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Trial registered on ANZCTR
Registration number
ACTRN12611000686909
Ethics application status
Approved
Date submitted
4/07/2011
Date registered
6/07/2011
Date last updated
6/07/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Treating Voice Disorders: Which Therapy Works Best?
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Scientific title
A Randomized Controlled Trial Comparing the Effect of Expiratory Muscle Strength Training versus Traditional voice therapy on dysphonia in Patients with Unilateral Vocal Fold Palsy
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Secondary ID [1]
259629
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Unilateral Vocal Fold Palsy causing Dysphonia
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Condition category
Condition code
Physical Medicine / Rehabilitation
259344
259344
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0
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Speech therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Expiratory Muscle Strength Training (EMST) arm - 6 weeks
a) subjects exhales on one breath through the expiratory pressure threshold device. Device will be set at 75% of the subject's maximum expiratory pressure (MEP).
b) five repetitions of the exercise = 1 block
c) five blocks completed daily, five days per week
Traditional voice therapy/ Usual Care arm - 6 weeks
a) release of muscle tension
b) establishment of 'Twang' voice quality
c) visual and auditory biofeedback
d) negative practice
e) improved breath support via postural stability
1x weekly one-on-one sessions with a speech pathologist for up to 60 minutes per session
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Intervention code [1]
258060
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Rehabilitation
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Comparator / control treatment
Patients may be required to wait for services, in which case they will be allocated to a waitlist for 6 weeks. These patients will act as the control group, as they will be reevaluated to see if spontaneous recover has occurred prior to being allocated to one of the two 'active treatment' arm (Expiratory Muscle Strength Training OR Traditional Voice Therapy/Usual Care)
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Control group
Active
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Outcomes
Primary outcome [1]
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Determine which therapy is more efficacious in treating dysphonia secondary to unilateral vocal fold palsy using:
1) Videostroboscopy - measuring (a) degree of cord movement; (b) mucosal wave; (c) electroglottography
2) Consensus Auditory Perception of Voice (CAPE-V)
3) Voice Handicap Index (VHI)
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Assessment method [1]
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Timepoint [1]
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Baseline (pre treatment) and post therapy (after 6 weeks treatment)
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Secondary outcome [1]
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determine whether participants who are waitlisted for therapy experience spontaneous recovery from unilateral vocal fold palsy using
1) Videostroboscopy - measuring
(a) degree of cord movement;
(b) mucosal wave;
(c) electroglottography
2) Consensus Auditory Perception of Voice (CAPE-V)
3) Voice Handicap Index (VHI)
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Assessment method [1]
273236
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Timepoint [1]
273236
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Baseline and after 6 weeks on waitlist
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Eligibility
Key inclusion criteria
1. dysphonia
2. willing to participate in the study and return for follow up
3. able to understand and follow instructions
4. able to tolerate nasopharyngeal endoscopic examination
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Minimum age
18
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. currently undergoing radiation therapy
2. untreated hypertension
3. diagnosis of respiratory imapirment (COPD/COAD/Emphysema)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
patients referred to Voice Clinic who meet inclusion criteria will be invited to participate. Once consented, they will be allocated to either (a) intervention (b) waitlisted. If they are allocated to the intervention group, they will be randomized to one of the two treatment arms. If they are waitlisted, they will be reviewed in six weeks to determine if their dysphonia has resolved. If they continue to demonstrate vocal fold palsy they will move to (a) and be randomized to one of the two interventions.
Randomization will occur using a computer program 'Sealed Envelope Limited' which wil allocate patients to one of the two active treatment arms.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
permuted block randomization using computer program 'Sealed Envelope Limited'
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/07/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Sir Charles Gairdner Hospital
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Address [1]
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Hospital Avenue
Nedlands Western Australia 6009
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Sir Charles Gairdner Hospital
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Address
Hospital Avenue
Nedlands Western Australia 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
257661
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Address [1]
257661
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Country [1]
257661
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260492
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Sir Charles Gairdner Hospital Human Research Ethics committee
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Ethics committee address [1]
260492
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Hospital Avenue Nedlands Western Australia 6009
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Ethics committee country [1]
260492
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Australia
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Date submitted for ethics approval [1]
260492
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22/02/2011
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Approval date [1]
260492
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Ethics approval number [1]
260492
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2011-024
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Summary
Brief summary
1. Patients with a unilateral vocal fold palsy (UVFP) who are randomized to undertake Expiratory Muscle Strength Training (EMST) will demonstrate greater improvement in measures of voice quality and airway protection over a six-week period than patients who are randomized to undertake ‘Usual’ voice therapy. 2. Both the EMST and Usual groups will show improvement in their measures of voice quality compared to patients who elect not to undertake therapy. 3. Patients who undergo EMST and Usual therapy will maintain improvements to their vocal quality when followed up one month post completion of treatment. 4. Patients with UVFP in the EMST group will show greater adherence to treatment techniques than patients in the Usual group.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Claire Langdon
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Address
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Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands Western Australia 6009
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Country
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Australia
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Phone
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61 8 9346 2044
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Claire Langdon
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Address
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Sir Charles Gairdner Hospital
Hospital Avenue
Nedlands Western Australia 6009
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Country
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Australia
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Phone
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61 8 9346 2044
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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