The efficacy of voice therapy for pediatric voice-disordered population : a systematic review

Abstract

This systematic review evaluated the efficacy of voice therapy in improving the voice quality of pediatric population with dysphonia secondary to phonotrauma, compared to no intervention. It also compared the relative effectiveness of both direct and indirect voice therapy in improving the voice quality for this population. This systematic review primarily followed the Cochrane Handbook for Systematic Review of Interventions framework and the PRISMA 2009 Checklist. Two reviewers independently searched 31 electronic databases from December 2018 to January 2019, selected analytic studies and grey literature meeting the eligibility criteria, and appraised included studies using an appraisal tool adapted from Critical Appraisal of Treatment Evidence (CATE) and Scottish Intercollegiate Guidelines Network (SIGN). Seven studies were included in a qualitative synthesis. Results cannot conclude on whether voice therapy could outweigh spontaneous recovery, or the optimal therapy approach. Confidence in results was reduced due to presence of various types and magnitude of biases. Meta-analysis could not be conducted due to insufficient number of studies at low risks of bias addressing the same outcomes. To conclude, the current evidence was insufficient to answer the two review questions, and had low internal and external validity. More high quality randomized controlled trials are warranted.