scholarly journals Application of manual therapy in muscle tensional dysphonia

2021 ◽  
Vol 18 (1) ◽  
pp. 20-28
Author(s):  
Stevan Jovanović ◽  
Slađana Arsić ◽  
Biljana Stojanović-Jovanović ◽  
Dragana Kljajić ◽  
Marija Trajkov
Keyword(s):  
Manual Therapy ◽  
Repeated Measures ◽  
Muscle Tension ◽  
Voice Disorder ◽  
Therapeutic Effects ◽  
Small Pilot Study ◽  
Muscle Tension Dysphonia ◽  
Vocal Qualities ◽  
Before And After ◽  
Control Study

Muscle tension dysphonia is a functional voice disorder caused by unbalanced activity of the laryngeal and extralaryngeal muscles. People with dysphonia may have changes in the cervical and perilaryngeal muscles, limited amplitude of movement of the cervical spine, but also posture disorders. The aim of this paper is to present the analyzed therapeutic effects of manual techniques in muscle tension dysphonia, based on a review of the available literature. In accordance with the set criteria and the goal of the paper, the collection and analysis of professional and scientific research papers available in PubMed / MEDLINE databases and others, published in the period from 2004 to 2018, was performed. The analyzed studies belong to the type of clinical studies and by design, two types of studies are included: the type of randomized control study and the study of one group of subjects with before and after-examination. Some studies with one group of respondents were characterized by the authors as a series of cases and one, as a small pilot study of repeated measures. The results of the research indicate a larger number of corrective effects of laryngeal manual therapy. It is certain that by developing a broader manual-therapeutic approach, the etiological factor of muscle tension dysphonia can be more effectively influenced which leads to a reduction in pain, improvement of physical functioning as well as improvement of specific vocal qualities.

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.

scholarly journals Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course

2021 ◽  
Author(s):  
Mohammad Fallah ◽  
Seyyedeh Maryam Khoddami ◽  
Shohreh Jalaie ◽  
Keyvan Aghazadeh ◽  
Amin Rezaei Rad
Keyword(s):  
Manual Therapy ◽  
Spontaneous Recovery ◽  
Vocal Tract ◽  
Muscle Tension ◽  
Nonparametric Test ◽  
Perceptual Evaluation ◽  
Muscle Tension Dysphonia ◽  
Significant Difference ◽  
Perceptual Characteristics ◽  
Wilcoxon Nonparametric Test

Introduction: This study aimed to investigate the effect of Mathieson Laryngeal Manual Therapy (MLMT) following a therapeutic course in patients with primary Muscle Tension Dysphonia (MTD). Materials and Methods: Twelve patients with primary MTD participated in this study. At first, videostroboscopy and perceptual voice assessment was performed, and the Persian version of Vocal Tract Discomfort (VTDp) scale was completed. After two and a half weeks that patients received no treatment, the assessments were repeated to evaluate the effect of spontaneous recovery. For studying the effect of MLMT, it was presented in five sessions. Then, all assessments were repeated. The frequency of supraglottic activity was elicited. For the perceptual evaluation and VTDp, the Wilcoxon nonparametric test was used to study and compare the effect of spontaneous recovery and MLMT. Results: After spontaneous recovery, a significant difference was observed only in strain (P<0.05). After MLMT, the frequency of supraglottic activity decreased, and perceptual voice parameters significantly changed (P<0.05), but the VTDp showed no significant difference (P>0.05). There was no significant difference between spontanous recovery and MLMT based on the paerceptual voice evaluation and VTDp scale (P>0.05). Conclusion: The MLMT can remarkably improve the supraglottic activity and perceptual characteristics of voice in primary MTD after a therapeutic course. Further studies are recommended to confirm the effectiveness of MLMT on decreasing VTD sensations.

scholarly journals Trajectories of alcohol consumption up to 30 years before and after the diagnosis of cardiovascular diseases: a longitudinal case–control study of 12 502 participants

2021 ◽  
pp. jech-2021-217237
Author(s):  
Chengyi Ding ◽  
Dara O'Neill ◽  
Annie Britton
Keyword(s):  
Cardiovascular Diseases ◽  
Alcohol Consumption ◽  
Repeated Measures ◽  
Case Control Study ◽  
Case Control ◽  
Drinking Behaviour ◽  
Before And After ◽  
Incident Cases ◽  
The Impact ◽  
Control Study

