Assessment of the influence of osteopathic myofascial techniques on normalization of the vocal tract functions in patients with occupational dysphonia

Abstract

Objectives: Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia. Material and Methods: Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chisquare McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment. Results: The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination. Conclusions: The use of osteopathic therapy helps significantly improve the functions of the vocal tract in patients with occupational dysphonia.

Evaluating the efficacy of voice therapy for functional, organic and neurological voice disorders

“…There have been a number of recent additional Robey Phase 1 studies which aim to detect a treatment effect for previously unevaluated treatment interventions. These include evaluation of laryngeal palpation (manual) therapies . However, these studies are yet to demonstrate clear validity and reliability, and further intervention research using higher quality designs is required.…”

“…These include evaluation of laryngeal palpation (manual) therapies. [19][20][21][22][23][24][25][26] However, these studies are yet to demonstrate clear validity and reliability, and further intervention research using higher quality designs is required. Similarly, there is recent interest in the examination of flow phonation therapy or semi-occluded vocal tract therapy.…”

Managing dysphonia in occupational voice users

“…Osteopathic therapy, myofascial techniques together with voice exercises, relaxation, and aerobic activities apart from balneological treatment were used to treat 40 teachers with chronic vocal problems, in a health spa in Poland [55]. A reduction of tenderness and normalization of perilaryngeal tonus was observed.…”

An overview of occupational voice disorders in Poland

“…A result of the program was formulating and implementing a multi-specialist model of extensive treatment of voice disorders both in an outpatient clinic and in a health spa. The model includes holistic management of occupational dysphonia with a close collaboration of phoniatricians, speech therapists, psychologists, and physiotherapists/osteopaths [43]. Besides, in Poland, each teacher throughout their professional career is eligible to take three one-year-long paid leaves to take care of, or regain, health.…”