ABSTRACT
The present study aimed to carry out a systematic review of the effects of voice therapy on individuals diagnosed with muscle tension dysphonia (MTD) or hyperfunctional dysphonia. This is a systematic literature review on the databases Medline (via PubMed), Cochrane Library, Scopus, and Lilacs using a search strategy related to the theme of the study. The selection included clinical trials that assessed the effects of speech therapy intervention on patients diagnosed with MTD or hyperfunctional dysphonia published over the last 10 years in Portuguese, English, or Spanish. The Physiotherapy Evidence-Based Database (PEDro) Scale was used to assess the methodology of the studies. Of the 634 publications, 12 studies were included in this review, of which three were excluded due to a low score on the PEDro Scale, resulting in a final number of nine publications. Regarding the techniques approached, semioccluded vocal tract exercises (22.22%), nasal sound and frequency modulation (22.22%), maximum phonation time (MPT) technique and vocal hygiene (11.11%), vocal function exercises (11.11%), respiratory exercises along with phonoarticulatory sounds (11.11%), manual laryngeal therapy (11.11%), and manual laryngeal therapy associated with respiratory exercises (11.11%) were identified. These techniques promoted the following effects: improvement in intraoral and subglottal pressure, positive alterations in the glottal contact quotient, significant changes in fundamental frequency measures, increased MPT, and reduced voice roughness. Methodology was identified to be a shortcoming in the studies. The clinical trials reviewed showed positive results in using the therapeutic techniques selected in the speech therapy approach.
Subject(s)
Dysphonia/therapy , Muscle Tonus , Phonation , Vocal Cords/physiopathology , Voice Quality , Voice Training , Adolescent , Adult , Aged , Aged, 80 and over , Dysphonia/diagnosis , Dysphonia/etiology , Dysphonia/physiopathology , Female , Humans , Male , Middle Aged , Recovery of Function , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: This study aimed to verify the effects of a voice therapy program focusing on patients with muscle tension dysphonia (MTD). PATIENTS AND METHODS: The sample comprised 30 participants diagnosed with MTD, 8 men and 22 women, none of whom was a voice professional. The assessments and reassessments employed the perceptual-auditory protocol GRBASI, measures of maximum phonation times, s/z ratio, and acoustic voice analysis. The voice therapy program included indirect and direct therapy approaches. RESULTS: All parameters assessed using the GRBASI protocol improved following treatment, particularly in regard to lowering voice strain, which is important when treating MTD. The average overall maximum phonation times increased from 8.15 to 10.8 s, while the average s/z ratio did not significantly change. Among the various acoustic parameters, a positive difference was observed for vocal jitter and shimmer. CONCLUSIONS: The therapeutic approach adopted in this study proved effective in the treatment of primary and secondary MTD. Speech therapy favored lower phonation effort, lowered vocal strain, and adequacy of adjustment of laryngeal muscles.
