17 - Treatment Exercises Flashcards
What are vocal function exercises used for?
3
Increasing STRENGTH of the laryngeal muscles
Increasing ENDURANCE of the laryngeal muscles
Increasing COORDINATION of the laryngeal muscle.
Who created Vocal Function Exercises?
Do you need to be certified to teach these?
Joseph Stemple
No
What are vocal function exercises (VFEs)?
A four-step program completed twice per day by the patient
What areas are targeted by VFEs?
3
Respiration
Phonation
Resonance
What three things are included in vocal function exercises?
Vocal warm-up
Pitch glides
Sustained vowels at specific pitches.
Who can vocal function exercises be useful to?
2
All ages
Variety of hyper- and hypofunctional disorders.
What is a characteristic of HYPERfunctional voice disorders?
Increased laryngeal tension
What is a characteristic of HYPOfunctional voice disorders?
2
Reduced function
Low muscular effort
What conditions or disorders can Vocal Function Exercises be useful for?
(8)
Parkinson’s
Myasthenia Gravis
Presbylaryngis
Muscle Tension Dysphonia
Vocal Fold Paralysis
Vocal Polyps
Vocal Nodules
Vocal Cysts.
What are the four steps in Vocal Function Exercises?
Warm-up
Stretching
Contracting
Adductory Power
What is the Warm Up portion of Vocal Function Exercises?
Sustain the vowel /i/ for as long as possible on the musical note
(ugly and obnoxious sound)
What is the Stretching portion of Vocal Function Exercises?
1+4
Glide from your lowest note to your highest note
- On word “knoll”
- On tongue trill
- On lip trill
- On word “whoop.”
What is the Contracting portion of Vocal Function Exercises?
1+4
Glide from comfortable high note to your lowest note
- On word “knoll”
- On tongue trill
- On lip trill
- On word “boom.”
What is the Adductory Power portion of Vocal Function Exercises?
(2)
Sustain the musical notes (C-D-E-F-G) for as long as possible
Use sound “ol”.
What is Resonant Voice Therapy?
3
Voice production involving oral vibratory sensations
Made in the context of easy phonation
Focus toward anterior aspects of the vocal tract.
Who can Resonant Voice Therapy be useful for?
5
Professional voice users
Muscle tension dysphonia
Hypo- and hyperfunctional voice disorders
Vocal fold lesions
Mild vocal atrophy and paralysis
What is the emphasis of Resonant Voice Therapy?
3
Frontal tone focus
Increasing levels of loudness
Achieving an optimal balance of oronasal resonance.
What are the basic training gestures of Resonant Voice Therapy?
(4)
Hmmm-molm-molm-molm-molm…. as a sigh
Extreme forward focus (with appropriate breath support)
Abdominal breathing to support the tone production with VF constriction at the extreme end of the resonators.
Patient should feel relaxed at the end of the gestures.
What are the three stages of Resonant Voice Therapy?
Stage 1: All voiced
Stage 2: Voice-Voiceless Consonants
Stage 3: Any phrase
What is the goal of Lussac-Madsen Resonant Voice Therapy?
2
Producing the strongest voice possible
Using least amount of stress on the vocal folds and respiratory system.
What population is Lussac-Madsen Resonant Voice Therapy use in?
Adolescents and adults with hypo- and hyperfunctional voice disorders
What is the treatment protocol for Lussac-Madsen Resonant Voice Therapy?
(3)
30-45 minutes per session
Once or twice a week
4-8 weeks
What is the focus of Lussac-Madsen Resonant Voice?
2
Using sensory information to help self-monitoring
Concentrates on auditory feedback.
What are the steps in Lussac-Madsen Resonant Voice?
3
Patient stretching and practicing breathing
Continues in a structured fashion
Hierarchy of progression with increasing complexity.
How long are stretches held in Lussac-Madsen Resonant Voice ?
3 to 10 seconds per stretch
What do you explore while patient says “mmmmmm” for Lussac-Madsen Resonant Voice ?
(7)
Making vibrations wider then narrower
Making vibrations narrower then narrower,
Making voice easier and easier
Shifting the tongue in mouth
Gliding through pitch range
Sustaining pitch in ranch where vibrations are strongest
Sustaining pitch in ranch where voice is easiest
What is the Circumlaryngeal Massaging?
Direct manual intervention to reducing excessive tension in laryngeal muscles
What is the goal of Circumlaryngeal Massaging?
3
Restore natural resting position of larynx in neck
Reduce overall muscle tension
Reduce vocal hyperfunction
What are the steps of Circumlaryngeal Massaging?
3
Evaluation of extrinsic muscle tension
Evaluation of laryngeal reposturing
Crcumlaryngeal massage concentrated over specific areas of the neck
Who is Circumlaryngeal Massaging for?
2
Adults and children with muscle tension dysphonia
Patients with elevated laryngeal positioning
What are three examples of patients who may have Elevated Laryngeal Positioning?
Those needing reposturing of larynx
Transgender patients
Puberphonia patients
What can Circumlaryngeal Massaging allow for?
Differential diagnosis of Muscle Tension Dysphonia (MTD) versus Spasmodic Dysphonia (SD)
How is Circumlaryngeal Massaging done?
No universal method
Descriptions vary throughout literature
What are the two types of Circumlaryngeal Massaging according to Mathieson (2011)?
(2)
Laryngeal Manual Therapy
Manual Circumlaryngeal Therapy
What is Manual Circumlaryngeal Therapy?
Kneading and sustained pressure beginning superficially then increasing in depth
What is Laryngeal Manual Therapy?
Incorporates Vocal Tract Discomfort Scale and Palpatory Evaluation Protocol
