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Steven L, Thompson J, Brown D. (2002)
Explores the role of physiotherapy in combination with SLT for a specific group of clients with voice disorder due to lack of postural neck mobility. Previous studies have shown the value of osteopathy in this condition, but this is not generally available on the NHS. Following the successful outcome of treating a 70-year-old client with a combination of manual physiotherapy and voice therapy, a pilot study was set up to be conducted over the period of one year. Unfortunately, due to exclusion criteria and withdrawals, the anticipated number of subjects was not achieved and only five patients could be included. This was an insufficient cohort for the study, and so the design was revised to a single case study conducted on a 69-year-old man with a hoarse high-pitched voice, reduced pitch range and intermittent aphonia. Traditional voice therapy procedures were carried out and laryngeal constriction treated by relaxation, retraction of false cords, and use of ingressive airstream. Manual physiotherapy was conducted using Maitland mobilisations to stiff segments as well as advice and exercises to improving general posture and neck posture. Improvements to voice use, quality and production, and to neck status were seen over the course of treatment, although no change had been effected in range of movement, perhaps due to the patient's osteoarthritis of the neck. A multicentre trial with larger numbers of patients is required to achieve a statistically valid evaluation of the treatment. Until that can be done, the authors believe this is a valuable adjunct to conventional dysphonia therapy for patients who use, and have difficulty in modifying, inappropriate high pitch.
Steven L, Thompson J, Brown D. (2002)
Explores the role of physiotherapy in combination with SLT for a specific group of clients with voice disorder due to lack of postural neck mobility. P…