Episode 66: PhoRTE voice therapy: Revving up the aging voice with Edie Hapner, PhD, CCC-SLP, Aaron Ziegler, PhD, CCC-SLP
Age-related voice changes (presbyphonia) are characterized by decreased loudness, increased hoarseness, and greater vocal effort. Patients with presbyphonia demonstrate different pathogenic profiles of laryngeal and respiratory deficits. Such deficits are thought to arise from negative changes to muscle structure and muscle strength or function in addition to the aging process. Phonation Resistance Training Exercises (PhoRTE) is a Level 1B voice therapy to treat presbyphonia (that is, published prospective, randomized, and controlled clinical trial). PhoRTE voice therapy is guided by principles of exercise physiology and requires patients to produce progressively higher vocal intensities during vocal tasks. By progressively overloading the phonatory system in PhoRTE, patients regain their vocal power with less vocal effort. Importantly, PhoRTE voice therapy places a strong emphasis on understanding the values of successful aging to promote communication, socialization, and vocation in our older adult population.
topics covered:
The origin of PhoRTE & developments in PhoRTE since establishing the protocol
Physiological changes to the vocal mechanism evident in presbyphonia.
Overview of techniques to manage the aging voice (presbyphonia)
Medical management of presbyphonia
Behavioral management of presbyphonia
Conceptual underpinnings of PhoRTE voice therapy
Design & Structure of PhoRTE
Resources mentioned in the episode:
Ziegler, A., Verdolini Abbott, K., Johns, M., Klein, A. and Hapner, E.R. (2014), Preliminary data on two voice therapy interventions in the treatment of presbyphonia. The Laryngoscope, 124: 1869-1876. doi:10.1002/lary.24548
PhoRTE website for more information about training workshops
Thanks to Dr.s Hapner & Ziegler for providing the links to this research! Mahalo!
*hitting a paywall? Can’t access the research? Try Google Scholar.
Edie Hapner is a Professor in the Department of Otolaryngology at the University of Alabama, Birmingham, Co-Director of the UAB Voice Center, and Director of Speech and Hearing. Dr Hapner has championed inter-professional care in the treatment of voice disorders through her develop of three marquee inter-professional voice care programs, the Emory Voice Center at Emory University in Atlanta,
GA 2003-2015, and the University of Southern California’s USC Voice Center in Los Angeles, CA, 2016-2020 and now the UAB Voice Center, March, 2020. Dr Hapner has served on the ASHA Board of Directors, was Coordinator for the ASHA Voice Special Interest Group, the AAOHNS Guidelines Committee for the Treatment of Dysphonia, the AAOHNS Voice Committee 2018-2020, Convention Chair for the ASHA 2020 convention, and serves on the voice committee for the International Association of Logopedics and Phoniatrics. She has published with over 50 peer reviewed papers, multiple invited chapters, is co-editor of Voice and Voice Disorders, Clinical Case Studies edition 4 and 5, and has developed a video teaching tool for Flexible Endoscopic Evaluation of Swallowing. She developed an online voice curriculum for Medbridge Inc to train speech language pathologist to treat a variety of voice disorders through inviting noted experts in the field to develop coordinated training modules. Her research and clinical passion is in aging voice and she has co-developed an evidence based voice therapy tool (PhoRTE), to treat voice problems associated with presbyphonia. Dr Hapner received three prestigious fellowships in 2018- Distinguished Fellow in the National Academy of Practice, Associate Fellow in the American Laryngological Association and Fellow of the American Speech Language and Hearing Association.
Aaron Ziegler, Ph.D., CCC-SLP is Director of The Wellness Group for Voice, Speech, and Swallowing. Dr. Ziegler obtained his Ph.D. in Communication Science and Disorders at the University of Pittsburgh with Dr. Verdolini Abbott and earned a Master’s degree in Speech-Language Pathology at Northwestern University. He received a certificate in Vocology from the National Center for Voice & Speech under the direction of Dr. Ingo Titze. Dr. Ziegler most recently worked at the NW Center for Voice & Swallowing at OHSU where he also completed a postdoctoral fellowship. He worked at the Emory Voice Center, where he completed his clinical fellowship, and the University of Pittsburgh Voice Center. His clinical interests include vocal aging, gender expansive voice and communication, and vocal injury prevention and treatment. He has published research, funded in part by grants through the National Institutes of Health, on models of voice therapy and prevention, including the co-development of Phonation Resistance Training Exercises (PhoRTE) to treat age-related voice changes. He was Associate Editor of Vocal Health and Science for the Voice and Speech Review from the Voice and Speech Trainers Association (VASTA), and he reviews for a variety of journals. He was a member of the voice topic committee for ASHA’s 2018 Convention. He is a regular speaker throughout the U.S. as well as internationally.
SUBSCRIBE & REVIEW
You’ll earn my undying gratitude by leaving a review on Apple Podcasts! Reviews help other SLPs find the podcast. Also, I love reading your feedback! Open Apple Podcasts, or click here to review, select “Ratings and Reviews” and “Write a Review,” and let me know what your favorite part of the podcast is. Malaho plenty!