Jennifer Craig1, Carey Tomlinson2, Kristin Stevens3, Kiran Kotagal4, Judith Fornadley5, Barbara Jacobson6, C Gaelyn Garrett7, David O Francis8. 1. Vanderbilt Voice Center, 1215 21st Ave South, 7302 Medical Center East, South Tower, Nashville, TN 37212, United States. Electronic address: Jennifer.n.craig@vanderbilt.edu. 2. Vanderbilt Dayani Center, Nashville, TN 37212, United States. 3. Vanderbilt University School of Medicine, Nashville, TN 37212, United States. 4. Northwest Clinic for Voice and Swallowing, United States. 5. University Health-Shrevport, United States. 6. Vanderbilt Department of Hearing and Speech Sciences, United States. 7. Vanderbilt Voice Center, 1215 21st Ave South, 7302 Medical Center East, South Tower, Nashville, TN 37212, United States. 8. Vanderbilt Voice Center, 1215 21st Ave South, 7302 Medical Center East, South Tower, Nashville, TN 37212, United States; Center for Surgical Quality and Outcomes Research, United States.
Abstract
OBJECTIVE: This study investigated the role of a specialized physical therapy program for muscle tension dysphonia patients as an adjunct to standard of care voice therapy. STUDY DESIGN: Retrospective Cohort Study Methods Adult MTD patients seen between 2007 and 2012 were identified from the clinical database. They were prescribed voice therapy and, if concomitant neck pain, adjunctive physical therapy. In a pragmatic observational cohort design, patients underwent one of four potential treatment approaches: voice therapy alone (VT), voice therapy and physical therapy (VT+PT), physical therapy alone (PT), or incomplete/no treatment. Voice handicap outcomes were compared between treatment approaches. RESULTS: Of 153 patients meeting criteria (Median age 48 years, 68% female, and 30% had fibromyalgia, chronic pain, chronic fatigue, depression, and/or anxiety), there was a similar distribution of patients with moderate or severe pre-treatment VHI scores across treatment groups (VT 45.5%, VT+PT 43.8%, PT 50%, no treatment 59.1%; p=0.45). Patients treated with VT alone had significantly greater median improvement in VHI than those not treated: 10-point vs. 2-point (p=0.02). Interestingly, median VHI improvement in patients with baseline moderate-severe VHI scores was no different between VT (10), VT+PT (8) and PT alone (10; p=0.99). CONCLUSIONS: Findings show voice therapy to be an effective approach to treating MTD. Importantly, other treatment modalities incorporating physical therapy had a similar, albeit not significant, improvement in VHI. This preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of MTD patients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. LEARNING OUTCOMES: The reader will describe symptoms associated with muscle tension dysphonia and current treatment. The reader will describe the systematic adjunctive physical therapy approach and understand the rationale to consider incorporation of physical therapy into the current treatment regimen.
OBJECTIVE: This study investigated the role of a specialized physical therapy program for muscle tension dysphoniapatients as an adjunct to standard of care voice therapy. STUDY DESIGN: Retrospective Cohort Study Methods Adult MTDpatients seen between 2007 and 2012 were identified from the clinical database. They were prescribed voice therapy and, if concomitant neck pain, adjunctive physical therapy. In a pragmatic observational cohort design, patients underwent one of four potential treatment approaches: voice therapy alone (VT), voice therapy and physical therapy (VT+PT), physical therapy alone (PT), or incomplete/no treatment. Voice handicap outcomes were compared between treatment approaches. RESULTS: Of 153 patients meeting criteria (Median age 48 years, 68% female, and 30% had fibromyalgia, chronic pain, chronic fatigue, depression, and/or anxiety), there was a similar distribution of patients with moderate or severe pre-treatment VHI scores across treatment groups (VT 45.5%, VT+PT 43.8%, PT 50%, no treatment 59.1%; p=0.45). Patients treated with VT alone had significantly greater median improvement in VHI than those not treated: 10-point vs. 2-point (p=0.02). Interestingly, median VHI improvement in patients with baseline moderate-severe VHI scores was no different between VT (10), VT+PT (8) and PT alone (10; p=0.99). CONCLUSIONS: Findings show voice therapy to be an effective approach to treating MTD. Importantly, other treatment modalities incorporating physical therapy had a similar, albeit not significant, improvement in VHI. This preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of MTDpatients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. LEARNING OUTCOMES: The reader will describe symptoms associated with muscle tension dysphonia and current treatment. The reader will describe the systematic adjunctive physical therapy approach and understand the rationale to consider incorporation of physical therapy into the current treatment regimen.
Authors: P G C Kooijman; F I C R S de Jong; M J Oudes; W Huinck; H van Acht; K Graamans Journal: Folia Phoniatr Logop Date: 2005 May-Jun Impact factor: 0.849
Authors: Jarrad H Van Stan; John Whyte; Joseph R Duffy; Julie Barkmeier-Kraemer; Patricia Doyle; Shirley Gherson; Lisa Kelchner; Jason Muise; Brian Petty; Nelson Roy; Joseph Stemple; Susan Thibeault; Carol Jorgensen Tolejano Journal: Am J Speech Lang Pathol Date: 2021-08-31 Impact factor: 2.408