Floating Ball Voice Therapy: Preliminary Effects on Outcomes and Predicting Individual Patient Differences in...

Area of Science:

• Speech and Hearing Sciences
• Voice Disorders
• Rehabilitation Technology

Background:

• Nonphonotraumatic vocal hyperfunction (NPVH) presents a challenge in voice therapy.
• Evidence-based therapies often target improved vocal efficiency through modified resonance and airflow.
• Floating ball voice therapy (FBVT) is a novel virtual environment designed to facilitate these therapeutic targets.

Purpose of the Study:

• To preliminarily assess the effects of FBVT on voice therapy outcomes.
• To explore the potential of FBVT's novel variability metrics in predicting individual patient generalization.
• To evaluate FBVT's efficacy in improving vocal efficiency and reducing symptoms of NPVH.

Main Methods:

• Ten patients diagnosed with NPVH participated in 10 days of FBVT practice.
• Outcomes were measured using vocal efficiency ratio, NPVH index, Voice-Related Quality of Life (V-RQOL) scores, and auditory judgments of severity.
• Early practice (Day 1) variability (airflow and intensity) was analyzed in relation to the vocal efficiency ratio error.
• Generalization to spontaneous speech was assessed using the NPVH index.

Main Results:

• A short dosage of FBVT (10 sessions) led to significant improvements in vocal efficiency (Cohen's d = 1.3).
• Patients showed reduced NPVH index scores (d = -1.1) and improved V-RQOL (d = 0.9).
• FBVT also improved overall voice severity (odds ratio = 2.5).
• Early variability metrics on Day 1 predicted generalization to connected speech by Day 10 (d = 0.6-1.2).

Conclusions:

• FBVT demonstrates potential as an effective voice therapy tool, showing significant positive outcomes with a minimal practice duration.
• Novel variability metrics within FBVT show promise for predicting treatment generalization.
• Further research with larger cohorts is warranted to confirm these findings and further characterize vocal exploration quality.