Pre and Post Stimulation Results for DysphonicParticipants on the Multidimensional VoiceProgram

Objective: The purpose of this study was to compare acoustic data for the following vocal parameters to assess vocal noise in dysphonic participant’s pre and post stimulability training: Relative Average Perturbations (RAP), Shimmer, and Noise-Harmonic Ratio (NHR) using the Multi-Dimensional Voice Program (MDVP) were assessed. The objective was to determine if stimulability training could improve the parameters on the MDVP and corroborate perceptual improvements in vocal quality with the acoustic data. Such data could provide evidence of the MDVP’s value as a measure of parameter changes resulting from stimulability training. There is little research on this instrument’s efficacy for documenting change after stimulability training. Method: The investigator assessed 20 participants (male and female) between the ages of 20 and 30 (mean age=25) who were perceptually rated as dysphonic. The diagnostic team rated the participants upon listening to their monologue, conversational speech, and a reading passage. The participants prolonged the vowel /a/ on the MDVP to obtain acoustic parameters. They were subsequently stimulated to use proper coordination of respiration and phonation and actively engage their abdominal muscles upon phonation of /a/. After stimulation, the participants again phonated /a/ on the MDVP using the stimulation technique. The same parameters were compared before and after stimulability training. Results: Results of the MDVP (before stimulation) revealed aberrant vocal parameters for all the participants, corroborating informal vocal perception of dysphonia by the diagnostic team with the MDVP results. After stimulation training, the participants’ voices were again measured on the MDVP as they used the stimulation technique. Decreased RAP, Shimmer, and NHR levels were observed for all participant, although NHRs were either minimal or within normal limits before stimulation. Perceptual improvements in vocal quality post-stimulation were also reported by the evaluators. Conclusion and implications: The MDVP can measure parameter change with regard to vocal improvement after the present stimulability training. Acoustic improvement corroborated perceptual improvement.