{"title":"喉部手法治疗对原发性肌张力性发音障碍(MTD-1)的影响:对 MTD-1 型的影响。","authors":"Nassim Ahmadi , Katherine Verdolini Abbott , Fatemeh Rajati , Seyyedeh Maryam Khoddami , Farhad Torabinezhad , Ismail Ebrahimi Takamjani , Behnoosh Vasaghi-Gharamaleki","doi":"10.1016/j.jvoice.2022.04.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The study investigated effects of laryngeal manual therapy on different types of primary muscle tension dysphonia (MTD-1).</div></div><div><h3>Study Design</h3><div>Interventional pre-test post-test design.</div></div><div><h3>Methods</h3><div>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<span>, 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).</span></div></div><div><h3>Results</h3><div>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; <em>P</em> = 0.011), a sharp decrease in HNR from 23.26 dB to 14.74 dB (<em>P</em> = 0.000), and an increase in shimmer from 4.18% to 6.90 % while no appreciable change was found in jitter (<em>P</em> = 0.57). Mean P-SVHI score decreased significantly from 52.03 to 41.16 (<em>P</em> = 0.002) and EAI score increased from 4.41 to 6.31 (<em>P</em> = 0.000) after treatment.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1377-1385"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Laryngeal Manual Therapy on Primary Muscle Tension Dysphonia (MTD-1): Implications for MTD-1 Type\",\"authors\":\"Nassim Ahmadi , Katherine Verdolini Abbott , Fatemeh Rajati , Seyyedeh Maryam Khoddami , Farhad Torabinezhad , Ismail Ebrahimi Takamjani , Behnoosh Vasaghi-Gharamaleki\",\"doi\":\"10.1016/j.jvoice.2022.04.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>The study investigated effects of laryngeal manual therapy on different types of primary muscle tension dysphonia (MTD-1).</div></div><div><h3>Study Design</h3><div>Interventional pre-test post-test design.</div></div><div><h3>Methods</h3><div>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<span>, 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).</span></div></div><div><h3>Results</h3><div>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; <em>P</em> = 0.011), a sharp decrease in HNR from 23.26 dB to 14.74 dB (<em>P</em> = 0.000), and an increase in shimmer from 4.18% to 6.90 % while no appreciable change was found in jitter (<em>P</em> = 0.57). Mean P-SVHI score decreased significantly from 52.03 to 41.16 (<em>P</em> = 0.002) and EAI score increased from 4.41 to 6.31 (<em>P</em> = 0.000) after treatment.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":49954,\"journal\":{\"name\":\"Journal of Voice\",\"volume\":\"38 6\",\"pages\":\"Pages 1377-1385\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Voice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0892199722001060\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Voice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0892199722001060","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
Effects of Laryngeal Manual Therapy on Primary Muscle Tension Dysphonia (MTD-1): Implications for MTD-1 Type
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.
期刊介绍:
The Journal of Voice is widely regarded as the world''s premiere journal for voice medicine and research. This peer-reviewed publication is listed in Index Medicus and is indexed by the Institute for Scientific Information. The journal contains articles written by experts throughout the world on all topics in voice sciences, voice medicine and surgery, and speech-language pathologists'' management of voice-related problems. The journal includes clinical articles, clinical research, and laboratory research. Members of the Foundation receive the journal as a benefit of membership.