Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia.

BACKGROUND: The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE). MATERIAL AND METHODS: The examinations were performed in a study (dysphonic) group of professional voice users who had developed voice disorders (N = 51) and in the control group of normophonic subjects (N = 50). All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index) questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained) perceptual evaluation, maximum phonation time (MPT) measurement and videostroboscopy was performed in the study group. RESULTS: The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001). In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05), perceptual evaluation by the GRBAS (p < 0.05) and the objective parameter MPT (p < 0.05). CONCLUSIONS: The study has proven that the LMTPE scale is characterized by the high score of Cronbach's α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2):179-188.

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

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 chi-square 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.

[The application of physiotherapeutic and ostheopatic diagnostics in ocuppational voice disorders]. / Diagnostyka fizjoterapeutyczna i osteopatyczna w zawodowych zaburzeniach glosu.

The article presents the role of a physiotherapist and an ostheopath in the multidimensional management of occupational voice disorders. The influence ofbiomechanical characteristics of the musculo-fascial system on vocal apparatus is described. The visual and palpating methods used in physiotherapeutic/ostheopatic diagnostics, including the assessment of joint mobility and ergonomics in dynamic and static situations are also outlined.

[Extensive treatment of teacher's voice disorders in health spa]. / Turnus sanatoryjny intensywnej rehabilitacji glosu u nauczycieli.

Treatment in a health spa with proper infrastructure and professional medical care can provide optimal conditions for intensive voice rehabilitation, especially for people with occupational voice disorders. The most numerous group of people with voice disorders are teachers. In Poland, they have an opportunity to take care of, or regain, their health during a one-year paid leave. The authors describe a multi-specialist model of extensive treatment of voice disorders in a health spa, including holistic and interdisciplinary procedures in occupational dysphonia. Apart from balneotherapy, the spa treatment includes vocal training exercises, relaxation exercises, elements of physiotherapy with the larynx manual therapy and psychological workshops. The voice rehabilitation organized already for two groups of teachers has been received with great satisfaction by this occupational group. The implementation of a model program of extensive treatment of voice disorders in a health spa should become one of the steps aimed at preventing occupational voice diseases.