Vocal Function Exercises With and Without Maximally Sustained Phonation: A Randomized Controlled Trial of Individuals With Normal Voice.

Only 23 participants completed the study, and the authors note the unknown effect size of maximally sustained phonation complicated the sample size calculation. All participants had normal voice, so the findings cannot be applied to patients with voice disorders. Compliance with home practice was self-reported via practice logs and could not be verified by the investigator. Research assistants who conducted weekly maintenance sessions were well-trained but lacked experience in delivering Vocal Function Exercises. The study lasted only six weeks, so it is unknown whether the midpoint and baseline groups would eventually catch up to the traditional group. Only three variations of the sustained phonation requirement were tested.

The first four authors declared no conflicts of interest. The last author receives textbook and educational product royalties from Plural Publishing and Medbridge.

Do not read this as proof that you can skip sustained phonation entirely in Vocal Function Exercises. The baseline group, which was capped at their starting level, did not improve significantly. The finding is that the degree of the requirement can be modified, not that it can be removed. And every participant had normal voice, so this says nothing about a patient with a voice disorder.