Faculty of Physical Education, Sport and Rehabilitation, University School of Physical Education in Poznań, Poznań, Poland.
Int J Occup Med Environ Health. 2012 Jun;25(3):225-35. doi: 10.2478/S13382-012-0041-7. Epub 2012 Jun 22.
Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia.
Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chi-square McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment.
The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination.
The use of osteopathic therapy helps significantly improve the functions of the vocal tract in patients with occupational dysphonia.
职业性嗓音障碍伴有喉外肌张力增加，改变了喉的位置，从而扰乱了声道的功能状态。本研究的目的是评估整骨疗法在职业性发声障碍的诊断和治疗中的应用。
研究对象包括 40 名患有慢性声带疾病的教师（38 名女性和 2 名男性），年龄 39 至 59 岁（平均年龄：48.25 岁）。在嗓音治疗前后，根据利伯曼方案进行整骨检查，以及包括喉频闪喉镜检查（LVSS）在内的语音检查，评估最长发声时间（MPT）和嗓音障碍指数（VHI）评分。由喉科语音病理学家计划和监督、言语语言病理学家进行的嗓音治疗，辅以喉的整骨肌筋膜康复。在统计评估中应用了卡方 McNemar 检验和非参数 Wilcoxon 配对检验。
应用包括整骨和嗓音治疗在内的跨学科治疗，可使提升喉的肌肉（环甲韧带、胸锁乳突肌和咽缩肌）的触压痛以及降低张力（舌骨肌、咽缩肌和胸锁乳突肌）显著下降，具有统计学意义。在测试滑音和打哈欠时的环杓关节功能障碍以及甲状舌骨肌装置的不对称性方面，也观察到显著改善。此外，治疗还显著改善了头部位置的正常化和身体重心的控制。在语音检查方面，包括 VHI 评分、MPT 结果和频闪喉镜检查参数，治疗后也有显著改善。
在职业性发声障碍患者中，整骨疗法有助于显著改善声道功能。
