Rehabilitation for Sensory disorders of the larynx: clinical trial

INTERVENTION: 40 participants will be allocated by simple randomization into two groups: Experimental Group (EG) ‐ made up of 20 individuals who will perform Vocal Therapy for Chronic Cough; and Control Group (CG) ‐ made up of 20 individuals who will perform the Integral Vocal Rehabilitation Program (PIRV). For this purpose, numbered sheets will be printed in ascending order, which will then be arranged in individual opaque white envelopes. The first half of the numbers will be allocated in the GE and the second half in the GC. In the first intervention session the individual will draw an envelope, which will contain the number that will designate the group he will be part of. Participants will be blinded to the existence of two intervention groups. In both groups, participants will hold four intervention sessions, 30 minutes each, once a week. The GE will perform the vocal therapy for chronic cough. The therapy program involves three components: cough counseling and laryngeal well‐being; cough suppression, control and replacement; respiratory and laryngeal control. The program consists of guidance, suppression techniques and exercises for chronic cough. The GC will hold the PIRV (BEHLAU et al., 2013). The PIRV methodology was developed based on clinical experience to treat behavioral vocal disorders. The program has an eclectic approach and combines body work, glottal source, resonance and pneumophonic coordination, combined with knowledge of vocal hygiene and communicative attitude. The researcher responsible for rehabilitation will be blinded as to the evaluation of outcome variables. Both groups will hold 4 sessions of 30 minutes, with weekly frequency. Behavior Therapy Behavioural CONDITION: Cough Refractory chronic cough ; Cough PRIMARY OUTCOME: Outcomes will be analyzed before; and after 4 therapy session:; 1) Self‐perception of laryngeal sensations ‐ For this purpose, the Newcastle Laryngeal Hypersensitivity Questionnaire ‐ QNHS‐Br, will be used before and after four sessions of individual vocal therapy. The QNHS‐Br is a 14‐question scale that analyzes the self‐perception of laryngeal sensitivity. Participants will be instructed to rate the frequency of occurrence of each sensitivity symptom on a likert scale from one (always) to seven (never) (RIBEIRO et al., 2019).; SECONDARY OUTCOME: Outcomes will be analyzed before ; and after 4 therapy session: ; 1) Self‐perception of vocal symptoms ‐ For this will be used the Voice Symptom Scale ‐ VoiSS, applied before and after four sessions of individual vocal therapy. The VoiSS is a 30‐question scale that analyzes the total, limitation, emotional and physical domains. Participants will be instructed to rate the frequency of occurrence of each symptom on a likert scale from zero (never) to four (always) (MORETI et al., 2014). INCLUSION CRITERIA: Brazilians; age over 18 years; both sexes; persistent cough for more than 8 weeks (CARROLL, 2019); refractory to treatment (CARROLL, 2019); presence of complaints related to laryngeal dysfunction syndromes (VERTIGAN; BONE; GIBSON, 2014); who adhere to the Informed Consent Form.