Low-frequency TENS with vocal exercises may improve vocal quality in women with vocal nodules
Photo by Edz Norton / Unsplash
Key Takeaway
Consider low-frequency TENS with vocal exercises for vocal nodules in women, noting preliminary data and small sample size.
This preliminary randomized clinical trial evaluated low-frequency TENS combined with vocal exercises in 12 women with vocal nodules. The intervention used a frequency at 10 Hz, a 200 µs duration phase, motor threshold, and electrodes placed on the thyroid cartilage lamina bilaterally. The comparator was placebo TENS simultaneously to the execution of vocal exercises. Follow-up occurred immediately after voice therapy.
Secondary outcomes included vocal quality, vocal economy, and vocal self-assessment. The study reported a reduction in ABI, an increase in CPPs, an increase in L1-L0, an increase in the physical V-RQOL domain, and an increase in the total V-RQOL domain. Absolute numbers and p-values were not reported for these specific outcomes.
No adverse events, serious adverse events, discontinuations, or tolerability issues were reported. However, the study is limited by its preliminary data and small sample size. The evidence is insufficient to determine long-term safety or efficacy beyond the immediate post-therapy period.
View Original Abstract ↓
PURPOSE: To verify the effectiveness of low-frequency transcutaneous electrical nerve stimulation (TENS) simultaneously applied to the performance of vocal exercises in women with behavioral dysphonia.
METHODS: This is a randomized, blinded clinical trial (Register Number: RBR-5k95vs). Twelve adult women with vocal nodules, randomly divided into three groups (G1: 4 participants - 12 sessions - application of placebo TENS simultaneously to the execution of vocal exercises; G2: 5 participants - 12 sessions - application of low-frequency TENS (frequency at 10 Hz, 200 μs duration phase, motor threshold, with electrodes placed on the thyroid cartilage lamina, bilaterally); and G3: 3 participants - 12 sessions - application of low-frequency TENS (same condition as G2) simultaneously to the execution of vocal exercises), participated in this study. The therapies were performed for 30 minutes in each session, twice a week. The participants were evaluated regarding vocal quality through acoustic voice analysis (fundamental frequency, Cesptral Peak Prominence-Smoothed (CPPs), alpha ratio, L1-L0, Acoustic Breathiness Index (ABI), and Acoustic Vocal Quality Index (AVQI)), vocal economy through electroglottography, and vocal self-assessment using the Voice-Related Quality of Life (V-RQOL) protocol. Assessments were performed before and immediately after voice therapy. Data were analyzed using the two-way repeated-measures ANOVA (variance analysis) test to compare assessment times and intervention groups.
RESULTS: It was observed that G2 presented a reduction in the ABI acoustic parameter after the intervention and an increase in the values of the CPPs and L1-L0 parameter and in the scores of the physical and total V-RQOL domains. There were no differences for the other outcomes in relation to time and group.
CONCLUSION: Preliminary results indicate that low-frequency TENS applied alone can reduce ABI parameter values and improve voice-related quality of life in dysphonic women.
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