Short-Term Intensive Therapy and Outcomes for Athletes With Paradoxical Vocal Fold Motion Disorder

• Published in: American journal of speech-language pathology 2019-02, Vol.28 (1), p.83-95
• Main Authors: Gallena, Sally K, Johnson, Arthur T, Vossoughi, Jafar
• Format: Article
• Language: English
• Subjects: Adolescent; Airway Resistance - physiology; Athletes; Behavior modification; Breathing Exercises - methods; Care and treatment; Child; Control Groups; Disorders; Dyspnea; Dyspnea - diagnosis; Dyspnea - etiology; Dyspnea - physiopathology; Evidence; Evidence-based medicine; Evidence-Based Medicine - methods; Exercise - physiology; Exercise Test - methods; Female; Follow-Up Studies; Generalization; Humans; Laryngeal diseases; Laryngology; Laryngoscopy; Learning Theories; Male; Methods; Modeling (Psychology); Muscular Strength; Neurophysiology; Otolaryngology; Outcome Measures; Outcomes of Treatment; Patient Education as Topic - methods; Perceptions; Physical Fitness; Physiology; Prospective Studies; Psychotherapy; Resistance (Psychology); Respiratory therapy; Severity of Illness Index; Speech Language Pathology; Speech therapy; Sports training; Strength training; Teaching Methods; Teenage athletes; Teenagers; Treatment Outcome; Vocal Cord Dysfunction - complications; Vocal Cord Dysfunction - physiopathology; Vocal Cord Dysfunction - therapy; Vocal folds
• ISSN: 1058-0360; 1558-9110
• DOI: 10.1044/2018_AJSLP-17-0223

Purpose The aim of the study was to develop a treatment for athletes with paradoxical vocal fold motion disorder (PVFMD) based on exercise physiology and learning theory principles and administer it over a preestablished time frame. Method A prospective, repeated-measures, within-subject group design was used. Eleven adolescent/teen athletes diagnosed with PVFMD via laryngoscopy received short-term intensive (STI) therapy. Eight of the athletes returned for extended follow-up. Changes in postexercise inspiratory ( R ) and expiratory ( R ) resistances and Modified Borg Dyspnea Scale (MBDS) ratings collected at baseline were compared immediately posttreatment and at extended follow-up. Dyspnea Index scores were collected at baseline and at extended follow-up. Two no-treatment control athletes with PVFMD participated in two exercise challenges-baseline and 6 weeks later. Results Immediately after STI therapy, athletes attained significant improvement in R , R , and MBDS ratings. These changes were maintained at extended follow-up as well as a significant change in Dyspnea Index scores. The 2 control athletes who were reassessed 6 weeks after baseline experienced negative changes in postexercise R and MBDS ratings. Conclusion STI therapy that incorporated individuality, specificity, and variable practice effectively changed outcome measures posttreatment with further improvement observed at extended follow-up. These results provide preliminary evidence for STI therapy for PVFMD.