Wpływ wibracyjnej terapii stymulującej na jakość głosu w postaci hiperfunkcjonalnej dysfonii zawodowej

Neuromuscular electrical stimulation improves swallowing initiation in patients with post-stroke dysphagia

Objective

More than half of post-stroke patients develop dysphagia, which manifests as delayed swallowing and is associated with a high risk of aspiration. In this study, we aimed to investigate the immediate effect of neuromuscular electrical stimulation (NMES) on swallowing initiation in post-stroke patients using videofluoroscopic swallowing study (VFSS) data.

Materials and methods

This randomized, self-controlled crossover study included 35 patients with post-stroke dysphagia. All selected patients received real and sham NMES while swallowing 5 ml of thin liquid. Participants completed the conditions in random order, with a 10-min interval between conditions. The primary evaluation indicators included the Modified Barium Swallow Impairment Profile-6 (MBSImp-6) and Penetration-Aspiration Scale (PAS). Secondary indicators included oral transit time (OTT), pharyngeal transit time (PTT), and laryngeal closure duration (LCD).

Results

Modified Barium Swallow Impairment Profile-6 (P = 0.008) and PAS (P < 0.001) scores were significantly lower in the Real-NMES condition than in the Sham-NMES condition. OTT (P < 0.001) was also significantly shorter during Real-NMES than during Sham-NMES. However, LCD (P = 0.225) and PTT (P = 0.161) did not significantly differ between the two conditions.

Conclusion

Neuromuscular electrical stimulation may represent a supplementary approach for promoting early feeding training in patients with post-stroke dysphagia.

Clinical trial registration

[https://clinicaltrials.gov/], identifier [ChiCTR2100052464].

A Case of Nervus Laryngeus Superior Paresis Treated With Novafon Local Vibration Voice Therapy

OBJECTIVE

The aim of the study is to present a case of chronic idiopathic superior laryngeal nerve paresis (SLNp) treated with a novel voice therapy approach called Novafon Local Vibration Voice Therapy (NLVVT).

METHODS

Outcome measurements including acoustics, aerodynamics, and self-perception of voice handicap were acquired before intervention (i.e., NLVVT) and after intervention (i.e.,follow-up). The use of NLVVT was modified from previous reports of use in functional voice disorders for application to a neurological voice disorder (SLNp).

RESULTS

The results showed that NLVVT had meaningful improvements in Voice Range Profile boundaries, an increase in speaking fundamental frequency, and improved acoustic indices of voice quality in a case of SLNp. The follow-up after NLVVT intervention revealed maintenance of the post-treatment improvements at a 1-month measurement interval.

CONCLUSION

The NLVVT program may have potential to improve voice quality and vocal function in a case of SLNp. Further research is necessary to test a potential effectiveness for NLVVT applied to vocal fold immobility due to paresis in both larger numbers of patients and more well-designed, controlled experiments.

Vibrational Therapies for Vocal Fatigue

BACKGROUND

Vibration is commonly used to relax tension in the limb and truck muscle. Vibration used directly on the muscle concerned and vertical vibration used on the whole-body through a foot platform have been reported in the literature to be useful to release muscle tension.

AIM

The present study investigated the effect of indirect whole-body vibration (WBV) and direct localized perilaryngeal vibration (LPV) on the phonatory functions of nondysphonic individuals with vocal fatigue.

METHODS

Forty-four subjects (mean age = 21.67 years) with normal voice, were randomly assigned to either the WBV group, the LPV group, or the Control (sham hand-held vibratory device) group. They performed karaoke singing for at least 95 minutes. They then received either WBV through a Turbosonic vibratory machine, LPV with a Novofan vibrator, or a sham vibrator for 10 minutes. The highest pitch produced, and self-reported vocal fatigue score were taken before singing, after singing, and after the intervention. Data were analyzed separately for the gender subgroups.

RESULTS

All subject groups showed significant reduction of vocal function (highest pitch production, and vocal fatigue score) after singing. Following the vibrational interventions, both the WBV and LPV groups showed significantly recovery in the highest pitch production and the perception of vocal fatigue (P < 0.002) than the Control groups.

CONCLUSION

Vibrational therapy, whether it is localized vibration on the peri-laryngeal muscles, or whole-body vibration, is more effective than voice rest per se in relieving vocal fatigue. Vibrational methods are recommended for treating vocal fatigue.