Respiratory Muscle Strength Training in Presbyphonia

Presbyphonia is an age-related voice disorder that affects more than 10 million people in the
United States. Presbyphonia is characterized by vocal fold atrophy that impairs older
individuals' ability to communicate, leading to social isolation and reduced quality of life.
Outcomes from current treatment approaches are often suboptimal for patients with
presbyphonia as they do not sufficiently challenge the respiratory system to induce
meaningful change. It is highly likely that the addition of respiratory training would result
in greatly improved outcomes, such as the ability to speak loud and long enough to have a
normal conversation. The purpose of this study will be to examine the effect of adding
inspiratory muscle strength training (IMST) or expiratory muscle strength training (EMST) to
standard of care voice therapy on respiratory and voice outcomes in patients with an
age-related voice disorder.

Forty-eight participants diagnosed with presbyphonia will be blocked-randomized into three
intervention groups, using a 3-parallel arm design: IMST and voice exercises, EMST and voice
exercises, and voice exercises during all session. Study endpoints will be the change in
voice and respiratory measures after four treatment sessions compared to baseline values.
Response to treatment will be analyzed to determine if there are subgroups of high- or
low-responders based on baseline voice and respiratory characteristics.