scholarly journals Combining voice therapy and physical therapy: A novel approach to treating muscle tension dysphonia

2015 ◽  
Vol 58 ◽  
pp. 169-178 ◽  
Author(s):  
Jennifer Craig ◽  
Carey Tomlinson ◽  
Kristin Stevens ◽  
Kiran Kotagal ◽  
Judith Fornadley ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia ◽  
Novel Approach

Physical Therapy for Muscle Tension Dysphonia with Cervicalgia

2021 ◽  
pp. 014556132110632
Author(s):  
Alan D Tate ◽  
Carey A Tomlinson ◽  
David Oliver Francis ◽  
Emily D Wishik ◽  
Anne S Lowery ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Confidence Interval ◽  
Tertiary Care ◽  
Muscle Tension ◽  
Standard Of Care ◽  
Voice Therapy ◽  
Anterior Neck ◽  
Myofascial Release ◽  
Muscle Tension Dysphonia ◽  
Full Body

Objectives This study investigated the effectiveness of a specialized manual physical therapy (PT) program at improving voice among patients diagnosed with concomitant muscle tension dysphonia (MTD) and cervicalgia at a tertiary care voice center. Materials and Methods Cervicalgia was determined by palpation of the anterior neck. Both voice therapy (VT) and PT was recommended for all patients diagnosed with MTD and cervicalgia. PT included full-body manual physical therapy with myofascial release. Patients underwent: 1) VT alone, 2) concurrent PT and VT (PT with VT), 3) PT alone, 4) VT, but did not have PT ordered by treating clinician (VT without PT order) or 5) VT followed by PT (VT then PT). The pairwise difference in post–Voice Handicap Index-10 (VHI-10) controlling for baseline variables was calculated with a linear regression model. Results 178 patients met criteria. All groups showed improvement with treatment. The covariate-adjusted differences in mean post–VHI-10 improvement comparing the VT alone group as a reference were as follows: PT with VT 9.95 (95% confidence interval 7.70, 12.20); PT alone 8.31 (6.16, 10.45); VT without PT order 8.51 (5.55, 11.47); VT then PT 5.47 (2.51, 8.42). Conclusion Among patients diagnosed with MTD with cervicalgia, treatment with a specialized PT program was associated with improvement in VHI-10 scores regardless of whether they had VT. While VT is the standard of care for MTD, PT may also offer benefit for MTD patients with cervicalgia.

scholarly journals Intractable Muscle Tension Dysphonia Treated by Injection Laryngoplasty and Lidocaine Injection

2021 ◽  
Vol 32 (2) ◽  
pp. 94-97
Author(s):  
You Young An ◽  
Jun Yeong Jeong ◽  
Ki Nam Park ◽  
Seung Won Lee
Keyword(s):  
Gold Standard ◽  
Muscle Tension ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Voice Therapy ◽  
Voice Disorder ◽  
Injection Laryngoplasty ◽  
Muscle Tension Dysphonia ◽  
Lidocaine Injection ◽  
Botox Injection

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

Presbylarynx, Functional Voice Disorders, Muscle Tension Dysphonia

2021 ◽  
Author(s):  
Elizabeth Erickson-DiRenzo ◽  
Christine M. Kim ◽  
C. Kwang Sung Sung
Keyword(s):  
Muscle Tension ◽  
Voice Disorders ◽  
Neuromuscular Control ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Type I ◽  
Muscle Tension Dysphonia ◽  
Functional Dysphonia ◽  
Age Related ◽  
Type I Thyroplasty

Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood. This review contains 5 figures, 7 tables, 4 videos and 10 references Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto  

Comparative Evaluation and Management of Dysphonia Between Adults <65 and ≥65 Years of Age

2020 ◽  
pp. 019459982097843
Author(s):  
Amy Jacks ◽  
Hannah Kavookjian ◽  
Shannon Kraft
Keyword(s):  
Vocal Cord ◽  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Muscle Tension ◽  
Voice Handicap Index ◽  
Voice Therapy ◽  
Old Patients ◽  
Presenting Symptoms ◽  
Muscle Tension Dysphonia ◽  
Significant Relationships

