The role of the assessment of posture and movement patterns in re-education and improvement of voice in functional voice disorders

Background
Observation of patients with functional voice problems with typical musculoskeletal symptoms revealed the frequent adoption of a characteristic head position in excessive anterior extension, a lack of coordination, and sense of space. So far, there are lack of standards and the difficulty in obtaining objective parameters in the study of both voice and abnormal posture disrupted at a functional level.

Aims
Assessment of the impact of physiotherapeutic methods, associated with improving posture and movement patterns based on existing voice disorders, on enhancing voice emission.

Material and methods
The impact of physiotherapeutic treatment on the voice emission was evaluated. Self-constructed questionnaire and validated scales: Vocal Tract Discomfort (VTD) and Laryngeal Manual Therapy Palpatory Evaluation (LMTPE) were used.

Results
Teachers accounted for 86.4% of the participants in the study. The maximum phonation time has not changed significantly in either of the groups (except for 1 measurement). Therapy resulted in a reduction in the frequency and intensity of symptoms. The head angle in standing position and the chest angle in sitting positions improved significantly in the study group.

Conclusions
Physiotherapy for altering head angle and improving head and neck alignment in a neutral position has an impact on reducing the frequency and intensity of symptoms associated with functional voice problems. Normalizing muscle tone, the larynx alignment and improving the mobility of structures near the vocal tract in patients with excessive head protraction has the effect of improving maximum time results and reducing symptoms.