Immediate effect of laryngeal manual therapy in dysphonic individuals.

Ana Paula Reimann,Alcione Ghedini Brasolotto,Ana Vitória Rondon,Larissa Thaís Donalonso Siqueira,Kelly Cristina Alves Silverio

doi:10.1590/2317-1782/20162015089

Ana Paula Reimann, Alcione Ghedini Brasolotto + Show 3 more

Open Access

https://doi.org/10.1590/2317-1782/20162015089

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Abstract

To investigate the immediate effect of Laryngeal Manual Therapy (LMT) in musculoskeletal pain, in voice and sensations referred to individuals with behavioral dysphonia and individuals without it. 30 individuals ranging from 18 to 45 years old were selected and sorted into two groups: the dysphonic group (DG) - 15 individuals with functional or organofunctional dysphonia, and the control group (CG) - 15 individuals without vocal complaints and with non-impaired voices. The individuals answered a pain questionnaire and their voices were subsequently registered. The initial evaluation was repeated after the LMT. The LMT was applied for 20 minutes. After the LMT, the individuals were self-evaluated in terms of sensations in their voices, larynxes, articulations and respiration. After the application of LMT, the DG reported significant improvement of pain in the following areas: temporal, larynx, posterior neck, wrists/hands/fingers, upper and lower back, hip/thigh, which did not occur in CG. The perceptual analysis of the vowel /a/ revealed no significant difference in any parameter in both groups after the LMT. The analysis of the speech showed that there was an increase of the roughness parameter after the application of LMT just in the DG. The DG individuals reported better sensations in the larynx and articulations after the submission to LMT, which did not occur in CG. this study clarified that TML immediately reduces the intensity of corporal pain in dysphonic individuals, which did not occur in individuals without any vocal impairments. Although the perceptual analysis reveals an increase of the roughness in the quality of the voice, positive sensation in the larynx and articulation were reported by dysphonic individuals after the application of TML.

Highlights

To compose the dysphonic group (DG) and the control group (CG), the exclusion criteria followed were: individuals aged more than 45 years, those with neurological dysphonia or who had presented any general neurological alteration; people who underwent surgery in the larynx; individuals with report of thyroid changes; people reporting changes or those who underwent treatments in the cervical spine; those reporting any sort of heart conditions; and people who do weight lifting and smokers
In the DG, pain was reduced after Laryngeal Manual Therapy (LMT) in the following regions: temporal, larynx, posterior region of the neck, fists, hands, fingers, upper and lower back, hips, and thighs
LMT could decrease the intensity of musculoskeletal pain in the following regions: temporal, larynx, posterior part of the neck, fists/hands/fingers, lower back, and hips/thighs in dysphonic individuals, which did not occur for individuals without vocal changes

Summary

Introduction

Individuals with dysphonia related to vocal behavior, called functional or organofunctional[1], may have changes in cervical and perilaryngeal muscles[2,3], muscle pain at rest or during function[2,4], hyperactivity of extrinsic laryngeal muscles[5], limitation in the amplitude of the cervical movement[2,4], and even postural changes[5,6].Traditionally, the treatment of dysphonia related to muscle change uses body techniques, laryngeal massage and massage on the shoulder girdle, postural changes in the neck and shoulder, besides techniques to soften the production and the stabilization of emission[7].With the specific goal of minimizing the symptoms related to the lack of balance in cervical and perilaryngeal muscles, techniques using manual therapy have been developed by professionals from several fields, such as speech-language pathologists[8,9,10,11], osteopathic physicians[12], and physical therapists[13]. Individuals with dysphonia related to vocal behavior, called functional or organofunctional[1], may have changes in cervical and perilaryngeal muscles[2,3], muscle pain at rest or during function[2,4], hyperactivity of extrinsic laryngeal muscles[5], limitation in the amplitude of the cervical movement[2,4], and even postural changes[5,6]. The treatment of dysphonia related to muscle change uses body techniques, laryngeal massage and massage on the shoulder girdle, postural changes in the neck and shoulder, besides techniques to soften the production and the stabilization of emission[7]. The main objective of manual circumlaryngeal technique is to relax the laryngeal muscles, excessively tense, which ends up inhibiting the balance of phonatory function. The high position of the larynx in the neck may influence the vocal function, changing length control and the rigidity of vocal folds, which contributes to the imbalance of the vocal quality[21,22]

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