U. Effectiveness of smartphone-based televoice therapy for individuals with hyper-functional voice disorders: a pilot study. The Egyptian Journal of Otolaryngology . 2025;41(1). doi:10.1186/s43163-025-00932-1
14. Choi SH, Yu M, Choi CH. Comparisons of 4-Point GRBAS, 7-Point-GRBAS, and CAPE-V for Auditory Perceptual Evaluation of Dysphonia. Audiology and Speech Research . 2021;17(2):206-219. doi:10.21848/asr.200086
15. Huttunen K, Rantala L. Effects of Humidification of the Vocal Tract and Respiratory Muscle Training in Women With Voice Symptoms—A Pilot Study. Journal of Voice . 2019;35(1). doi:10.1016/j.jvoice.2019.07.019
16. Haowutikul C, Jeeraumporn J, Dechongkit S, Thayansin S. Efficacy of straw phonation exercises with breathing exercises and indirect approaches for dysphonic adults with benign vocal fold lesions. Journal of Associated Medical Sciences . 2022;56(2):47-52. doi:10.12982/jams.2023.015
17. Stepp CE, Merchant GR, Heaton JT, Hillman RE. Effects of Voice Therapy on Relative Fundamental Frequency During Voicing Offset and Onset in Patients With Vocal Hyperfunction. Journal of Speech Language and Hearing Research . 2011;54(5):1260-1266. doi:10.1044/1092-4388(2011/10-0274)
18. Titze IR. Voice Training and Therapy With a Semi-Occluded Vocal Tract: Rationale and Scientific Underpinnings. Journal of Speech Language and Hearing Research . 2006;49(2):448-459. doi:10.1044/1092-4388(2006/035)
19. Goipkishore P. Multiparametric Assessment of the Efficacy of Voice Therapy in the Management of Hyper functional Voice Disorders. Journal of Otolaryngology-ENT Research . 2017;8(2). doi:10.15406/joentr.2017.08.00239
20. Rajasudhakar R. Effect of voice therapy in sulcus vocalis: A single case study. South African Journal of Communication Disorders. 2016;63(1). doi:10.4102/sajcd.v63i1.146
21. Watts CR, Hamilton AL, Toles LE, Childs LF, Mau T. Intervention Outcomes of Two Treatments for Muscle Tension Dysphonia: A Randomized Controlled Trial. Journal of Speech, Language, and Hearing Research. 2019;62(2):272-282. doi:10.1044/2018_jslhr-s-18-0118
22. Talari K, Goyal M. Retrospective Studies – Utility and Caveats. The Journal of the Royal College of Physicians of Edinburgh. 2020;50(4):398-402. doi:10.4997/jrcpe.2020.409
23. Abbott KV, Barton FB, Terhorst L, Shembel AC. Retrospective Studies: A Fresh Look. American Journal of Speech-Language Pathology. 2016;25(2):157-163. doi:10.1044/2016_ajslp-16-0025
24. Ruotsalainen J, Sellman JD, Lehto L, Jauhiainen M, Verbeek J. Interventions for treating functional dysphonia in adults. Cochrane Database of Systematic Reviews . 2007;(3). doi:10.1002/14651858.cd006373.pub2
25. Meerschman I, Lierde KV, D’haeseleer E, et al. Immediate and Short-term Effects of Straw Phonation in Air or Water on Vocal Fold Vibration and Supraglottic Activity of Adult Patients with Voice Disorders Visualized with Strobovideolaryngoscopy: A Pilot Study. Journal of Voice. 2021;38(2):392-403. doi:10.1016/j.jvoice.2021.09.017
26. Liu Y, Chen F, Liang F, et al. Comparison of the efficacy and adverse effects of unilateral or bilateral botulinum toxin injections for adductor spasmodic dysphonia: a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology. 2023;281(3):1357-1369. doi:10.1007/s00405-023-08366-2
27. Bian Y, Wang J, Zhang H, Yin X, Zhang Y. Voice treatment of school-aged children with vocal nodules with ABCLOVE rehabilitation. Pediatr Neonatol. 2024;65(6):560-565. doi:10.1016/j.pedneo.2023.09.015
28. Mumović G, Veselinović M, Arbutina T, Škrbić R. Vocal therapy of hyperkinetic dysphonia. Srp Arh Celok Lek. 2014;142(11-12):656-662. doi:10.2298/sarh1412656m
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