Combined treatment of muscle tension dysphonia: voice therapy with instrumental postural rehabilitation

Objectives. This investigation aimed to propose a new rehabilitation technique that com-bines voice exercises and instrumental postural rehabilitation for patients with muscle ten-sion dysphonia (MTD). Methods. We enrolled nine dysphonic patients (8 women and 1 man, aged 22-55 years). Voice assessment included strobovideolaryngoscopy, Maximum Phonation Time (MPT), perceptual evaluation by GRBAS scale and patient's self-rating by Italian version of the Voice Handicap Index (VHI). Vestibular function was evaluated by the Bed Side Examina-tion and Video Head Impulse test (VHIT). Postural control was evaluated by Dynamic Pos-turography (DP) using the Sensory Organization Test (SOT) and analysing the Equilibrium Score (ES) and balance subsystems (somatosensorial, visual, vestibular).Results. All cases underwent different types of voice exercises combined with balance training based on NeuroCom Balance Master Protocols, once a week for six 35-minutes sessions. After therapy, an improvement in MPT, VHI, GRBAS scores and endoscopic la-ryngeal features was obtained. DP results at baseline were normal and after therapy we showed a slight improvement of ES (somatosensorial and visual components).Conclusions. A combined rehabilitation technique for MTD, by improving the attention to postural control, allows for significant improvement in vocal symptoms.