Who Benefits Most From Voice Use Reduction? Baseline Predictors Of Vocal Fatigue Improvement In Occupational Voice...

Occupational voice users are at increased risk of vocal fatigue, and voice use reduction (VUR) programs are commonly implemented to support symptom management. Although the overall effectiveness of VUR interventions has been described, less is known about which individuals demonstrate more favorable post-intervention outcomes.

To identify baseline predictors of post-intervention vocal fatigue in occupational voice users following a structured VUR program.

A secondary analysis was conducted on data from 30 occupational voice users who completed an 8-week VUR program. Vocal fatigue was assessed using Factor 1 of the Vocal Fatigue Index before and after intervention. A generalized linear model with robust (Huber-White) standard errors was used to predict post-intervention Vocal Fatigue Index Factor 1 scores, adjusting for baseline fatigue severity. Baseline VFI Factor 1 was included as a covariate to control for initial fatigue severity. Daily voice use category and GERD status were examined as baseline factors associated with post-intervention outcomes. Estimated marginal means were calculated to illustrate adjusted outcomes.

The overall model was statistically significant (likelihood ratio χ²(3) = 12.52, P = 0.006). Baseline VFI Factor 1 was significantly associated with post-intervention fatigue (B = 0.344, P < 0.001). Daily voice use was also a significant predictor (B = -3.508, P = 0.002), with participants reporting moderate baseline voice use demonstrating lower adjusted post-intervention fatigue scores than those with high voice use. GERD status was not a significant predictor (P = 0.307).

Baseline vocal load and symptom severity are key predictors of post-intervention vocal fatigue following VUR. Individuals with lower baseline voice use demands demonstrate more favorable adjusted outcomes, underscoring the importance of considering vocal load when tailoring behavioral voice interventions.