Manual Therapy with Neural Mobilization: Immediate Effect on the Vocal Quality of Women with Dysphonia

Author(s):  
Vinícius Marinho de Brito ◽  
Hugo Pasin Neto ◽  
Ana Cristina Côrtes Gama
Keyword(s):  
PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248484
Author(s):  
Ena Bula-Oyola ◽  
Juan-Manuel Belda-Lois ◽  
Rosa Porcar-Seder ◽  
Álvaro Page

Introduction People with ulnar, radial or median nerve injuries can present significant impairment of their sensory and motor functions. The prescribed treatment for these conditions often includes electrophysical therapies, whose effectiveness in improving symptoms and function is a source of debate. Therefore, this systematic review aims to provide an integrative overview of the efficacy of these modalities in sensorimotor rehabilitation compared to placebo, manual therapy, or between them. Methods We conducted a systematic review according to PRISMA guidelines. We perform a literature review in the following databases: Biomed Central, Ebscohost, Lilacs, Ovid, PEDro, Sage, Scopus, Science Direct, Semantic Scholar, Taylor & Francis, and Web of Science, for the period 1980–2020. We include studies that discussed the sensorimotor rehabilitation of people with non-degenerative ulnar, radial, or median nerve injury. We assessed the quality of the included studies using the Risk of Bias Tool described in the Cochrane Handbook of Systematic Reviews of Interventions and the risk of bias across studies with the GRADE approach described in the GRADE Handbook. Results Thirty-eight studies were included in the systematic review and 34 in the meta-analysis. The overall quality of evidence was rated as low or very low according to GRADE criteria. Low-level laser therapy and ultrasound showed favourable results in improving symptom severity and functional status compared to manual therapy. In addition, the low level laser showed improvements in pinch strength compared to placebo and pain (VAS) compared to manual therapy. Splints showed superior results to electrophysical modalities. The clinical significance of the results was assessed by effect size estimation and comparison with the minimum clinically important difference (MCID). Conclusions We found favourable results in pain relief, improvement of symptoms, functional status, and neurophysiological parameters for some electrophysical modalities, mainly when applied with a splint. Our results coincide with those obtained in some meta-analyses. However, none of these can be considered clinically significant. Trial registration PROSPERO registration number CRD42020168792; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168792.


2017 ◽  
Vol 10 (1) ◽  
pp. 54-63
Author(s):  
Denis Vladimirovich Ilchenko ◽  
Andrey Aslanovich Kardanov ◽  
Aleksandr Sergeevich Karandin ◽  
Andrey Vadimovich Korolev

Background The issue of rehabilitation after surgical treatment of the foot deformities is not sufficiently covered in the contemporary literature. In spite of diversity of certain approaches used in the rehabilitation process, there is no consistency in their application. In addition, there is no consensus on the effectiveness of various techniques, on the quantity and quality of the procedures and the timing of their introduction in the rehabilitation process. The objective of this article is to analyze the effectiveness of the techniques used in the rehabilitation of patients after surgical treatment of the foot deformities. Methods The article describes methods that are, in our opinion, the most effective and well-established in the post-operative recovery of patients. The  principles of complex usage of conservative treatment methods, including lymph drainage massage, manual therapy and therapeutic physical training, are covered. Results The introduction of the protocols we have developed in the rehabilitation of patients after surgical treatment of the foot deformities helped to organize the recovery process, to clarify the timing of rehabilitation measures, to improve the final result of treatment. Conclusions The use of pathogenetically justified methods of rehabilitation, which include massage, manual therapy and therapeutic physical training, promotes the most rapid and complete recovery of motor functions in patients after surgical treatment of the foot deformities.  


1976 ◽  
Vol 85 (4) ◽  
pp. 451-459 ◽  
Author(s):  
Herbert H. Dedo

Spastic dysphonia is a severe vocal disability in which a person speaks with excessively adducted vocal cords. The resulting weak phonation sounds tight, as if he were being strangled, and has also been described as laryngeal stutter. It is often accompanied by face and neck grimaces. In the past it has been regarded as psychoneurotic in origin and treated with speech therapy and psychotherapy with disappointing results. Because of laboratory and clinical observation that recurrent nerve paralysis retracts the involved vocal cord from the midline, it was proposed that deliberate section of the recurrent nerve would improve the vocal quality of patients with spastic dysphonia. In 34 patients the recurrent nerve was sectioned after Xylocaine® temporary paralysis showed significant improvement in vocal quality. Several patients have been advised against this operation because of the type of voice they developed with one vocal cord temporarily paralyzed. With nerve section plus postoperative speech therapy, approximately half of the patients have returned close to a “normal” but soft phonatory voice. The rest had varying degrees of improvement, but all, so far, have been pleased with the improvement in ease and quality of phonation and reduction or elimination of face and neck grimaces. Two men have a breathy component in their phonatory voices, and one woman has variable pitch.


