Reducing Vocal Fatigue while Preserving Realism during Video Game Voice Overs using the Vocal Combat Technique: A Randomized Controlled Trial

Vocal Combat Technique (VCT) teaches indirect and direct behavioral voice techniques to voice over artists performing for violent videogames. Although previous work on VCT has shown promise for mitigating dysphonia symptoms, a randomized clinical trial has yet to be undertaken. Therefore, we completed a randomized, controlled trial between a group of experienced video game voice over actors receiving VCT and a control group comparison. A total of 24 video game voice over actors completed this study. Participants were randomly assigned to receive VCT or indirect vocal hygiene training prior to completing an intensive 1-hour video game voice recording session. The primary outcome was change in Voice Handicap Index-10 (VHI-10) pre/post-performance. Secondary measures included a modified version of the Evaluation of the Ability to Sing Easily (m-EASE), the Vocal Tract Discomfort Scale (VTDS), and questions regarding return to work. Participants were also rated on the realism of their vocal performance by a blinded video game director. The VCT group showed a significantly smaller change in VHI-10 and m-EASE scores post-performance, and a higher increased likelihood to return to work when compared to the control group. There were no group differences for VTDS or realism ratings. Four participants from the control group exhibited outlier behavior with more pronounced phonotraumatic symptoms following performance than all other participants. VCT shows evidence of mitigating symptoms of dysphonia while preserving the realism of vocal performance. More work is needed to understand performers at risk for more severe vocal symptoms following extreme voice over work so as to target them for preventative techniques and voice preservation.