Efficacy of Digital Manipulation of Thyroid Cartilage, Fluency Shaping Therapy and Combination of Both in Treatment of Stuttering Severity: A Randomized Clinical Trial

Abstract

Background: The stuttering is manifested by disruption in normal speech flow and fluency that also disturbs social and emotional wellbeing. There is immediate need of rehabilitation for the improvement of fluency and reduce the severity of stuttering.Objective:To compare the digital manipulation of thyroid cartilage (DMTC), fluency shaping therapy (FST) and combination of DMTC and FST for improving severity in stuttering patients. Material and Method: A randomized clinical trial was conducted at National Institute of Rehabilitation Medicine. The patients were enrolled through non-probability, convenient sampling technique. The participants were randomly allocated into three equal groups (n=10): DMTC group, FST group and combination of both. The Scale of Rating Severity of Stuttering (SRSS) was used to assess the severity level at baseline, 2ndweek, 4thweek, 8thweek and 12thweek of intervention.Results: The mean age of DMTC, FST and combination group was, 22.25 ±3.33 years, 21.65±3.36 and 21.35±3.76 years respectively. Friedman with post hoc test revealed significant improvement (p<0.05) in all groups but combination group had showed better outcome than single DMTC and FST intervention. A Kruskal-Wallis H test showed that there was no significant difference (p≥0.05) among DMTC, FST and Combination group from baseline to 8thweeks of training, but significant difference {X2(2) =5.897, p<0.014} was observed after 12thweek of training among the groups. The post hoc test showed that the combination group was more significantly improved as compared to DMTC group {MR=9.10 ver. MR=17.71, p=0.012} but not significant difference between difference between combination and FST group (p=0.317) as well as DMTC and FST group (p=0.619) regarding severity of stuttering. Conclusion: It is concluded that combination of digital manipulation of thyroid cartilage and fluency shaping therapy were more beneficial for improving fluency in stuttering patients. Key words:Digital manipulationtherapy,fluency shaping therapy, stammering, stuttering.