2021 ◽  
Vol 11 (15) ◽  
pp. 6856
Author(s):  
Aida Herranz-Gómez ◽  
Irene García-Pascual ◽  
Pablo Montero-Iniesta ◽  
Roy La Touche ◽  
Alba Paris-Alemany

The aim of the study was to perform a mapping and umbrella review with meta-meta-analysis (MMA) to synthesise and critically evaluate the effectiveness of manual therapy (MT) and aerobic exercise (AE) in relation to pain intensity, frequency, disability and quality of life in patients with migraines, tension-type headaches (TTH) and cervicogenic headaches (CGH). A systematic search was conducted in PubMed, PEDro, Scielo and Google Scholar up to December 2020. A total of 18 articles met the inclusion criteria, and only 8 were included in the quantitative analysis. The MMA showed results in favour of the interventions in terms of pain intensity and quality of life in migraine, TTH and CCH. Data were also in favour of the intervention in terms of pain frequency in migraine and in terms of disability in TTH. However, there were no significant effects on pain frequency in TTH and CGH. The results showed moderate evidence to suggest that AE reduces pain intensity in patients with migraine. In addition, the evidence in favour of MT or a mixed intervention (including therapeutic exercise) was also moderate in terms of reducing pain intensity in patients with TTH.


2000 ◽  
Vol 43 (3) ◽  
pp. 796-809 ◽  
Author(s):  
Floris L. Wuyts ◽  
Marc S. De Bodt ◽  
Geert Molenberghs ◽  
Marc Remacle ◽  
Louis Heylen ◽  
...  

The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F 0 -High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI=0.13 x MPT + 0.0053 x F 0 -High – 0.26 x I-Low – 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices –5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.


2016 ◽  
Vol 96 (1) ◽  
pp. 9-25 ◽  
Author(s):  
Susan Armijo-Olivo ◽  
Laurent Pitance ◽  
Vandana Singh ◽  
Francisco Neto ◽  
Norman Thie ◽  
...  

Background Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. Purpose The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. Data Sources Electronic data searches of 6 databases were performed, in addition to a manual search. Study Selection Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. Data Extraction Data were extracted in duplicate on specific study characteristics. Data Synthesis The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. Limitations Quality of the evidence and heterogeneity of the studies were limitations of the study. Conclusions No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Raymond Li ◽  
Ann Jose ◽  
Jessica Poon ◽  
Cindy Zou ◽  
Maria Istafanos ◽  
...  

Abstract Context Parkinson’s disease (PD) is a neurodegenerative disease that leads to impaired motor and non-motor function in patients. PD is non-curative and gradually reduces quality of life, leading patients to seek treatment for symptom management. Osteopathic manipulative treatment (OMT) applies the biomechanical, neurologic, circulatory, metabolic, and psychosocial models in approaching and treating the major symptomatology of PD patients. Objectives This article evaluates the literature published in the past 10 years analyzing evidence on OMT and its functional application on gait, balance, motor function, bradykinesia, and autonomic dysfunctions, and to identify promising avenues for further investigation. Methods The authors obtained studies from the research databases MEDLINE/PubMed, ScienceDaily, and EBSCO, as well as the Journal of American Osteopathic Association’s published archives. Searches were conducted in December 2020 utilizing the search phrases “OMM” (osteopathic manipulative medicine), “OMT,” “osteopathic,” “Parkinson Disease,” “manual therapy,” “physical therapy,” “training,” “autonomics,” “gait,” and “balance.” Articles published between 2010 and 2021 including subjects with Parkinson’s disease and the use of OMT or any other form of manual therapy were included. Five authors independently performed literature searches and methodically resolved any disagreements over article selection together. Results There were a total of 10,064 hits, from which 53 articles were considered, and five articles were selected based on the criteria. Conclusions The progressive nature of PD places symptom management on the forefront of maintaining patients’ quality of life. OMT has demonstrated the greatest efficacy on managing motor-related and neurologic symptoms and assists in treating the greater prevalence of somatic dysfunctions that arise from the disease. Research in this field remains limited and should be the target of future research.


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