The Impact of Different Rehabilitation Training Modes on VHI Scores and MPT in Patients with Post- Stroke Dysphonia: A Case Study of Visual Glottal Closure Training

Abstract

Objective: To systematically evaluate the effects of visual glottal closure training guided by swallowing electronic laryngoscopy and conventional voice training on the Voice Handicap Index (VHI) scores and Maximum Phonation Time (MPT) in patients with post-stroke dysphonia (PSD), providing evidence-based support for precise rehabilitation in such patients. Methods: A randomized controlled trial design was employed, selecting patients with post-stroke dysphonia who met the inclusion criteria as the study subjects. Patients were randomly divided into an experimental group (receiving visual glottal closure training) and a control group (receiving conventional voice training), with 32 cases in each group. Both groups underwent training for 8 weeks, twice a week, with each session lasting 30 minutes. The VHI scale was used to assess the subjective degree of voice impairment, and MPT was measured to evaluate vocal efficiency at four time points: baseline (T0), mid-treatment (T1, 4 weeks), end of treatment (T2, 8 weeks), and follow-up 3 months after treatment (T3). Statistical analysis was performed on the data. Results: A total of 64 patients were included, with 58 completing the study (29 in the experimental group and 29 in the control group), resulting in a dropout rate of 9.38%. There were no statistically significant differences in VHI scores and MPT between the two groups at baseline (T0) (P > 0.05). During the mid-treatment phase (T1), at the end of treatment (T2), and during the follow-up period (T3), the Voice Handicap Index (VHI) scores of patients in both groups significantly decreased compared to the baseline period (P < 0.05), and the Maximum Phonation Time (MPT) significantly increased compared to the baseline period (P < 0.05). Moreover, the VHI scores of the experimental group at each time point (T1: 42.35 points vs. 56.82 points, T2: 28.16 points vs. 45.73 points, T3: 25.48 points vs. 41.95 points) were significantly lower than those of the control group (P < 0.05), and the MPT (T1: 12.68s vs. 9.35s, T2: 16.82s vs. 11.57s, T3: 15.96s vs. 10.83s) was significantly longer than that of the control group (P < 0.05). Conclusion: Both visual glottal closure training guided by swallowing electronic laryngoscopy and conventional voice training can improve the subjective voice impairment and vocal efficiency of patients with post-stroke dysphonia. However, visual glottal closure training demonstrates superior efficacy and sustained therapeutic effects, making it a preferred rehabilitation option for patients with post-stroke dysphonia.