International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 11 , ISSUE 1 ( January-June, 2021 ) > List of Articles

RESEARCH ARTICLE

Determining the Outcome of Laryngeal Manual Therapy in Female Subjects with Muscle Tension Dysphonia: An Experimental Study

Lorna Das, Aniruddha Majumdar, Indranil Chatterjee, Susmi Pani, Bibhu P Hota

Keywords : Laryngeal manual therapy, Muscle tension dysphonia, Palpatory assessment, Voice handicap index

Citation Information : Das L, Majumdar A, Chatterjee I, Pani S, Hota BP. Determining the Outcome of Laryngeal Manual Therapy in Female Subjects with Muscle Tension Dysphonia: An Experimental Study. Int J Phonosurg Laryngol 2021; 11 (1):10-15.

DOI: 10.5005/jp-journals-10023-1194

License: CC BY-NC 4.0

Published Online: 18-08-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive muscular tension in the perilaryngeal areas (Roy and Leeper). Laryngeal manual therapy (LMT) is one of the direct approaches of voice therapy that involves kneading the laryngeal area without voicing to reduce hyperfunction of the muscles and improve the quality of voice. Aims and objectives: The present study was conducted to determine the outcome of LMT in females with MTD by comparing assessment data between pre-therapy, immediate post-LMT, and 1 week after LMT. Materials and methods: Ten females (20–40 years) with MTD were taken. Palpatory assessment, Dr Speech (Version 4), GRBAS scale, and voice handicap index (VHI) were used for voice evaluation. First, a pre-therapy assessment of all the voice parameters was collected. Second, LMT was carried out. Immediately after LMT, post-LMT data collection was done. No intervention was given following LMT. After 1 week of LMT, again data collection was done. Results: A significant reduction in vocal parameters of jitter, shimmer, and NNE (p < 0.05) were found after LMT except for Mean Fo (p > 0.05). Hoarseness was reduced. A significant difference was found between VHI measures (p < 0.05), GRBAS scale (p < 0.05), and palpatory assessment (p < 0.05) in pre-LMT, immediate post-LMT, and 1-week post-LMT. Conclusion: The present study would assist to determine the therapeutic efficacy of direct voice therapy and in predicting voice therapy outcomes in persons with MTD.


