Characterizing the Impact of Presbyphonia on Social Interaction

NCT ID: NCT06441136

Last Updated: 2025-07-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-10

Study Completion Date

2026-08-31

Brief Summary

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The purpose of this study is to determine if presbyphonia, or voice disorder caused by age-related change in the larynx, is associated with change in social interaction. This proposal investigates the impact of voice impairment in older adults on social interaction, loneliness, social disconnectedness, and depression. A series of questionnaires, voice assessments, and interviews will be performed to improve our understanding of how voice disorders affect older adults and how treatment of voice impairment with voice therapy may improve quality of life.

Detailed Description

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During the study visit, all subjects (including the control group) will be given ten questionnaires asking them to rate their loneliness and quality of life in relation to the changes in their voice. All participants will undergo audiometry to assess hearing (with hearing aids if used at home). If they do not pass the hearing test, they will be screened out of the study.

Participants will then provide a required voice sample using sustained vowels for 3-5 seconds 5 times each, repeating six standard sentences, and 20 seconds of natural conversational speech. Using this voice recording, the following assessments and measurements will be obtained: CAPE-V rating (Consensus auditory perceptual evaluation of voice), Cepstral peak prominence (measurement of dysphonia), fundamental frequency, signal-to-noise ratio, and voice type components (captures breathiness).

Subjects will then be asked to produce a train of /pi pi pi/ at a comfortable pitch and loudness into a mask with an intra-oral mouthpiece to record both pressure and airflow. Five trials will be performed. The following measurements will be obtained: mean flow rate, subglottal pressure, and vocal efficiency.

Subjects will then undergo an awake videostroboscopy using a small flexible camera passed through the nose to view the vocal folds. During this procedure, the nose is anesthetized and the subject is asked to produce sustained vowels for 3-5 seconds. This part of the study takes about 2 minutes to complete. The parameters to be measured for this are: bowing index of the vocal folds and normalized glottal gap.

For the second part of this study, subjects from the presbyphonia population only will be recruited to participate in the phonation resistance training exercises or PhoRTE voice therapy. Prior to therapy, for two weeks, participants will take pictures when their voice disorder may be affecting them or ability to socialize. Brief journal entry will be completed. Photos will be collected, printed, and used as memory recall tool for a pre-treatment semi-structured interview. Interviews will be conducted, approximately 45-60 minutes induration. Both online and in-person options will be available to facilitate participation. An interview guide will include questions designed to assess participants' perception of voice and how voice affects social participation.

Subjects will then complete PhoRTE therapy. Participants perform 5 vocal exercises at individualized target vocal intensity. Goals of therapy are to increase muscular workload on vocal mechanism and target the respiratory and laryngeal muscular deficits that result from aging. Participants practice 6 days per week at home and meet with speech pathologist weekly for 4 weeks.

Following therapy, participants will participate in 60-75-minute semi-structured small group interviews approximately 3 months after voice therapy. Interviews will address experience with voice therapy, and any changes after voice therapy.

Conditions

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Presbyphonia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phonation Resistance Training Exercises (PhoRTE) Voice Therapy Program

PhoRTE is a voice therapy program administered by a speech language pathologist for participants with presbyphonia. During sessions, participants perform five vocal exercises at individualized target vocal intensity. Goals of therapy are to increase muscular workload on vocal mechanism and target the respiratory and laryngeal muscular deficits that result from aging. Participants practice 6 days per week at home and meet with speech pathologist weekly for 4 weeks.

Group Type EXPERIMENTAL

PhoRTE Program

Intervention Type OTHER

Speech therapy program guided by a speech language pathologist. This program includes in person or virtual visits and at home exercises.

University of California Los Angeles (UCLA) Loneliness Scale

Intervention Type OTHER

A questionnaire measuring levels of loneliness.

Social Disconnectedness Scale

Intervention Type OTHER

A questionnaire that asks about social network size and the frequency of social activities attended.

Patient Health Questionnaire 9

Intervention Type OTHER

A questionnaire measuring levels of depression.

Aging Voice Index

Intervention Type OTHER

A questionnaire of patient-reported voice outcome measures designed to capture the quality of life impact of dysphonia in older adults.

The Edmonton Frail Scale

Intervention Type OTHER

A questionnaire that measures frailty levels.

Vocal Effort Scale

Intervention Type OTHER

A picture based questionnaire scale that asks the subject to rate their perceived effort when using their voice.

