Research Article

Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course


Introduction: This study aimed to investigate the effect of Mathieson laryngeal manual therapy (MLMT) following a therapeutic course in patients with primary muscle tension dysphonia (MTD).
Materials and Methods: Twelve patients with primary MTD participated in this study. At first, videostroboscopy and perceptual voice assessment was performed, and the Persian version of vocal tract discomfort (VTDp) scale was completed. After two and a half weeks that patients received no treatment, the assessments were repeated to evaluate the effect of spontaneous recovery. For studying the effect of MLMT, it was presented in five sessions. Then, all assessments were repeated. The frequency of supraglottic activity was elicited. For the perceptual evaluation and VTDp, the Wilcoxon nonparametric test was used to study and compare the effect of spontaneous recovery and MLMT.
Results: After spontaneous recovery, a significant difference was observed only in strain (P<0.05). After MLMT, the frequency of supraglottic activity decreased, and perceptual voice parameters significantly changed (P<0.05), but the VTDp showed no significant difference (P>0.05). There was no significant difference between spontanous recovery and MLMT based on the paerceptual voice evaluation and VTDp scale (p>0.05).
Conclusion: The MLMT can remarkably improve the supraglottic activity and perceptual characteristics of voice in primary MTD after a therapeutic course. Further studies are recommended to confirm the effectiveness of MLMT on decreasing VTD sensations.

1. khoddami S.M, Ansari N.N, Izadi F. The Assessment methods of laryngeal muscles activity in MTD. hindawi publishing corporation. the scienthfhc world journal. volume 2013 ID 507379, 6 pages.
2. Boon D.R, Mcfarlane S.C, VonBerg S.L. the voice and voice thrapy. chapture voice disorders.7th.ed, 2005 Englewood Cliffs, NJ: Prentice hall. p1-100
3. Colton R.H, Casper J.K. Understanding voice problem: A phisiyological perspective for diagnosis and treatment.6th edition2006. Baltimore, MD: Lippincott Williams and wilkins .
4. Mathieson L, Hirani S, Epstein R, Baken R, Wood G, Rubin J. Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia. Journal of Voice. 2009;23(3):353-66.
5. Mathieson L, Greene M, Baken R.J. Greene and Mathieson's the Voice and Its Disorders.chapture 7; hyperfunctional voice disorders-muscle tension dysphonia. 6th ed2001. whurr publisher Ltd. london and philadelphia.2001:498-501.
6. Amiri-Shavaki Y, Jenabi M.S, Ghelichi L. voice hygiene for teachers. Andishmand journal . 1385; volume1.
7. ROY N, Ford C.N, Bless D.M. Muscle Tension dysphonia and spasmodic dysphonia: the role of manual laryngeal tension reduction in diagnosis and management. Ann otol rhinol laryngol. 1996;105(11):851-856.
8. Stemple J.C, Roy N, Klaben B. Clinical voice pathology: theory and management. plural publishing, Inc; 5th edition jan 2014. san diego .p. 205-214.
9. Riemann AP, Siqueira L, Rondon A.V, Brasolotto AG, Silverio K. Immediate effect of laryngeal manual therapy in dysphonic individuals.journal CoDAS. 2016;28(1):59-65.
10. Salehi A, Barkmeier-Kraemer J. laryngeal manual therapy as a treatment for impaired production of tahrir vibrato in traditional Iranian singers. Folia phoniatr logop. 2014;66(6):265-272.
11. Siqueira L.T.D, Silverio K.C.A, Brasolloto A.G. Effects of laryngeal manualtherapy and transcutaneous electrical nerve stimulation in vocal folds diadochokinesis of dysphonic women: a randomized clinical trial. journal CoDAS. 2017;29(3).
12. Roy N, Leeper H.A. Effect of manual laryngeal muskoskeletal tension reduction technique as a treatment for functional voice disorders: perceptual and acoustic measure. Journal of Voice. 1993;7:242-9.
13. Roy N, Bless D.M, Heisy D, Ford C.N. Manual circumlaryngeal therapy for functional dysphonia: an evalution of short and longterm treatment outcome. Journal of Voice. 1997;11(3):321-331.
14. Ternstorm S, Andersson M, Bergman U. An effect of body massage on voice loudness and phonation frequency in reading. logoped phoniatr vocol. 2000;25(4):146-150.
15. Vanlierde K.M, Deley S, Debodt M, VanCauwanberge P. outcome of manual laryngeal therapy in four dutch adult with persistent moderate to severe vocal hyperfunction: apilot study. Journal of Voice. 2004;18(4):467-74.
16. Rubin J.S, Liberman J, Harris T.M. Laryngeal manipulation. Otolaryngol clin north AM. 2000;33(5):1017-1034.
17. Poburka B.J, Patel R.R, Bless D.M. Voice-vibratory assessment with laryngeal imaging (VALI) form: Reliability of rating stroboscopy and high-speed videoendoscopy. Journal of Voice. 2017;31(4):513. e1-. e14.
18. Torabi H, Khoddami S.M, Ansari N.N, Dabirmoghaddam P. The Vocal Tract Discomfort Scale: validity and reliability of the Persian version in the assessment of patients with muscle tension dysphonia. Journal of Voice. 2016;30(6):711-6.
19. SalaryMajd N, Khoddami S.M, Drinnan M, Kamali M, Amiri-Shavaki Y, Fallahian N. Validity and rater reliability of Persian version of the Consensus Auditory Perceptual Evaluation of Voice. Bimonthly Audiology-Tehran University of Medical Sciences. 2014;23(3):65-74.
20. Mathieson L. Vocal tract discomfort in hyperfunctional dysphonia. Journal of Voice. 1993;2:40-8.
21. Khoramshahi H, Khatoonabadi A.R, Khoddami S.M, Dabirmoghaddam P, Ansari N.N. Responsiveness of Persian Version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), Persian Version of Voice Handicap Index (VHI), and Praat in Vocal Mass Lesions with Muscle Tension Dysphonia. Journal of Voice. 2018;32(6):770. e21-. e30.
22. Mansuri B, Torabinejad F, Jamshidi A.A, Dabirmoghaddam P, Vasaghi-gharamaleki B, Ghelichi L. Transcutaneous Electrical Nerve Stimulation Combined With Voice Therapy in Women With Muscle Tension Dysphonia. journal of vocie. 2020;34(3):490.
IssueVol 15 No 2 (2021) QRcode
SectionResearch Article(s)
Muscle tension dysphonia Manual therapy Perceptual Self assessment

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Fallah M, Khoddami SM, Jalaie S, Aghazadeh K, Rezaei Rad A. Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course. jmr. 15(2):73-82.