A Manual Therapy in Need of a Manual: Conceptualizing and Comparing Existing Vocal Massage Protocols and Their Use in the Treatment of Voice Problems

Abstract

ABSTRACT Vocal manual therapy (VMT) is a heterogenous term used to describe a variety of touch-based approaches to voice rehabilitation and maintenance. VMT aims to use manipulation, massage, and reposturing to change how the voice sounds and feels. Since first described in 1990, there has been a proliferation in the use of VMT in the treatment of voice problems, with increasing interest in its usefulness within clinical and non-clinical voice settings. This forum article presents a narrative review of 42 studies investigating the use of VMT in a vocal health context. The aim was to identify the theoretical orientations of VMT protocols, draw links between the techniques employed in their administration, and highlight similarities and differences in use of language across VMT protocols. Relevant articles for review were identified via informal literature search using forward and backward citation screening and then described using narrative synthesis. Theoretical orientations were broad and influenced by speech pathology research as well as Finnish massage, naprapathy and yoga. 26 ostensibly different protocols were identified across the 42 studies, with considerable variation in protocol length and frequency. Language was highly varied across protocols. The forum article therefore advocates for greater shared understanding in VMT research and practice.