PDF Share
  1. Roy N, Leeper H. Effects of the manual laryngeal musculoskeletal tension reduction technique as a treatment for functional voice disorders: perceptual and acoustic measures. J Voice 1993;7(3):242–249. DOI: 10.1016/s0892-1997(05)80333-9.
  2. Lieberman J, Rubin JS, Harris S, et al. Laryngeal manipulation. In: Rubin JS, Sataloff RT, Korovin GS, ed. Diagno Treat Voice Disord. San Diego, CA: Thomson-Delmar Publishing; 2003(2):561–582.
  3. Stemple J, Glaze L, Klaben B. Clinical voice pathology. San Diego: Plural Pub; 2010. p. 426.
  4. Rubin JS, Sataloff RT, Korovin GS, ed. Diagnosis and treatment of voice disorders. San Diego: Plural Publishing; 2006. p. 3.
  5. Van Lierde K, Bodt M, Dhaeseleer E, et al. The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach. J Voice 2010;24(3):294–301. DOI: 10.1016/j.jvoice.2008.09.003.
  6. Harris T, Harris S, Rubin JS, et al. The voice clinic handbook. London: Whurr; 1998. p. 412.
  7. Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice 2011;25(2):202–207. DOI: 10.1016/j.jvoice.2009.10.009.
  8. Oates J, Winkworth A. Current knowledge, controversies and future directions in hyperfunctional voice disorders. Int J Speech Langu Pathol 2008;10(4):267–277. DOI: 10.1080/17549500802140153.
  9. Altman K, Atkinson C, Lazarus C. Current and emerging concepts in muscle tension dysphonia: a 30-month review. J Voice 2005;19(2):261–267. DOI: 10.1016/j.jvoice.2004.03.007.
  10. Hapner ER, Stemple JC. Voice Therapy: Clinical Case Studies, 5th ed., 2014.
  11. Mathieson L, Hirani S, Epstein R, et al. Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension sysphonia. J Voice 2009;23(3):353–366. DOI: 10.1016/j.jvoice.2007.10.002.
  12. Mathieson L. The evidence for laryngeal manual therapies in the treatment of muscle tension dysphonia. Curr Opin Otolaryngol Head Neck Surg 2011;19(3):171–176. DOI: 10.1097/MOO.0b013e3283448f6c.
  13. Roy N, Nissen S, Dromey C, et al. Articulatory changes in muscle tension dysphonia: evidence of vowel space expansion following manual circumlaryngeal therapy. J Communicat Disord 2009;42(2):124–135. DOI: 10.1016/j.jcomdis.2008.10.001.
  14. Rosing-Schow A, Pedersen S. Voice release. Logoped Phoniatr Vocol 2010;35(4):166–168. DOI: 10.3109/14015431003599004.
  15. Guzman M, Rubin A, Muñoz D, et al. Changes in glottal contact quotient during resonance tube phonation and phonation with vibrato. J Voice 2013;27(3):305–311. DOI: 10.1016/j.jvoice.2013. 01.017.
  16. Aronson AEE, Bless DM. Clinical voice disorders. New York: Thieme Medical Publishers; 2009. p. 4.
  17. Rubin J, Lieberman J, Harris T. Laryngeal manipulation. Otolaryngol Clin N Am 2000;33(5):1017–1034. DOI: 10.1016/s0030-6665(05) 70261-9.
  18. Van Lierde K, De Ley S, Clement G, et al. Outcome of laryngeal manual therapy in four Dutch adults with persistent moderate-to-severe vocal hyperfunction: a pilot study. J Voice 2004;18(4):467–474. DOI: 10.1016/j.jvoice.2004.02.003.
  19. Salehi A, Izadi F, Tehrani LG, et al. Voice-based laryngeal manual therapy in treatment of hyperfunctional voice disorders: a preliminary study. Audiol 2013;22(3):52–62.
  20. Huang DZ, Lin S, Brien R. Dr. Speech User's Guide. Tiger DRS. Inc.; 1998. p. 4.
  21. Hirano M. Psycho-acoustic evaluation of voice: GRBAS scale for evaluating the hoarse voice. 1981.
  22. Jacobson BH, Johnson A, Grywalski C, et al. The voice handicap index (VHI) development and validation. Am J Speech Langu Pathol 1997;6(3):66–70. DOI: 10.1044/1058-0360.0603.66.
  23. Angsuwarangsee T, Morrison M. Extrinsic laryngeal muscular tension in patients with voice disorders. J Voice 2002;16(3):333–343. DOI: 10.1016/s0892-1997(02)00105-4.
  24. Reimann A, Siqueira L, Rondon A, et al. Efeito imediato da terapia manual laríngea em indivíduos disfônicos. CoDAS 2016;28(1):59–65. DOI: 10.1590/2317-1782/20162015089.
  25. Roy N. Functional dysphonia. Curr Opin Otolaryngol Head Neck Surg 2003;11(3):144–148. DOI: 10.1097/00020840-200306000-00002.
  26. Roy N, Bless D, Heisey D, et al. Manual circumlaryngeal therapy for functionaldysphonia: an evaluation of short- and long-term treatment outcomes. J Voice 1997;11(3):321–331. DOI: 10.1016/s0892-1997(97)80011-2.
  27. Mumovic G, Veselinovic M, Arbutina T, et al. Vocal therapy of hyperkinetic dysphonia. Srp Arh Celok Lek 2014;142(11-12):656–662. DOI: 10.2298/sarh1412656m.
  28. Dutta S. Voice therapy in muscle tension dysphonia cases. Int J Phonosurg Laryngol 2015;5(1):20–24. DOI: 10.5005/jp-journals-10023-1097.
  29. Khoddami S, Ansari N, Jalaie S. Review on laryngeal palpation methods in muscle tension dysphonia: validity and reliability issues. J Voice 2015;29(4):459–468. DOI: 10.1016/j.jvoice.2014.09.023.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.