Description:
<jats:sec><jats:title>Background:</jats:title><jats:p> Hypophonia is a prevailing problem in people with multiple sclerosis (PwMS). However, evidence supporting the effectiveness of voice rehabilitation is lacking. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> The aim of this study was to identify the most effective method to reduce hypophonia. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> In this randomized controlled trial, 44 PwMS were randomized to intensive and high-effort voice treatment groups, the LSVT-LOUD<jats:sup>®</jats:sup>, and conventional treatment group. Subjects received 16 treatments (4 sessions/week) lasting 45 minutes. The primary outcome was voice intensity (dB) in monologue, vocalization, and sentences while voice handicap index (VHI) measured voice self-perception. Outcomes were assessed by a blinded observer at baseline, post-treatment, and 15-month follow-up (FU). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Linear models revealed a significant post-intervention between-group mean difference in favor of LSVT-LOUD for monologue: +6.3 dB (95% CI: 2.5 to 10.1); vocalization: +7.4 dB (95% CI: 2.3 to 12.5); and sentences: +9.5 dB (95% CI: 4.7 to 14.3). However, 43.7% PwMS in the LSVT-LOUD and 10% in the conventional treatment group obtained a full recovery of voice intensity (>60 dB) post-treatment, Fisher’s test = 13.3, p < 0.01. However, these improvements were not maintained at FU. Between-group differences at VHI were −10.8 (95% CI: −21.2 to −0.4) and −11.3 (95% CI: −24.3 to −1.7) in favor of LSVT-LOUD at post and FU. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> LSVT-LOUD can be a valid treatment to increase voice intensity in PwMS. However, results suggest the need for FU interventions targeting maintenance. </jats:p></jats:sec>