Physical Therapy for Muscle Tension Dysphonia with Cervicalgia

Author:

Tate Alan D1ORCID,Tomlinson Carey A2,Francis David Oliver3,Wishik Emily D4,Lowery Anne S5,Watkins Mariel O6ORCID,Stewart Thomas G7,Gong Wu H7,Gilbert Mark R8,Garrett C Gaelyn4

Affiliation:

1. Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, San Antonio, TX, USA

2. Vanderbilt Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, TN, USA

3. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Wisconsin Surgical Outcomes Research Program, Madison, WI, USA

4. Vanderbilt Voice Center, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

5. Vanderbilt University Medical Center, Nashville, TN, USA

6. Meharry Medical College, Nashville, TN, USA

7. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA

8. Department of Otolaryngology-Head and Neck Surgery, University of Missouri Health Care, Missouri, MO, USA

Abstract

Objectives This study investigated the effectiveness of a specialized manual physical therapy (PT) program at improving voice among patients diagnosed with concomitant muscle tension dysphonia (MTD) and cervicalgia at a tertiary care voice center. Materials and Methods Cervicalgia was determined by palpation of the anterior neck. Both voice therapy (VT) and PT was recommended for all patients diagnosed with MTD and cervicalgia. PT included full-body manual physical therapy with myofascial release. Patients underwent: 1) VT alone, 2) concurrent PT and VT (PT with VT), 3) PT alone, 4) VT, but did not have PT ordered by treating clinician (VT without PT order) or 5) VT followed by PT (VT then PT). The pairwise difference in post–Voice Handicap Index-10 (VHI-10) controlling for baseline variables was calculated with a linear regression model. Results 178 patients met criteria. All groups showed improvement with treatment. The covariate-adjusted differences in mean post–VHI-10 improvement comparing the VT alone group as a reference were as follows: PT with VT 9.95 (95% confidence interval 7.70, 12.20); PT alone 8.31 (6.16, 10.45); VT without PT order 8.51 (5.55, 11.47); VT then PT 5.47 (2.51, 8.42). Conclusion Among patients diagnosed with MTD with cervicalgia, treatment with a specialized PT program was associated with improvement in VHI-10 scores regardless of whether they had VT. While VT is the standard of care for MTD, PT may also offer benefit for MTD patients with cervicalgia.

Publisher

SAGE Publications

Subject

Otorhinolaryngology

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