Effects of Voice Therapy on Vocal Tract Discomfort in Muscle Tension Dysphonia

Document Type : Original

Authors

1 Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

2 Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

3 Otolaryngology Research Center, Tehran University of Medical Science, Tehran, Iran.

4 Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction:
Patients with muscle tension dysphonia (MTD) suffer from several physical discomforts in their vocal tract. However, few studies have examined the effects of voice therapy (VT) on the vocal tract discomfort (VTD) in patients with voice disorders. Therefore, the aim of the present study was to investigate the effects of VT on the VTD in patients with MTD.
 
Materials and Methods:
This study was carried out on 25 subjects with MTD, including 5 men and 20 women, with the mean age of 37.20±5.70 years. The participants underwent 10 consecutive sessions of VT twice a week. The acoustic voice analysis, auditory-perceptual assessment, and the Persian version of the vocal tract discomfort (VTDp) scale were used to compare the pre- and post-treatment results.
 
Results:
After VT, significant improvements were observed in the acoustic characteristics, including jitter, shimmer, and harmonics-to-noise ratio (P<0.05). Regarding the auditory-perceptual assessment, a significant reduction was noticed in the overall severity, roughness, and breathiness (P<0.05). Moreover, VT led to a significant reduction in all the items of the VTDp, including burn, tightness, dryness, pain, tickling, soreness, irritability, and lump in the throat, after VT in both frequency and severity sections of the VTDp scale (P<0.05).
 
Conclusion:
The results of the present study showed that VT can be effective in reducing the frequency and severity of the VTD in patients with MTD in addition to improving voice quality.

