The Effects of Cervical Spine Manipulation on Phonation in Patients with Muscle Tension Dysphonia

• Main Author: Maris, Robin Mark
• Format: Others
• Language: en
• Published: 2019
• Online Access: https://hdl.handle.net/10539/26555

A dissertation submitted to The Department of Speech Pathology and Audiology School of Human and Community Development Faculty of Humanities University of the Witwatersrand In fulfilment of the requirements of the degree Master of Arts in Speech-Pathology by research === Purpose: Muscle Tension Dysphonia is a debilitating condition that affects people throughout the world. It is characterised by decreased or complete loss of voice, partially caused by altered position or decreased movement of the larynx. The disorder negatively impacts the lives of those affected and inevitably leads to an increase in patient morbidity. Muscle tension dysphonia presents with various musculoskeletal symptoms and much success has been achieved in alleviating these symptoms through the use of various types of laryngeal manual therapy. As yet there has been no research into the effects of cervical spine manipulation on patients with Muscle Tension Dysphonia but there is currently research available that indicates that spinal manipulation is effective in reducing muscle inhibition. The proposed study aimed to show that cervical spine manipulation, through a decrease in inhibition of the extrinsic laryngeal muscles, would result in normalisation of laryngeal position and movement thus improving phonation in patients with Muscle Tension Dysphonia. Design: A descriptive, randomised, experimental, blinded design was used in this study. Method: The study aimed at determining the effects of cervical spine manipulation on phonation in patients suffering with Muscle Tension Dysphonia. The objectives were to document and compare results of the experimental participants and the comparison/control participants and to determine whether the effects were permanent or temporary. The experimental participants were treated with laryngeal manual therapy and cervical spine manipulation and the comparison/control participants received laryngeal manipulative therapy alone. A self-completing vocal tract discomfort scale and evaluation using the multidimensional voice program analysis (MDVP) was completed pre and post treatment for data collection and repeated again one week later. All voice recordings were then perceptually evaluated randomly The Effects of Cervical Spine Manipulation on Phonation in Patients with Muscle Tension Dysphonia viusing the GRBAS scale by a blinded speech therapist. The proposed research took the form of a descriptive experimental design with purposive sampling. The sample for the study included individuals that presented to the Voice and Swallowing Centre located in Parktown in Johannesburg, South Africa and who had been diagnosed with muscle tension dysphonia. The minimum number of experimental participants was initially 15 and 15 control participants. Unfortunately only 6 patients presented to the clinic with muscle tension dysphonia during the two year period that the study was conducted. The study made use of research assistants and data gleaned from the vocal tract discomfort scale and the acoustic evaluation was descriptively evaluated. Results: Changes in MDVP parameters, VTD scale and GRBAS were seen in both the experimental and control participants but these changes were inconsistent and inconclusive. Conclusion: Although a working model is presented to explain the effects of cervical spine manipulation on phonation in patients with MTD, the small sample size, the fact that all the participants suffered with secondary MTD and the inconsistency of the data does not make it possible to conclude that cervical spine manipulation results in positive vocal changes in these patients. === E.R. 2019