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Immediate effects of postural repositioning on maximum phonation duration tasks in seated individuals with acquired
Marie Julien1,2,3, Maureen MacMahon3, Dre Céline Lamarre1,3
1Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, CRIR, Montreal, Canada.
Purpose:
To determine the effectiveness of a single 10-min postural repositioning session on the maximum phonation duration (MPD) of the vowel/a/in individuals with acquired dysarthria.
Materials And Methods:
A pre-post interventional design was implemented; five patients with dysarthria (PWDs) underwent a single 2-hour experimental session. MPD capacities were assessed before and immediately after a 10-min postural repositioning intervention by a physical and occupational therapist. Five age- and sex-matched individuals without dysarthria were recruited as controls. The main outcome measure was the MPD of the vowel/a/at conversational and louder voice levels, with a speech-and-language therapist standing 1 and 6 m away, respectively. Secondary outcome measures were thoracic expansion, manometry, electromyographic recordings of axial muscles and perceived effort.
Results:
In PWDs, postural repositioning improved the MPD during the/a/-1-m (80.3% increase) and/a/-6-m tasks (18% increase), increased thoracic expansion and manometric measurements, and reduced the perceived effort necessary to perform the tasks. A triphasic electromyographic pattern was observed during both/a/-1-m and/a/-6-m tasks in controls, but was absent in participants with severe dysarthria, even after postural repositioning. Nonetheless, postural repositioning enabled an earlier onset of EMG activity prior to voice production.
Conclusions:
These data suggest the efficacy of postural repositioning in improving phonatory capacities essential for voice production in PWDs.
