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Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder.
J Voice. 2020 Jul; 34(4):559-566.JV

Abstract

OBJECTIVE

To investigate patient-level predictors of initiation of voice therapy for paradoxical vocal fold motion disorder (PVFM).

STUDY DESIGN

Prospective outcomes database study.

METHODS

Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database between March 2010 and November 2016 who were diagnosed with PVFM and recommended for voice therapy were eligible. Patients who attended at least one voice therapy session were considered to have initiated therapy. Analyzed variables included age, gender, distance to the clinic, insurance status, socioeconomic factors, comorbidity score, spirometry results, presence of asthma and/or dysphonia diagnoses, length of evaluation and evaluation model, and patient scores on the Voice Handicap Index and Generalized Anxiety Disorder 7-item scale.

RESULTS

One-hundred seventy-eight patients met inclusion criteria. Of these, 118 initiated voice therapy as recommended (66.29%). The majority of patients were female (n = 127; 71.35%). Age was the only factor significantly associated with therapy initiation in both univariate (P = 0.0359) and multivariable (P = 0.0295) analyses, with patients aged 30-39 least likely to attend compared with other age groups. Multivariable analysis also showed that patients evaluated by a speech-language pathologist alone were an estimated three times as likely to initiate therapy compared to patients evaluated by speech-language pathologist and otolaryngologist (ENT) together (P = 0.0407). Other variables were not statistically significant for prediction of therapy initiation.

CONCLUSIONS

This study suggests that age group and evaluation model are associated with initiation of voice therapy for PVFM. Further study is needed to investigate social-cognitive and quality-of-life factors in predicting therapy initiation.

Authors+Show Affiliations

Voice and Swallow Clinics, University Hospital, Madison, Wisconsin. Electronic address: pasternak@surgery.wisc.edu.Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30660338

Citation

Pasternak, Kevin, and Susan L. Thibeault. "Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder." Journal of Voice : Official Journal of the Voice Foundation, vol. 34, no. 4, 2020, pp. 559-566.
Pasternak K, Thibeault SL. Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder. J Voice. 2020;34(4):559-566.
Pasternak, K., & Thibeault, S. L. (2020). Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder. Journal of Voice : Official Journal of the Voice Foundation, 34(4), 559-566. https://doi.org/10.1016/j.jvoice.2018.12.013
Pasternak K, Thibeault SL. Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder. J Voice. 2020;34(4):559-566. PubMed PMID: 30660338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors Affecting Initiation of Voice Therapy for Paradoxical Vocal Fold Motion Disorder. AU - Pasternak,Kevin, AU - Thibeault,Susan L, Y1 - 2019/01/17/ PY - 2018/10/31/received PY - 2018/12/20/revised PY - 2018/12/20/accepted PY - 2019/1/21/pubmed PY - 2019/1/21/medline PY - 2019/1/21/entrez KW - Paradoxical vocal fold motion (PVFM) KW - Therapy adherence KW - Therapy initiation KW - Vocal cord dysfunction (VCD) KW - Voice therapy SP - 559 EP - 566 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 34 IS - 4 N2 - OBJECTIVE: To investigate patient-level predictors of initiation of voice therapy for paradoxical vocal fold motion disorder (PVFM). STUDY DESIGN: Prospective outcomes database study. METHODS: Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database between March 2010 and November 2016 who were diagnosed with PVFM and recommended for voice therapy were eligible. Patients who attended at least one voice therapy session were considered to have initiated therapy. Analyzed variables included age, gender, distance to the clinic, insurance status, socioeconomic factors, comorbidity score, spirometry results, presence of asthma and/or dysphonia diagnoses, length of evaluation and evaluation model, and patient scores on the Voice Handicap Index and Generalized Anxiety Disorder 7-item scale. RESULTS: One-hundred seventy-eight patients met inclusion criteria. Of these, 118 initiated voice therapy as recommended (66.29%). The majority of patients were female (n = 127; 71.35%). Age was the only factor significantly associated with therapy initiation in both univariate (P = 0.0359) and multivariable (P = 0.0295) analyses, with patients aged 30-39 least likely to attend compared with other age groups. Multivariable analysis also showed that patients evaluated by a speech-language pathologist alone were an estimated three times as likely to initiate therapy compared to patients evaluated by speech-language pathologist and otolaryngologist (ENT) together (P = 0.0407). Other variables were not statistically significant for prediction of therapy initiation. CONCLUSIONS: This study suggests that age group and evaluation model are associated with initiation of voice therapy for PVFM. Further study is needed to investigate social-cognitive and quality-of-life factors in predicting therapy initiation. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/30660338/Factors_Affecting_Initiation_of_Voice_Therapy_for_Paradoxical_Vocal_Fold_Motion_Disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(18)30491-0 DB - PRIME DP - Unbound Medicine ER -
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