Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
J Voice. 2020 Sep;34(5):657-666. doi: 10.1016/j.jvoice.2019.02.009. Epub 2019 May 9.
The aim of the present study was to investigate the immediate effect of the application of high-frequency Transcutaneous electrical nerve stimulation (TENS) in muscle tension dysphonia (MTD) patients with the pain complaint.
Thirty patients with MTD, 10 men and 20 women with a mean age of 36.40 ± 5.76 years, participated in the study. The patients were randomized into two groups: (1) Treatment group (TENS) (10 women and 5 men) and (2) Sham TENS group (10 women and 5 men). The treatment group (TENS) received a unique 20-minute session of high-frequency TENS. The sham TENS group was treated in the same condition as the treatment group and received a unique 20-minute session of high-frequency TENS, but no stimulation was given. Auditory-perceptual assessments, acoustic voice analysis, vocal tract discomfort (VTD), and musculoskeletal pain were used to compare the patients pre- and post-treatment.
There was a significant improvement in the asthenia parameter of auditory-perceptual assessment in the TENS group. This improvement in asthenia was significant when comparing the TENS group with the sham TENS group. These differences in the asthenia were not significant after using Holm-Bonferroni correction. A comparison of the VTD before and after the TENS application showed there was a significant reduction in the severity of the symptoms (burning, tight, dry, pain, tickling, sore, irritable, and lump in the throat). When comparing the TENS group with the sham TENS group, improvements in burn, tight, dry, pain, and irritable items of VTD were observed. However, after applying the Holm-Bonferroni correction, only reductions in dry and pain items remain significantly different between the groups. After the TENS application, the pain intensity was significantly reduced in the anterior and posterior neck, larynx, submandibular, masseter, temporal region, and upper back. After applying the Holm-Bonferroni correction, pain intensity reduction was significant in the anterior neck and larynx. When comparing the TENS group with the sham TENS group, pain intensity was reduced significantly in the larynx of the TENS group. This difference between the two groups was not significant after using Holm-Bonferroni correction. The pain and VTD assessments in the present study were performed using valid and reliable self-reported scales (NMSQ-E and VTD).
High-frequency TENS can be used in the voice treatment program of patients with MTD. MTD patients with pain complaint reported that their vocal tract discomfort and pain were decreased following the high-frequency TENS. Notably, these positive effects were obtained after a single session of high-frequency TENS application.
本研究旨在探讨高频经皮神经电刺激（TENS）应用于伴有疼痛主诉的肌肉紧张性发声障碍（MTD）患者的即时效果。
30 名 MTD 患者，10 名男性和 20 名女性，平均年龄 36.40±5.76 岁，参与了这项研究。患者被随机分为两组：（1）治疗组（TENS）（10 名女性和 5 名男性）和（2）假 TENS 组（10 名女性和 5 名男性）。治疗组（TENS）接受了独特的 20 分钟高频 TENS 治疗。假 TENS 组在与治疗组相同的条件下接受治疗，并接受了独特的 20 分钟高频 TENS 治疗，但没有给予刺激。在治疗前后使用听觉感知评估、声学语音分析、声带不适（VTD）和肌肉骨骼疼痛来比较患者。
TENS 组在听觉感知评估的乏力参数方面有显著改善。当将 TENS 组与假 TENS 组进行比较时，这种乏力的改善具有统计学意义。在用 Holm-Bonferroni 校正后，这些乏力差异不显著。TENS 应用前后 VTD 的比较显示，症状严重程度（烧灼感、紧绷感、干燥感、疼痛、刺痛感、酸痛感、易怒感和喉咙有异物感）显著降低。当比较 TENS 组与假 TENS 组时，观察到 VTD 的灼烧、紧绷、干燥、疼痛和易怒项目的改善。然而，在用 Holm-Bonferroni 校正后，只有干燥和疼痛项目的组间差异仍然具有统计学意义。TENS 应用后，颈部前、后、喉部、下颌下、咬肌、颞区和上背部的疼痛强度显著降低。在用 Holm-Bonferroni 校正后，颈部前、后和喉部的疼痛强度降低具有统计学意义。当比较 TENS 组与假 TENS 组时，TENS 组的喉部疼痛强度显著降低。在用 Holm-Bonferroni 校正后，两组之间的差异没有统计学意义。本研究中疼痛和 VTD 的评估使用了有效的、可靠的自我报告量表（NMSQ-E 和 VTD）。
高频 TENS 可用于 MTD 患者的嗓音治疗方案。伴有疼痛主诉的 MTD 患者报告说，他们的声带不适和疼痛在接受高频 TENS 治疗后减轻。值得注意的是，这些积极的效果是在单次高频 TENS 应用后获得的。
