- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03349086
Effects of Vocal Exercises for Spasmodic Dysphonia
Effects of Vocal Exercise Following Botox Injection on Voice Handicap and Communicative Participation for Adductor Spasmodic Dysphonia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Spasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms of the vocal folds resulting in a strained and strangled voice quality. This disorder is quite disabling to patients who suffer from it, particularly affecting patients' quality of life. Botulinum toxin (Botox) has been found to be the most effective treatment for SD. The Botox is injected into the affected muscle resulting in temporary weakening of the muscle. The patients return for injections on average every 3 - 6 months.
There is a suggestion in the literature that increased diffusion of the Botox injectate could improve the effects of the injection. Furthermore, there is literature supporting the use of exercise to increase the diffusion of the Botox. Previous research examined the use of voluntary muscle activity vs. rest immediately following Botox injection for writer's cramp. It was found that the active condition resulted in greater reduction of muscle strength in the injected muscle. Another small study of 9 patients implemented intense exercise comprised of loud reading for one hour and a rest condition of total voice rest for 24 hours. They found that the exercise condition resulted in improved scores on the voice related-quality of life (V-RQOL) measure and concluded that improvement in results of Botox injections may be achieved more consistently with the implementation of exercise following the injection. The exercise used in this study was intense and may be contrary to the overall benefit as the subjects may experience phonotrauma. Timing of the exercise post-injection may also be a factor. Previous literature review revealed combined modality treatment of Botox injection only, Botox with therapy and Botox with sham treatment. They found no significant differences in acoustic stability, V-RQOL, or duration of injection benefit. However, the exercise was initiated 3 weeks post-injection and completed once per week for 5 weeks. Investigators aim to identify what might improve or extend the duration of botox injections for adductor Spasmodic dysphonia.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Wisconsin
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Madison, Wisconsin, United States, 53792
- University of Wisconsin - Madison
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Female
- 21-70 age
- Diagnosed with pure adductor spasmodic dysphonia
- Completed 2 consecutive standard of care Botox injection into the thyroarytenoid (TA) and/or thyroarytenoid/lateral cricoarytenoid (TA/LCA) junction with the same dosage
Exclusion Criteria:
- Receiving Botox to other laryngeal or supraglottic musculature
- Other neuro-laryngological conditions
- Those with an average of less than two injections per year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: Voice Exercise
Randomized participants in this group will undergo 45 minutes of voice exercise, including sustained pitches and pitch glides on a variety of different vocal facilitators.
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Voice exercise will consist of sustained pitches and pitch glides on a variety of different vocal facilitators.
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No Intervention: Voice Rest
Randomized participants in this group will undergo 45 minutes of voice rest.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
A quantifiable difference between the effects of voice exercise vs. voice rest post Adductor Spasmodic Dysphonia botox treatment through analysis of the Voice Handicap Index Questionnaire.
Time Frame: Assessing the change of the post VHI questionnaire between groups. Data will be reported at study completion, an average of 1 year.
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Pre randomized condition and post 6 week and 12 week, participants will be asked to complete the Voice Handicap Index (VHI). The VHI Questionnaire (Voice Handicap Index) is a 30-item questionnaire divided into 3 subsections (Functional, Physical, Emotional) and a Total which measures the effect of voice problems on quality of life. Individuals mark each item on this 30-item questionnaire on a scale from 0-4 (0 being never and 4 being always). Points for each subscale are tallied and a total composite score is also given. A total score of 0-11 is considered Normal, 12-28 is considered Mild Minimal handicap, 29-56 is considered Moderate Handicap, and 57-120 is considered severe handicap. |
Assessing the change of the post VHI questionnaire between groups. Data will be reported at study completion, an average of 1 year.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Brienne Ruel, MS, University of Wisconsin, Madison
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2013-1746
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Adductor Spasmodic Dysphonia
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University of California, San FranciscoRecruitingSpasmodic Dysphonia | Adductor Spasmodic Dysphonia | Voice DisordersUnited States
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Kumamoto UniversityKyoto University; Hokkaido University Hospital; Yokohama City University HospitalCompletedAdductor Spasmodic DysphoniaJapan
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University of California, San FranciscoNational Spasmodic Dysphonia AssociationCompletedSpasmodic Dysphonia | Adductor Spasmodic Dysphonia | Voice DisordersUnited States
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Lawson Health Research InstituteUnknownAdductor Spasmodic DysphoniaCanada
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Fondazione Policlinico Universitario Agostino Gemelli...Not yet recruitingAdductor Spasmodic DysphoniaItaly
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University of MinnesotaNot yet recruitingAdductor Spasmodic Dysphonia | Laryngeal Dystonia | Abductor Spastic DysphoniaUnited States
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National Institute of Neurological Disorders and...Completed
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Eastern Virginia Medical SchoolRecruitingDysphonia | Laryngeal Dystonia | Dysphonia, SpasticUnited States
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