Objective To compare presenting symptoms, etiology, and treatment outcomes among dysphonic adults <65 and ≥65 years of age. Study Design Retrospective cohort study. Setting Tertiary care voice center between January 2011 and June 2016. Methods A total of 755 patients presenting for dysphonia were included in the study: 513 adults <65 years of age and 242 adults ≥65. Data collected included demographics, referral information, prior diagnoses, prior treatments, clinical examination findings, diagnosis, coexisting symptoms, treatments, and pre- and postintervention Voice Handicap Index scores. Statistical analysis was performed with SPSS to determine significant relationships between variables of interest. Results The most common etiologies of dysphonia were vocal cord atrophy (44.8%) in the ≥65 cohort and benign vocal cord lesions (17.8%) in the <65 cohort. When compared with adults <65 years old, patients ≥65 had a higher incidence of neurologic dysphonia ( P = .006) and vocal cord atrophy ( P < .001) but were less likely to have laryngopharyngeal reflux ( P = .001), benign vocal cord lesions ( P < .001), or muscle tension dysphonia ( P < .001). Overall, 139 patients had surgery, 251 received medical therapy, and 156 underwent voice therapy. The ≥65 cohort demonstrated improvement in Voice Handicap Index scores after surgery ( P = .001) and voice therapy ( P = .034), as did the <65 cohort (surgery, P < .001; voice therapy, P = .015). Adult surgical patients <65 reported greater improvements than patients ≥65 ( P = .021). Conclusions There are notable differences in the pathophysiology of dysphonia between patients aged ≥65 and <65 years. Although adults <65 reported slightly better outcomes with surgery, patients ≥65 obtained significant benefit from surgery and voice therapy.

scholarly journals Voice Therapy for Muscle Tension Dysphonia (MTD)

2013 ◽  
Vol 54 (1) ◽  
pp. 40-44
Author(s):  
Yukiko Yanagi ◽  
Daigo Komazawa ◽  
Michiko Kanno ◽  
Michi Aikawa ◽  
Chiho Ozaki ◽  
...  
Keyword(s):  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia

A randomized controlled trial of stretch-and-flow voice therapy for muscle tension Dysphonia

2015 ◽  
Vol 125 (6) ◽  
pp. 1420-1425 ◽  
Author(s):  
Christopher R. Watts ◽  
Amy Hamilton ◽  
Laura Toles ◽  
Lesley Childs ◽  
Ted Mau
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia ◽  
Randomized Controlled

scholarly journals Manual Therapy and Exercise to Improve Outcomes in Patients With Muscle Tension Dysphonia: A Case Series

2015 ◽  
Vol 95 (1) ◽  
pp. 117-128 ◽  
Author(s):  
Carey A. Tomlinson ◽  
Kristin R. Archer
Keyword(s):  
Physical Therapy ◽  
Manual Therapy ◽  
Rating Scale ◽  
Muscle Tension ◽  
Case Series ◽  
Vocal Folds ◽  
Patient Specific ◽  
Meaningful Improvement ◽  
Muscle Tension Dysphonia ◽  
Patient Reported

Background and Purpose Muscle tension dysphonia (MTD), a common voice disorder that is not commonly referred for physical therapy intervention, is characterized by excessive muscle recruitment, resulting in incorrect vibratory patterns of vocal folds and an alteration in voice production. This case series was conducted to determine whether physical therapy including manual therapy, exercise, and stress management education would be beneficial to this population by reducing excess muscle tension. Case Description Nine patients with MTD completed a minimum of 9 sessions of the intervention. Patient-reported outcomes of pain, function, and quality of life were assessed at baseline and the conclusion of treatment. The outcome measures were the numeric rating scale (NRS), Patient-Specific Functional Scale (PSFS), and Voice Handicap Index (VHI). Cervical and jaw range of motion also were assessed at baseline and postintervention using standard goniometric measurements. Outcomes Eight of the patients had no pain after treatment. All 9 of the patients demonstrated an improvement in PSFS score, with 7 patients exceeding a clinically meaningful improvement at the conclusion of the intervention. Three of the patients also had a clinically meaningful change in VHI scores. All 9 of the patients demonstrated improvement in cervical flexion and lateral flexion and jaw opening, whereas 8 patients improved in cervical extension and rotation postintervention. Discussion The findings suggest that physical therapists can feasibly implement an intervention to improve outcomes in patients with MTD. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the intervention. A clinical implication is the expansion of physical therapy to include referrals from voice centers for the treatment of MTD.

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