Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect.

INTRODUCTION: The aim of the present study was to investigate the immediate effect of the application of high-frequency Transcutaneous electrical nerve stimulation (TENS) in muscle tension dysphonia (MTD) patients with the pain complaint. MATERIALS AND METHODS: Thirty patients with MTD, 10 men and 20 women with a mean age of 36.40 ± 5.76 years, participated in the study. The patients were randomized into two groups: (1) Treatment group (TENS) (10 women and 5 men) and (2) Sham TENS group (10 women and 5 men). The treatment group (TENS) received a unique 20-minute session of high-frequency TENS. The sham TENS group was treated in the same condition as the treatment group and received a unique 20-minute session of high-frequency TENS, but no stimulation was given. Auditory-perceptual assessments, acoustic voice analysis, vocal tract discomfort (VTD), and musculoskeletal pain were used to compare the patients pre- and post-treatment. RESULTS: There was a significant improvement in the asthenia parameter of auditory-perceptual assessment in the TENS group. This improvement in asthenia was significant when comparing the TENS group with the sham TENS group. These differences in the asthenia were not significant after using Holm-Bonferroni correction. A comparison of the VTD before and after the TENS application showed there was a significant reduction in the severity of the symptoms (burning, tight, dry, pain, tickling, sore, irritable, and lump in the throat). When comparing the TENS group with the sham TENS group, improvements in burn, tight, dry, pain, and irritable items of VTD were observed. However, after applying the Holm-Bonferroni correction, only reductions in dry and pain items remain significantly different between the groups. After the TENS application, the pain intensity was significantly reduced in the anterior and posterior neck, larynx, submandibular, masseter, temporal region, and upper back. After applying the Holm-Bonferroni correction, pain intensity reduction was significant in the anterior neck and larynx. When comparing the TENS group with the sham TENS group, pain intensity was reduced significantly in the larynx of the TENS group. This difference between the two groups was not significant after using Holm-Bonferroni correction. The pain and VTD assessments in the present study were performed using valid and reliable self-reported scales (NMSQ-E and VTD). CONCLUSION: High-frequency TENS can be used in the voice treatment program of patients with MTD. MTD patients with pain complaint reported that their vocal tract discomfort and pain were decreased following the high-frequency TENS. Notably, these positive effects were obtained after a single session of high-frequency TENS application.

Transcutaneous Electrical Nerve Stimulation Combined With Voice Therapy in Women With Muscle Tension Dysphonia.

OBJECTIVES: The purpose of the present study was to investigate the effect of Voice Therapy (VT) with and without Transcutaneous Electrical Nerve Stimulation (TENS) in women with Muscle Tension Dysphonia (MTD). METHODS: A total of 20 women with MTD participated in the study. Participants underwent evaluation of auditory-perceptual assessment, acoustic voice analysis, Vocal Tract Discomfort (VTD), and musculoskeletal pain before and after the treatment. The participants were divided into two groups: (1) TENS + VT group (10 participants) and (2) VT group (10 participants). Both groups received 10 sessions of treatment, twice a week, each lasting 50 minutes. The statistical analysis was performed using Wilcoxon signed ranked and Mann-Whitney U tests (P < 0.05). RESULTS: After VT, significant improvements were observed in all auditory-perceptual parameters and all VTD items except for the tickling frequency and severity. The VT caused significant reduction in the frequency of pain in anterior neck, posterior neck, and the larynx. Also, VT resulted in a significant reduction in pain intensity only in the larynx. After VT + TENS, significant improvements were observed in all auditory-perceptual parameters, shimmer, and all VTD items. Moreover, the VT + TENS led to a significant decrease in the frequency and intensity of pain in anterior neck, posterior neck, the larynx, masseters, shoulders, and upper back. The findings of between-group comparison after treatment showed significantly more reduction in the frequency (dry and pain items) and severity (tight and pain items) of the VTD in VT + TENS group compared with VT group. Regarding the musculoskeletal pain, significantly more reduction in the frequency and intensity of pain in anterior neck and the larynx was observed in VT + TENS group compared with VT group. CONCLUSIONS: The VT and VT + TENS could lead to positive outcomes in auditory perceptual assessment, acoustic voice analysis, the VTD, and assessment of musculoskeletal pain. In some items of frequency and severity of VTD scale and assessment of musculoskeletal pain, VT + TENS also produced better results compared with VT. As a result, TENS was recommended as a complementary therapy for patients with MTD, especially when these patients had more complaints about VTD and musculoskeletal pain.