Hard onset therapy for functional hypoadduction and presbylaryngis: our experience in 22 patients

Abstract

Objectives

The hard onset, also known as a hard attack, or glottal onset, is a technique of vocal production in which the vocal folds are adducted prior to exhalation and forced open to begin phonation. In this study, we assessed the short-term efficacy of voice therapy incorporating hard onset techniques for patients with functional hypoadduction and presbyphonia. Design: Prospective cohort study. Setting: Tertiary academic medical center. Participants: Twenty-two patients with functional hypoadduction who underwent voice therapy, including hard-onset therapy, for 3 months. Main outcome measures: Vocal function pre-therapy and 3 months post-therapy assessed objectively by quantitative aerodynamic and acoustic analysis and subjectively by vocal handicap index (VHI) and grade, roughness, breathiness, asthenia, strain (GRBAS) scale. Results: Voice quality as graded by the VHI and GRBAS were statistically significantly improved following voice therapy. Objective comparisons reflected improvement in fundamental frequency, jitter, shimmer, normalized noise energy, and maximal phonation time. Conclusions: Voice therapy, including hard onset therapy, improved vocal quality and performance by both subjective and objective measures in patients with functional hypoadduction/presbyphonia.

This article is protected by copyright. All rights reserved.

http://ift.tt/2Eiw3Eh