Inspiratory pressure threshold training for upper airway limitation: a case of bilateral abductor vocal fold paralysis

  • Susan E Baker
    Correspondence
    Address correspondence and reprint requests to Susan Baker, Department of Communication Sciences and Disorders, 63 Dauer Hall, PO Box 117420, University of Florida, Gainesville, FL 32611.
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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  • Christine M Sapienza
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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  • Danny Martin
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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  • Paul Davenport
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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  • Bari Hoffman-Ruddy
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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  • Gayle Woodson
    Affiliations
    From the Department of Communication Sciences and Disorders, Department of Physical Therapy, and Department of Physiological Sciences, University of Florida, Gainesville, Florida; §Department of Communicative Disorders, University of Central Florida, Orlando, Florida; and the Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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      Abstract

      Summary: A single subject design was used to determine if pressure threshold training strengthens the inspiratory muscles in a subject with a limited glottal airway as well as diminish dyspnea and improve parameters of speech. The subject was a 19-year-old woman whose glottal airway was limited due to bilateral abductor vocal fold paralysis following a thyroidectomy. A 5-week inspiratory muscle strength-training program was implemented using a pressure-threshold trainer to strengthen the inspiratory muscles with the intent of enabling the generation of higher inspiratory pressures. The pressure threshold on the trainer was set at 75% of the subject's maximum inspiratory pressure (MIP). The subject was required to generate sufficient inspiratory pressure to bring air through the trainer during an inspiratory maneuver. MIP was the dependent variable used as an indication of inspiratory muscle strength. MIP increased by 47% following the training program. Maximal minute ventilation and oxygen uptake increased posttraining. Dyspnea during exercise and speech decreased as reported by the subject. Total reading duration and pause duration demonstrated a declining trend during connected speech. The results indicated that inspiratory muscle training using a pressure threshold device improves functional tasks such as exercise and speech in a subject with upper airway limitation.

      Keywords

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