BackgroundTo examine the longitudinal trajectories of alcohol consumption prior to and following the diagnosis of cardiovascular diseases (CVD).MethodsWe conducted a case–control study of 2501 incident cases of angina, myocardial infarction or stroke and 10 001 matched controls without the condition. Repeated measures of alcohol were centred on the date of diagnosis, spanning up to 30 years before and after CVD onset. Mean trajectories of weekly consumption were estimated using growth curve models.ResultsFor trajectories prior to diagnosis, mean volume of alcohol consumed among male cases increased over time, peaking at around 8 years before diagnosis at 95 (95% CI 60 to 130) g/week and declining afterwards. Trajectories following diagnosis showed mean consumption in male cases dropped from 87 (95% CI 54 to 120) g/week to 74 (95% CI 45 to 102) g/week after the date of diagnosis and then slightly rose to 78 (95% CI 40 to 116) g/week at the subsequent 3.5 years, before gradually declining to 31 (95% CI 2 to 61) g/week at 30 years after diagnosis. Mean consumption among female cases remained stable prior to diagnosis (at about 30 g/week), fell marginally to 25 (95% CI 20 to 30) g/week after the date of diagnosis and kept decreasing afterwards. Similar trajectories were obtained in cases and controls.ConclusionsThis is the first attempt to show how patients with CVD change their drinking volume over such a wide time span. Future research needs to establish insight into drinking behaviour in other ways (such as frequency and context) and address the impact of changes in drinking on patients with CVD.

Updates on Vocal Tremor and its Management

2012 ◽  
Vol 22 (3) ◽  
pp. 97-103 ◽  
Author(s):  
Julie Barkmeier-Kraemer
Keyword(s):  
Neurological Disorders ◽  
Botulinum Toxin Type A ◽  
Muscle Tension ◽  
Botulinum Toxin Type ◽  
Voice Disorder ◽  
Behavioral Modification ◽  
Periodic Modulation ◽  
Pharmaceutical Treatment ◽  
Muscle Tension Dysphonia ◽  
Vocal Tremor

Vocal tremor is a neurogenic voice disorder characterized by a nearly periodic modulation in pitch and loudness during sustained phonation. This voicing pattern is the result of tremor affecting structures within the speech mechanism, resulting in modulation of lung pressure, phonation, articulation, and resonance during speaking. Speaking patterns in these individuals may be perceived as similar to spasmodic dysphonia or muscle tension dysphonia. The key to determining the presence of vocal tremor and distinguishing it from other voice disorders requires familiarity with the perceptual, acoustic, and physiologic patterns associated with vocal tremor during different voicing and speech contexts. Management of those with vocal tremor can be challenging because of its co-occurrence with other neurological disorders. The two most common methods for managing vocal tremor include pharmaceutical treatment, most commonly applied via injections of Botulinum Toxin Type A (Botox®), and behavioral modification of speaking patterns. The latter approach is in early clinical phases of research and has not yet been subjected to clinical trials. In this paper, I will summarize the clinical characteristics of vocal tremor in comparison to what is known about tremor in general and describe Botox® and behavioral approaches for managing individuals with this voice disorder.

Exploring the Clinical Utility of Relative Fundamental Frequency as an Objective Measure of Vocal Hyperfunction

2016 ◽  
Vol 59 (5) ◽  
pp. 1002-1017 ◽  
Author(s):  
Nelson Roy ◽  
Rebecca A. Fetrow ◽  
Ray M. Merrill ◽  
Christopher Dromey
Keyword(s):  
Fundamental Frequency ◽  
Muscle Activity ◽  
Clinical Utility ◽  
Muscle Tension ◽  
Objective Measure ◽  
Vowel Context ◽  
Muscle Tension Dysphonia ◽  
Vocal Hyperfunction ◽  
Before And After ◽  
Relative Fundamental Frequency

Purpose Vocal hyperfunction, related to abnormal laryngeal muscle activity, is considered the proximal cause of primary muscle tension dysphonia (pMTD). Relative fundamental frequency (RFF) has been proposed as an objective acoustic marker of vocal hyperfunction. This study examined (a) the ability of RFF to track changes in vocal hyperfunction after treatment for pMTD and (b) the influence of dysphonia severity, among other factors, on the feasibility of RFF computation. Method RFF calculations and dysphonia severity ratings were derived from pre- and posttreatment recordings from 111 women with pMTD and 20 healthy controls. Three vowel–voiceless consonant–vowel stimuli were analyzed. Results RFF onset slope consistently varied as a function of group (pMTD vs. controls) and time (pretherapy vs. posttherapy). Significant correlations between RFF onset cycle 1 and dysphonia severity were observed. However, in many samples, RFF could not be computed, and adjusted odds ratios revealed that these unanalyzable data were linked to dysphonia severity, phonetic (vowel–voiceless consonant–vowel) context, and group (pMTD vs. control). Conclusions RFF onset appears to be sensitive to the presence and degree of suspected vocal hyperfunction before and after therapy. The large number of unanalyzable samples (related especially to dysphonia severity in the pMTD group) represents an important limitation.

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.

Sign in / Sign up

Export Citation Format

Share Document