Keywords

Main Subjects

References

1. Sielska-Badurek E, Osuch-Wójcikiewicz E, Sobol M, Kazanecka E, Rzepakowska A, Niemczyk K. Combined functional voice therapy in singers with muscle tension dysphonia in singing. Journal of Voice. 2017;31(4):509. e23-. e31.
2. Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. Journal of Voice. 2011;25(2):202-7.
3. Van Houtte E, Van Lierde K, D'haeseleer E, Claeys S. The prevalence of laryngeal pathology in a treatment‐seeking population with dysphonia. The Laryngoscope. 2010;120(2):306-12.
4. Altman KW, Atkinson C, Lazarus C. Current and emerging concepts in muscle tension dysphonia: a 30-month review.Journal of Voice.2005;19(2): 261-7.
5. Kunduk M, Fink DS, McWhorter AJ. Primary Muscle Tension Dysphonia. Current Otorhinolaryngology Reports. 2016;4(3):175-82.
6. Mathieson L, Hirani S, Epstein R, Baken R, Wood G, Rubin J. Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia. Journal of Voice. 2009;23(3):353-66.
7. Casper JK, Leonard R. Understanding voice problems: A physiological perspective for diagnosis and treatment: Lippincott Williams & Wilkins; 2006.
8. de Oliveira Lemos I, da Cunha Pereira G, SantAnna GD, Cassol M. Effects of a Voice Therapy Program for Patients with Muscle Tension Dysphonia. Folia Phoniatrica et Logopaedica. 2017; 69(5-6):239-45.
9. Mansuri B, Torabinejhad F, Jamshidi AA, Dabirmoghaddam P, Vasaghi-Gharamaleki B, Ghelichi L. Transcutaneous Electrical Nerve Stimulation Combined With Voice Therapy in Women With Muscle Tension Dysphonia. Journal of Voice. 2018.
10. Jafari N, Salehi A, Izadi F, Moghadam ST, Ebadi A, Dabirmoghadam P, et al. Vocal Function Exercises for Muscle Tension Dysphonia: Auditory-Perceptual Evaluation and Self-Assessment Rating. Journal of Voice. 2016.
11. Roy N, Bless DM, Heisey D, Ford CN. Manual circumlaryngeal therapy for functionaldysphonia: An evaluation of short-and long-term treatment outcomes. Journal of Voice. 1997;11(3):321-31.
12. Kempster GB, Gerratt BR, Abbott KV, Barkmeier-Kraemer J, Hillman RE. Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol. American Journal of Speech-Language Pathology. 2009;18(2):124-32.
13. Woźnicka E, Niebudek-Bogusz E, Kwiecień J, Wiktorowicz J, Śliwińska-Kowalska M. Applicability of the vocal tract discomfort (VTD) scale in evaluating the effects of voice therapy of occupational voice disorders. Med Pr. 2012; 63(2): 141-52.
14. Stemple JC. Voice therapy: clinical case studies: St. Louis, MO: Mosby-Year Book, Inc; 1993.
15. Watts CR, Hamilton A, Toles L, Childs L, Mau T. A randomized controlled trial of stretch-and-flow voice therapy for muscle tension Dysphonia. The Laryngoscope. 2015;125(6):1420-5.
16. Sluka K, Vance C, Lisi T. High‐frequency, but not low‐frequency, transcutaneous electrical nerve stimulation reduces aspartate and glutamate release in the spinal cord dorsal horn. Journal of neurochemistry. 2005;95(6):1794-801.
17. Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G, et al. A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. European Archives of Oto-rhino-laryngology. 2001;258(2):77-82.
18. Paul B, Weenink D. doing phonetics by computer (Version 6.0.23) [Computer program]. Available at: http://www.praat.org/. Accessed December 12, 2016.
19. Salary Majd N, Maryam Khoddami S, Drinnan M, Kamali M, Amiri-Shavaki Y, Fallahian N. Validity and rater reliability of Persian version of the Consensus Auditory Perceptual Evaluation of Voice. Audiology. 2014;23(3).
20. Torabi H, Khoddami SM, Ansari NN, Dabirmoghaddam P. The Vocal Tract Discomfort Scale: validity and reliability of the Persian version in the assessment of patients with muscle tension dysphonia. Journal of Voice. 2015.
21. Rodríguez-Parra MJ, Adrián JA, Casado JC. Comparing voice-therapy and vocal-hygiene treatments in dysphonia using a limited multidimensional evaluation protocol. Journal of communication disorders. 2011;44(6):615-30.
22. Chan RWK. Does the voice improve with vocal hygiene education? A study of some instrumental voice measures in a group of kindergarten teachers. Journal of Voice. 1994;8(3):279-91.
23. Boone DR, McFarlane SC, Von Berg SL, Zraick RI. The voice and voice therapy. 2005.
24. Meerschman I, D’haeseleer E, Catry T, Ruigrok B, Claeys S, Van Lierde K. Effect of two isolated vocal facilitating techniques glottal fry and yawn-sigh on the phonation of female speech-language pathology students: A pilot study. Journal of communication disorders. 2017;66:40-50.
25. Van Lierde KM, De Ley S, Clement G, De Bodt M, Van Cauwenberge P. Outcome of laryngeal manual therapy in four Dutch adults with persistent moderate-to-severe vocal hyperfunction: a pilot study. Journal of Voice. 2004;18(4):467-74.
26. Khatoonabadi AR, Khoramshahi H, Khoddami SM, Dabirmoghaddam P, Ansari NN. Patient-Based Assessment of Effectiveness of Voice Therapy in Vocal Mass Lesions with Secondary Muscle Tension Dysphonia. Iranian journal of otorhinolaryngology. 2018;30(98):131.
27. Craig J, Tomlinson C, Stevens K, Kotagal K, Fornadley J, Jacobson B, et al. Combining voice therapy and physical therapy: a novel approach to treating muscle tension dysphonia. Journal of communication disorders. 2015;58:169-78.
28. Van Lierde KM, De Bodt M, Dhaeseleer E, Wuyts F, Claeys S. The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach. Journal of Voice. 2010; 24(3):294-301.
29. Dehqan A, Scherer RC. Positive Effects of Manual Circumlaryngeal Therapy in the Treatment of Muscle Tension Dysphonia (MTD): Long Term Treatment Outcomes. Journal of Voice. 2018.
30. Van Lierde K, Claeys S, De Bodt M, Van Cauwenberge P. Long-term outcome of hyperfunctional voice disorders based on a multiparameter approach. Journal of Voice. 2007; 21(2): 179-88.
31. Stemple JC, Roy N, Klaben BK. Clinical voice pathology: Theory and management: Plural Publishing; 2014.
32. Mansuri B, Tohidast SA, Soltaninejad N, Kamali M, Ghelichi L, Azimi H. Nonmedical treatments of vocal fold nodules: a systematic review. Journal of Voice. 2018 Sep 1;32(5):609-20.
33. Lukaschyk J, Brockmann-Bauser M, Beushausen U. Transcultural Adaptation and Validation of the German Version of the Vocal Tract Discomfort Scale. Journal of Voice. 2017; 31(2): 261.e1-.e8.
Iranian Journal of Otorhinolaryngology
Volume 31, Issue 5 - Serial Number 106
September and October 2019
Pages 297-304

Files

Share

How to cite

Statistics