The Effect of a Singing-based Voice Therapy Program for Older Adults with Aging Voice Problems

Objective: Direct voice therapy approaches driven by exercise science have been popular as an intervention for older adults with aging voice problems. Despite the positive treatment effect, systematic reviews show that the level of evidence and treatment adherence of the relevant studies are not high. In order to improve treatment adherence, leisure elements are suggested to be incorporated into voice training for older adults.

Singing was described as the athletic use of larynx, involving high vocal dose. It improves vocal functions by regulating respiration, phonation, and posture. Older adults with singing experience are less prone to aging-related voice problems with their laryngeal musculature than those without singing experience. Singing is also a leisure activity culturally accepted worldwide. It may bring a less challenging image of voice therapy to older adults, thus a greater satisfaction from the intervention and more motivation to attend voice therapy. Therefore, a singing-based voice therapy program for older adults with aging voice problem is developed.

Methods: A pilot study of a focus group with 16 older adults (eight female and eight male) was conducted to prepare the intervention protocol and develop a song bank comprising songs popular among older adults in Hong Kong. In the main study, older adults with diagnosed presbyphonia were recruited, and were randomly assigned to the experimental group and the control group. In the experimental group, excerpts of songs from the song bank of the pilot study were used as the singing exercises, with the components of endurance, resistance, and coordination training and musical adjustment according to the vocal functions of older adults. In the control group, vocal function exercises were used for voice therapy. Both groups involved eight one-hour group sessions, with two sessions per week. Home practices, twice daily, were prescribed. Outcome measures included perceptual rating and acoustic measures of voice recording, perceived phonatory effort, voice-related quality of life, and treatment adherence of the participating older adults.

Results & Conclusions: Eight participants were recruited at the time of abstract submission. On-going data collection with larger number of participants is currently in progress, and the results will be presented.