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Efficacy of Conversation Training Therapy

谈话训练疗法的功效

基本信息

批准号：
9241383
负责人：
Amanda I Gillespie
金额：
$ 14.95万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-03-10 至 2019-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9241383
关键词：
Acoustics Address Aftercare Asthma Behavior Behavior Therapy Benign Breathing Case Series Chronic Disease Chronic Obstructive Airway Disease Clinical Cohort Studies Complex Data Diabetes Mellitus Disabled Persons Dysphonia Early treatment Exercise Goals Healthcare Healthcare Systems Investigation Language Learning Learning Skill Length Lesion Mental Depression Methods Muscle Tension Neuronal Plasticity Outcome Outcome Measure Participant Pathologist Patients Performance at work Plant Roots Production Prospective Studies Publishing Quality of life Recommendation Recruitment Activity Rehabilitation therapy Relapse Relaxation Reporting Research Savings Social Functioning Specificity Speech Stress Techniques Testing Therapeutic Time Training Training Technics Transferable Skills Treatment Cost United States Voice Voice Disorders Voice Training Wit base cohort comparative effectiveness cost disability follow-up improved ineffective therapies meetings motor learning negative affect novel novel strategies patient oriented phrases programs public health relevance skills sound standard of care success theories traditional therapy treatment center trial comparing vocal cord voice therapy

项目摘要

DESCRIPTION (provided by applicant): Voice therapy, the behavioral treatment aimed at modifying behaviors that cause or contribute to voice disorders, is the standard of care for many people with voice disorders. Although voice therapy is effective at treating voice disorders initially; substantial limitations exist with traditional treatment paradigms. These limitations case a protracted length of time in required in treatment, as well as attrition and relapse rates approaching 70%, which contribute to the high costs associated with treating voice disorders. Traditional voice therapy builds hierarchically from breathing and relaxation exercises to production of single sounds, words, phrases, and finally, conversation. Patients report that this final step, transfer of skills to conversation, is the most difficult part of voice therapy. Motor learning theory states that training complex skills as a whole (e.g. conversation) facilitates learning and retention more-so than breaking these complexities down into simple components (e.g. single sounds). It is unknown if eliminating the therapeutic hierarchy and training target voice techniques in conversation, starting in the first session and throughout all sessions, would reduce the time spent in treatment and improve learning and retention, thereby reducing attrition and relapse. To that end, a new voice therapy approach, Conversation Training Therapy (CTT), was developed by a team of expert voice-specialized speech-language pathologists and successfully trialed on a small cohort of five patients with voice disorders. The CTT approach resulted in voice goals met in an average of 3 sessions, substantially below the number of sessions typically required in traditional therapy programs. Further, a clinically meaningful decrease in VHI-10 scores was observed for all patients. The goal of the current application is to determine the efficacy of CTT in the rehabilitation of patients with 2 common voice disorders, benign vocal fold lesions and muscle tension dysphonia. After determining initial efficacy, the long term goal of this research is to conduct multi-center comparative effectiveness trials comparing CTT to traditional voice therapy programs in people with voice disorders. This proposal is an investigation of the first voice therapy program based in theories of motor learning and neuroplasticity, developed without the use of a traditional therapeutic hierarchy, with input from patients with voice disorders and expert, clinical, speech-language pathologists. Results of the current research are potentially paradigm-shifting with regards to how voice therapy is delivered, including the necessary time spent in treatment, resulting in a potential savings of billions of dollars to the healthcare system and improved quality of life for people wit voice disorders.