Effects of Laryngeal Manual Therapy on Primary Muscle Tension Dysphonia (MTD-1): Implications for MTD-1 Type

IF 2.5 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Journal of Voice Pub Date : 2024-11-01 DOI:10.1016/j.jvoice.2022.04.002

Nassim Ahmadi , Katherine Verdolini Abbott , Fatemeh Rajati , Seyyedeh Maryam Khoddami , Farhad Torabinezhad , Ismail Ebrahimi Takamjani , Behnoosh Vasaghi-Gharamaleki

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Abstract

Objective

The study investigated effects of laryngeal manual therapy on different types of primary muscle tension dysphonia (MTD-1).

Study Design

Interventional pre-test post-test design.

Methods

Thirty-two traditional Iranian singers (mean age of 36.75 ± 9.34 years.) diagnosed with MTD-1, 8 female and 24 male, and recruited by convenience sampling completed the study. MTD-1 was classified as Morrison and Rammage's types 1-5, based on standardized criteria (1993). Pre-post-treatment measures were based on visual ratings of the larynx, acoustic analyses, auditory-perceptual assessments of voice (Auditory-Perceptual Rating Instrument for Operatic Singing Voice: EAI Scale Form), and the Persian Singing Voice Handicap Index (P-SVHI), reported before and after 10 sessions of laryngeal manual therapy (LMT).

Results

The most notable finding was that the number of cases with MTD-1 types 1 and 2 actually increased after treatment, while the number of cases with MTD-1 types 3, 4 and 5 decreased. The data suggested that MTD-1 types 3, 4, and 5 tended to convert to types 1 and 2 with LMT. Acoustic analyses showed a significant decrease in F0 (males only; P = 0.011), a sharp decrease in HNR from 23.26 dB to 14.74 dB (P = 0.000), and an increase in shimmer from 4.18% to 6.90 % while no appreciable change was found in jitter (P = 0.57). Mean P-SVHI score decreased significantly from 52.03 to 41.16 (P = 0.002) and EAI score increased from 4.41 to 6.31 (P = 0.000) after treatment.

Conclusions

The primary finding was that the distribution of MTD-1 type changed after treatment in many cases, converting from one to another type. Acoustic as well as glottal closure measures for several participants revealed closure insufficiency after treatment, unveiled as hyperfunction was unloaded with LMT. For those participants, complementary treatments aimed at reinforcement of laryngeal closure functions would be appropriate.

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喉部手法治疗对原发性肌张力性发音障碍（MTD-1）的影响：对 MTD-1 型的影响。

研究目的研究调查了喉部手法治疗对不同类型的原发性肌肉紧张性发音障碍（MTD-1）的影响：方法： 32 名伊朗传统歌手（平均年龄为 36.75 岁）进行前测后测：方法：通过方便抽样调查，32 名伊朗传统歌手（平均年龄为 36.75 ± 9.34 岁）被诊断为 MTD-1，其中 8 名女性，24 名男性。根据标准化标准（1993 年），MTD-1 被分为 Morrison 和 Rammage 的 1-5 型。治疗前和治疗后的测量基于喉部的视觉评分、声学分析、嗓音的听觉感知评估（歌剧演唱嗓音的听觉感知评分工具：结果：最显著的发现是，治疗后 MTD-1 类型 1 和 2 的病例数实际上有所增加，而 MTD-1 类型 3、4 和 5 的病例数则有所减少。数据表明，MTD-1 3、4 和 5 型在接受 LMT 治疗后往往会转化为 1 和 2 型。声学分析表明，F0 显著下降（仅男性；P = 0.011），HNR 从 23.26 dB 骤降至 14.74 dB（P = 0.000），闪烁从 4.18% 增至 6.90%，而抖动没有明显变化（P = 0.57）。治疗后，P-SVHI 平均得分从 52.03 显著下降到 41.16（P = 0.002），EAI 得分从 4.41 上升到 6.31（P = 0.000）：主要发现是许多病例在治疗后 MTD-1 类型的分布发生了变化，从一种类型转变为另一种类型。几位参与者的声学和声门闭合测量结果表明，治疗后声门闭合不全，这与 LMT 解除超负荷功能有关。对于这些参与者，旨在加强喉闭合功能的辅助治疗是合适的。

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来源期刊

Journal of Voice 医学-耳鼻喉科学

CiteScore

4.00

自引率

13.60%

发文量

395

审稿时长

59 days

期刊介绍： The Journal of Voice is widely regarded as the world''s premiere journal for voice medicine and research. This peer-reviewed publication is listed in Index Medicus and is indexed by the Institute for Scientific Information. The journal contains articles written by experts throughout the world on all topics in voice sciences, voice medicine and surgery, and speech-language pathologists'' management of voice-related problems. The journal includes clinical articles, clinical research, and laboratory research. Members of the Foundation receive the journal as a benefit of membership.