Montreal Cognitive Assessment

Intervention Type OTHER

A screening tool used to test for cognitive impairment.

Voice Handicap Index-10

Intervention Type OTHER

A questionnaire used to measure quality of life impact of dysphonia.

Voice Problem Impact Scales

Intervention Type OTHER

A 4 question survey that captures impact of voice on four domains - work/daily activities, social life, home, and overall quality of life.

Cough Severity Index

Intervention Type OTHER

A 10 question survey asking to rate severity of cough.

Laryngoscopy

Intervention Type PROCEDURE

Nose is anesthetized and a flexible endoscope is passed to visualize the larynx at rest and during sustained vowel production (/i/) for 3-5 seconds. This will be used to measure bowing index and normalized glottal gap of the vocal folds.

Acoustic, perceptual, and aerodynamic assessments

Intervention Type OTHER

Participants will complete voice recording tasks including sustained vowel production, six standard sentences, and 20 seconds of natural conversational speech. This will be used to measure CAPE-V rating, Cepstral peak prominence, fundamental frequency, signal-to-noise ratio, voice type components, mean flow rate, subglottal pressure, and vocal efficiency.

Interventions

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PhoRTE Program

Speech therapy program guided by a speech language pathologist. This program includes in person or virtual visits and at home exercises.

Intervention Type OTHER

University of California Los Angeles (UCLA) Loneliness Scale

A questionnaire measuring levels of loneliness.

Intervention Type OTHER

Social Disconnectedness Scale

A questionnaire that asks about social network size and the frequency of social activities attended.

Intervention Type OTHER

Patient Health Questionnaire 9

A questionnaire measuring levels of depression.

Intervention Type OTHER

Aging Voice Index

A questionnaire of patient-reported voice outcome measures designed to capture the quality of life impact of dysphonia in older adults.

Intervention Type OTHER

The Edmonton Frail Scale

A questionnaire that measures frailty levels.

Intervention Type OTHER

Vocal Effort Scale

A picture based questionnaire scale that asks the subject to rate their perceived effort when using their voice.

Intervention Type OTHER

Montreal Cognitive Assessment

A screening tool used to test for cognitive impairment.

Intervention Type OTHER

Voice Handicap Index-10

A questionnaire used to measure quality of life impact of dysphonia.

Intervention Type OTHER

Voice Problem Impact Scales

A 4 question survey that captures impact of voice on four domains - work/daily activities, social life, home, and overall quality of life.

Intervention Type OTHER

Cough Severity Index

A 10 question survey asking to rate severity of cough.

Intervention Type OTHER

Laryngoscopy

Nose is anesthetized and a flexible endoscope is passed to visualize the larynx at rest and during sustained vowel production (/i/) for 3-5 seconds. This will be used to measure bowing index and normalized glottal gap of the vocal folds.

Intervention Type PROCEDURE

Acoustic, perceptual, and aerodynamic assessments

Participants will complete voice recording tasks including sustained vowel production, six standard sentences, and 20 seconds of natural conversational speech. This will be used to measure CAPE-V rating, Cepstral peak prominence, fundamental frequency, signal-to-noise ratio, voice type components, mean flow rate, subglottal pressure, and vocal efficiency.

Intervention Type OTHER

Other Intervention Names

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Speech Therapy Program UCLA Loneliness Scale PHQ-9 MOCA VHI-10 VPIS Flexible transnasal videostroboscopy

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of presbyphonia with findings of presbylaryngis on videostroboscopy, with findings of bilateral true vocal fold atrophy and normal vocal fold motion bilaterally
* Able to complete all questionnaires and voice assessment tasks
* Normal to mild hearing loss in aided condition (with hearing aids)

Exclusion Criteria

* Liquid dysphagia or pneumonia in the last year
* Vocal fold lesion/scar/motion impairment
* Neurologic disorder affecting the voice
* Montreal cognitive assessment score \<26 or \<25 if 12 or fewer years of formal education
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Matthew R. Hoffman

OTHER

Sponsor Role lead

Responsible Party

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Matthew R. Hoffman

Assistant Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Matthew R Hoffman, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Locations

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University of Iowa Hospitals & Clinics

Iowa City, Iowa, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Matthew R Hoffman, MD, PhD

Role: CONTACT

319-356-2201

Emma L Thayer, BS

Role: CONTACT

319-678-7518

Facility Contacts

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Emma L Thayer, BS

Role: primary

515-371-7676

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Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

202307188

Identifier Type: -

Identifier Source: org_study_id

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