Summary
Objective
The study investigated effects of laryngeal manual therapy on different types of primary
muscle tension dysphonia (MTD-1).
Study Design
Interventional pre-test post-test design.
Methods
Thirty-two traditional Iranian singers (mean age of 36.75 ± 9.34 years.) diagnosed
with MTD-1, 8 female and 24 male, and recruited by convenience sampling completed
the study. MTD-1 was classified as Morrison and Rammage's types 1-5, based on standardized
criteria (1993). Pre-post-treatment measures were based on visual ratings of the larynx,
acoustic analyses, auditory-perceptual assessments of voice (Auditory-Perceptual Rating
Instrument for Operatic Singing Voice: EAI Scale Form), and the Persian Singing Voice
Handicap Index (P-SVHI), reported before and after 10 sessions of laryngeal manual
therapy (LMT).
Results
The most notable finding was that the number of cases with MTD-1 types 1 and 2 actually
increased after treatment, while the number of cases with MTD-1 types 3, 4 and 5 decreased.
The data suggested that MTD-1 types 3, 4, and 5 tended to convert to types 1 and 2
with LMT. Acoustic analyses showed a significant decrease in F0 (males only; P = 0.011), a sharp decrease in HNR from 23.26 dB to 14.74 dB (P = 0.000), and an increase in shimmer from 4.18% to 6.90 % while no appreciable change
was found in jitter (P = 0.57). Mean P-SVHI score decreased significantly from 52.03 to 41.16 (P = 0.002) and EAI score increased from 4.41 to 6.31 (P = 0.000) after treatment.
Conclusions
The primary finding was that the distribution of MTD-1 type changed after treatment
in many cases, converting from one to another type. Acoustic as well as glottal closure
measures for several participants revealed closure insufficiency after treatment,
unveiled as hyperfunction was unloaded with LMT. For those participants, complementary
treatments aimed at reinforcement of laryngeal closure functions would be appropriate.
Key Words
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Article info
Publication history
Published online: August 11, 2022
Accepted:
April 4,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of The Voice Foundation.
