Efficiency of Voice Therapy for Persons with Vocal Tremors

Introduction: Essential vocal tremor (EVT) is vocal tremor occurring in an individual diagnosed with essential tremor and is an action induced tremor that occurs during speech production. It causes fewer communication attempts, difficulty initiating and maintaining phonation, effortful speaking avoidance of social events trouble sustaining relationship leading to impair quality of life for such persons. Aim of the study: The aim of present study was to find out the efficacy of voice therapy in persons with voice tremors which may be shown in improvement in acoustic analysis and quality of life measures. Methodology: The study was conducted at ENT department of PGIMER, Chandigarh. Two subjects were included in the study having a complaint of vocal tremors. A 65-year-old male patient and a 68 -year old female patient both diagnosed with EVT. The acoustic assessment was done using Dr. Speech software. Effect of voice disorder on quality of life was assessed using Voice Handicap Index. Measurements were repeated after completion of a voice therapy program with a frequency of twice a week for eight weeks. A combination of Laryngeal maneuvers, Relaxation exercises and Breathing exercises were used in voice therapy protocol. Results and Discussion: Pre-therapy and post-therapy comparison shows improvement in the quality of life shown by reduction of VHI scores across three parameters (functional, physical and emotional) of VHI in both the patients. Acoustic parameters of voice also showed improvement in terms of shimmer and HNR in both the patients. Conclusion: The voice therapy shows improvement in the quality of life as well as acoustic parameters of voice in this population. More research is required in this area to find out the efficacy of this therapy protocol on a larger population.