Treatment of hypertonicity in muscles of lip retraction

Abstract

An EMG biofeedback program was developed for a 56-year-old Parkinsonism patient who exhibited pathological lip hypertonia and retraction. The program was designed to achieve the following goals: (1) to demonstrate a reduction in postural lip hypertonicity and (2) to demonstrate a reduction in lip hypertonicity during a series of increasingly complex speech activities. To achieve the first goal, contrastive tasks of full contraction and relaxation were utilized. Each posture was sustained while voltage measurements were made at specific intervals. Procedures to modify lip retraction during speech included five tasks in which the patient was to monitor the audio feedback signal. The tasks involved: prolongation of a neutral vowel, consonant-vowel combinations, monosyllabic words, sentences, and a paragraph-reading task. Data collected over six biofeedback sessions are presented. Trend analyses showed consistent muscular reduction within each task. The following explanations for the decrease in the patient's hypertonicity were discussed: (1) reduction of anisometric contraction, (2) reduction of isometric contraction, (3) relearning of agonistic-antagonistic muscle balance.

Treatment of articulatory impairment in a child with spastic dysarthria associated with cerebral palsy

“…For individuals with SCP, sEMG has the potential to reduce muscle spasticity by facilitating muscle control using relaxation. Relaxation reduces muscle tone and facilitates improved range of orofacial movement and muscle functioning, which ultimately improves articulation and speech performance [14][15][16][17][18]. More studies investigating sEMG biofeedback for treating articulatory disorders are required to confirm these findings in children with SCP.…”

“…The findings suggest that sEMG intervention facilitates a reduction in orofacial spasticity and may be an effective treatment modality for children with CP. In adults, several case studies have reported improved articulation and overall intelligibility following sEMG biofeedback treatment with severe spastic dysarthria [14][15][16][17][18].…”

“…The child, CB (fictitious initials), was referred for treatment as both she and her family ardently wanted to maintain speech as her primary means of communication despite the severity of her disability and previous speech treatment. Given the severity of the speech disorder, reported positive treatment outcomes for those with severe spastic dysarthria following sEMG treatment [14][15][16][17][18] and limited treatment outcomes of previous speech production treatment, it was hypothesized that sEMG biofeedback would facilitate a reduction in labial and lingual hypertonicity and thus result in greater improvements in articulation than PPT.…”

Effects of Biofeedback in Phonatory Disorders and Phonatory Performance: A Systematic Literature Review

“…As for speech and language therapy, biofeedback has been used in several disorders: Hearing disorders and deafness (Stark, 1971), resonance disorders (Brunner et al, 1994;Fletcher, 1972;Garber, Burzynski, Vale, & Nelson, 1979;Goldstein, Ziegler, Vogel, & Hoole, 1994;Künzel, 1982;Moller, Path, Werth, & Christiansen, 1973;Shelton, Paesani, McClelland, & Bradfield, 1975;Whitehill, Stokes, & Man, 1996), neurogenic speech disorders including facial paralysis (Daniel & Guitar, 1978;Finley, Niman, Standley, & Wansley, 1977;Gentil, Aucouturier, Delong, & Sambuis, 1994;Goldstein et al, 1994;Hammerschlag, Brudny, Cusumano, & Cohen, 1987;Hand, Burns, & Ireland, 1979;Jankel, 1978;Nemec & Cohen, 1984;Netsell & Cleeland, 1973;Netsell & Daniel, 1979;Rubow, Rosenbek, Collins, & Celesia, 1984;Rubow & Swift, 1985;Schram & Burres, 1984), fluency disorders (Craig & Cleary, 1982;Guitar, 1975;Hanna, Wilfling, & McNeill, 1975), articulation disorders (Brooks, Fallside, Gulian, & Hinds, 1981;Michi, Yamashita, Imai, Suzuki, & Yoshida, 1993), swallowing disorders (Denk & Kaider, 1997;Huckabee & Pelletier, 1999) and respiratory disorders (Murdoch, Pitt, Theodoros, & Ward, 1999). Also in the field of voice disorders, there have been studies regarding the use and effects of biofeedback, as will be discussed in the next section.…”

EMG Biofeedback in the Treatment of Dysarthria

“…The patient was presented with a tone whose frequency was analogous to the voltage recorded from the electrodes and she had to concentrate on lowering this tone. This method was replicated by Hand et al [7], who also used auditory feedback. Netsell and Daniel [8] used a multiple treatment ap proach to train a flaccid dysarthric patient to improve his speech: auditory biofeedback of lip EMG during nonspeech and speech activi ty and visual biofeedback of glottal flow dur ing sustained phonation of vowels.…”