Objective: To evaluate the effectiveness of laryngeal electrotherapy with low-frequency TENS, applied simultaneously with vocal exercises, and to compare its effects with isolated TENS on vocal quality and self-perception of easy and clear voice in women with hyperfunctional dysphonia.

Methodology: Cross-sectional study, Ethics Committee (approval 4.022.860). Twenty-two women (mean age 31.0 ± 7.27) with hyperfunctional dysphonia participated of this study. They were divided into two groups: ELVE (11 women) received TENS+vocal exercises, and EL (11 women) received only electrotherapy with TENS. TENS was applied with electrodes on the thyroid cartilage bilaterally (10Hz, 200_s phase, motor threshold at low intensity). All participants underwent 12 sessions, twice a week, with an initial 5-minute orientation on vocal hygiene. Recordings of sustained vowel /a/ and counting were made before and after intervention. Perceptual-auditory analysis of vocal quality (overall grade, breathiness, and tension), multiparametric measures (Acoustic Voice Quality Index [AVQI] and Breathiness Index [ABI]), and self-perception of “easy voice” and “clear voice” (10 cm visual analog scale) were conducted. To compare effects before/after intervention and between groups, paired T-test, Wilcoxon, and independent samples T-test were applied (p<0.05). Effect size analysis was conducted using Cohen's d (d=0.2 to 0.4=small effect; d=0.5 to 0.7=medium effect; and d=0.8 or greater=large effect.

Results: There was no significant difference in perceptual-auditory analysis after the intervention and between groups. Effect size on vocal quality was small (d0.5) after intervention. Improvement in self-perception of “easy voice” and “clear voice” was found only in the EL group (p=0.021 and p=0.005, respectively), with a large effect (r__=-1.00).

Conclusion: The isolated application of low-frequency TENS in women with hyperfunctional dysphonia resulted in a reduction of ABI values, indicating a significant improvement in the degree of breathiness. Similarly, there was improvement in self-perception of “easy voice” and “clear voice,” an effect not observed with TENS combined with vocal exercises.