Abstract
Objectives
Laryngeal palpation is a routine clinical method for evaluation of patients with muscle
tension dysphonia (MTD). The aim of this study was to develop a new comprehensive
valid and reliable “laryngeal palpatory scale” (LPS), based on psychometric criteria.
Methods
The scale items were selected based on an in-depth analysis of the literature and
an expert focus group. Scale item generation and item reduction were followed by a
psychometric assessment. Qualitative and quantitative content validity (the content
validity ratio (CVR), content validity index (CVI)), the qualitative face validity,
and the inter-rater reliability were determined. For this purpose, 531 patients were
assessed and finally 55 patients with primary MTD (26 women, mean age: 40.8 years,
SD: 12.5; 29 male, mean age: 41.6 years, SD: 11.8) participated in the study. A weighted
kappa (k*) statistic was used to examine the inter-rater reliability for each single item.
Results
Based on the CVR, three items were omitted because they had a score of less than 0.62.
The CVI for all remaining items was greater than 0.79 and the scale CVI was equal
to 0.96. The final 45 items were a result of the study. The inter-rater reliability
for each single item ranged from 0.41 to 1, indicating moderate to almost perfect
agreement.
Conclusions
The LPS is a reliable and valid instrument for assessing patients with MTD. However,
future studies are needed to provide adequate data on sensitivity, specificity, concurrent
validity, and cutoff scores.
Key Words
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References
- The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia.Laryngoscope. 2009; 120: 306-312
- Description of laryngeal pathologies by age, sex, and occupation in a treatment-seeking sample.J Speech Hear Disord. 1988; 53: 57-64
- Laryngeal manipulation.Otolaryngol Clin North Am. 2000; 33: 1017-1034
- Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge.J Voice. 2011; 25: 202-207
- Verdolini K. Rosen C.A. Rosen C.A. Branski R.C. Classification Manual for Voice Disorders-I. Psychology Press, 2014
- Manual circumlaryngeal techniques in the assessment and treatment of voice disorders.Curr Opin Otolaryngol Head Neck Surg. 1998; 6: 151-155
- Principles and techniques of manual therapy: applications in the management of dysphonia.in: Harris T. Harris S. Rubin J. Howard D.M. The Voice Clinic Handbook. Whurr Publishers Ltd, London1998: 91-138
- Extrinsic laryngeal muscular tension in patients with voice disorders.J Voice. 2002; 16: 333-343
- Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia.J Voice. 2009; 23: 353-366
- Muscular tension and body posture in relation to voice handicap and voice quality in teachers with persistent voice complaints.Folia Phoniatr. 2005; 57: 134-147
- Pattern recognition in muscle misuse voice disorders: how I do it.J Voice. 1997; 11: 108-114
- Review on laryngeal palpation methods in muscle tension dysphonia: validity and reliability issues.J Voice. 2015; 29: 459-468
- Clinical Voice Disorders: An Interdisciplinary Approach.3rd ed. Thieme, New York, NY1990
- Assessment and treatment of musculoskeletal tension in hyperfunctional voice disorders.Int J Speech-Lang Pathol. 2008; 10: 195-209
- Muscle tension dysphonia and spasmodic dysphonia: the role of manual laryngeal tension reduction in diagnosis and management.Ann Otol Rhinol Laryngol. 1996; 105: 851-856
- Effects of the manual laryngeal musculoskeletal tension reduction technique as a treatment for functional voice disorders: perceptual and acoustic measures.J Voice. 1993; 7: 242-249
- Outcome of laryngeal manual therapy in four Dutch adults with persistent moderate-to-severe vocal hyperfunction: a pilot study.J Voice. 2004; 18: 467-474
- The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.J Voice. 2010; 24: 294-301
- Assessment of the influence of osteopathic myofascial techniques on normalization of the vocal tract functions in patients with occupational dysphonia.Int. J Occup Med Environ Health. 2012; 25: 225-235
- Surface EMG and related measures in normal and vocally hyperfunctional speakers.J Speech Hear Disord. 1989; 54: 68-73
