Background
Primary muscle tension dysphonia (pMTD) is the commonest cause of voice disorders
and is treated by specialist speech therapists using a hierarchical and experiential
approach that draws on multiple techniques. Some singing teachers specializing in the
habilitation of the performance voice also have rehabilitation skills helping singers
recover form illness. The Complete Vocal Technique (CVT) is a structured and well
characterized habilitation and rehabilitation pedagogic technique potentially providing
additional tools that may be beneficial to patients with speaking voice problems.
Methods:
This feasibility study uses a single-arm, prospective cohort design. The 3 aims of this
study are to assess the feasibility and acceptability of using CVT voice therapy (CVT-
VT) in patients with pMTD (Type I-III) to: 1) improve the voice and voice function; 2)
assess the feasibility of recruiting patients for therapy and 3) assess the acceptability of
this approach to patients and the CVT practitioner (CVT-P). Fourteen patients with
pMTD meeting the inclusion criteria consented to take part in the study in a the 6
month trial period. Up to 6 video sessions of CVT-VT were delivered by the CVT-P
using a video link. Patients underwent a multidimensional assessment pre- and post –
therapy. The first primary outcome was a change in pre-/post-therapy scores of a self-
reported patient questionnaire (Voice Handicap Index (VHI)). Secondary outcomes
include meeting patient goals for treatment, changes in throat symptoms,
acoustic/electroglottographic and blinded auditory-perceptual assessments of voice.
The second feasibility aim was assessed by meeting a priori recruitment targets and
the third, the rating of the acceptability of the therapy by the patient and CVT-P.
Results
Eleven patients completed the study protocol exceeding the target. VHI scores, throat
scores, audio-perceptual evaluation and acoustic/electroglottographic measures all
showed evidence of improvement in the voice and voice function demonstrating better
control, loudness, coherence, and clarity with reduced instability, variability, and
perceived limitations and discomfort. 49,3% of 138 symptom goals resolved or were
much improved. All patients and the CVT-P rated the therapy very satisfactory or
satisfactory.
Conclusions
CVT-P is a feasible and acceptable form of treatment and warrants further evaluation
as a tool for voice therapy in patients with pMTD.