Conde Mariana de Cásisa Macedo, Siqueira Larissa Thaís Donalonso, Vendramini José Eduardo, Brasolotto Alcione Ghedini, Guirro Rinaldo Roberto de Jesus, Silverio Kelly Cristina Alves
Department of the Bauru School of Dentistry/University of São Paulo-FOB/USP, Bauru, São Paulo, Brazil.
Speech-Language Pathology and Audiology Department of the State University of Central-West, UNICENTRO, Irati, Paraná, Brazil.
J Voice. 2018 May;32(3):385.e17-385.e25. doi: 10.1016/j.jvoice.2017.04.019. Epub 2017 May 19.
This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia.
Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests.
After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT.
TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results.
本研究旨在验证低频经皮电刺激神经疗法（TENS）和喉部手法治疗（LMT）对发音障碍女性肌肉骨骼疼痛、嗓音质量及自我报告症状的即时效果。
30名行为性发音障碍女性被随机分为TENS组和LMT组。所有参与者均完成疼痛调查，并在干预前后进行嗓音录音，以便进行后部感知和声学分析。TENS组接受一次独特的低频TENS治疗（20分钟）。LMT组接受LMT治疗（20分钟），并对胸锁乳突肌、舌骨上肌群和喉部进行轻柔、表浅的按摩。之后，志愿者报告其嗓音、喉部、呼吸和发音症状。通过参数检验和非参数检验对前后数据进行比较。
TENS治疗后，观察到颈部前后区域、肩部、上背部或下背部以及咬肌的疼痛强度降低。LMT治疗后，观察到颈部前部区域、肩部、下背部和颞部的疼痛强度降低。此外，TENS治疗后，元音/a/的不稳定性有所改善；LMT治疗后，嗓音质量总体改善，紧张度降低，言语呼吸声减少。TENS治疗后报告了积极的嗓音和喉部症状，LMT治疗后报告了积极的喉部症状和发音症状。
TENS和LMT可用于行为性发音障碍女性的嗓音治疗，二者均可被视为减轻肌肉骨骼疼痛并产生积极喉部症状的重要治疗手段。TENS和LMT均能部分改善嗓音质量，但TENS的效果更佳。