- The irritable larynx syndrome.J Voice. 1999; 13: 447-455
- Comparison between palpatory findings of the hyoid position and their acoustic, videostroboscopic, and perceptual attributes in patients with muscle tension dysphonia (with and without organic lesions).J Voice. 2013; 27: 78-83
- An examination of surface EMG for the assessment of muscle tension dysphonia.J Voice. 2013; 27: 177-186
- Comparison of neck tension palpation rating systems with surface electromyographic and acoustic measures in vocal hyperfunction.J Voice. 2011; 25: 67-75
- Individual-patient monitoring in clinical practice: are available health status surveys adequate?.Qual Life Res. 1995; 4: 293-307
- Determination and quantification of content validity.Nurs Res. 1986; 35: 382-385
- Two quantitative approaches for estimating content validity.West J Nurs Res. 2003; 25: 508-518https://doi.org/10.1177/0193945903252998
- Content validity and its estimation.J Med Educ. 2003; 3: 25-27
- Qualitative assessment of the content validity of the Dermatology Life Quality Index in patients with moderate to severe psoriasis.J Dermatolog Treat. 2013; 24: 50-59https://doi.org/10.3109/09546634.2011.631980
- Current concepts in validity and reliability for psychometric instrument theory and application.Am J Med. 2006; 119 (e7-16): 166
- Critical values for Lawshe's content validity ratio: revisiting the original methods of calculation.Meas Eval Couns Dev. 2014; 47: 79-86https://doi.org/10.1177/0748175613513808
- Factors affecting the use of computerized information systems in community health.([PhD thesis]) University of Wollongong, Australia1997
- Ensuring content validity: an illustration of the process.J NursMeas. 2001; 9: 201-215
- Psychometric Theory.3rd ed. McGraw-Hill, New York1994
- Using qualitative methods to improve questionnaires for Spanish speakers: assessing face validity of a food behavior checklist.J Am Diet Assoc. 2010; 110: 80-90https://doi.org/10.1016/j.jada.2009.10.002
- The measurement of observer agreement for categorical data.Biometrics. 1977; : 159-174
- Principles and techniques of manual therapy: application in the management of dysphonia.in: Harris T. Harris S. Rubin J.S. Howard D.M. The Voice Clinic Handbook. Whurr Publishers, New York, NY2002: 91-138
- Prevalência de dor musculoesquelética em professors.Rev Bras Epidemiol. 2009; 12: 604-614
- Zervikale Dysphonie.Folia Phoniatr Logop. 1991; 43: 181-196
- Sataloff R.T. Treatment of Voice Disorders. Plural Publishing, 2005
- Understanding and Treating Psychogenic Voice Disorder: a CBT Framework.John Wiley & Sons, 2007
- Performance stress in professional voice users.in: Dejonckere P.H. Occupational Voice: Care and Cure. Kugler, The Hague2001: 81-100
- Muscle misuse voice disorders: description and classification.Acta Otolaryngol. 1993; 113: 428-434
Noyelles J.D. Short muscles vs. tight muscles. Move physical therapy. Health and Nutrition Newsletter. http://movephysicaltherapy.com/short-muscles-vs-tight-muscles/.
- Liebenson C. Rehabilitation of the Spine: a Practitioner's Manual. Lippincott Williams & Wilkins, 2007
- MRI anatomical and morphological differences in the vocal tract between dysphonic and normal adult women.J Voice. 2011; 25: 743-750
- The cricothyroid mechanism, its relation to vocal fatigue and vocal dysfunction.InVoice Forum. 1993; 2: 89-96
- Laryngeal manual compression in the evaluation of patient for laryngeal framework surgery.in: Gauffin J. Hammarberg B. Vocal Fold Physiology. Whurr and Co., London1991: 207-212
- Diagnostic criteria in functional dysphonia.Laryngoscope. 1986; 96: 1-8
- Muscular tension dysphonia.J Otolaryngol. 1983; 12: 302-306
- Manual circumlaryngeal therapy for functionaldysphonia: an evaluation of short-and long-term treatment outcomes.J Voice. 1997; 11: 321-331
- Position of the hyoid and larynx in people with muscle tension dysphonia.Laryngoscope. 2012; 122: 370-377
Article info
Publication history
Published online: October 12, 2018
Accepted:
September 5,
2018
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
