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Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction: A Randomized Clinical Trial.

William A Strober1, Matthew L Rohlfing1, Grace M Cutchin1

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Summary

Video biofeedback and respiratory retraining therapy (RRT) showed similar effectiveness for inducible laryngeal obstruction (ILO). This finding suggests biofeedback may be a viable, accessible option for managing ILO-related shortness of breath.

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Area of Science:

  • Otolaryngology
  • Pulmonology
  • Speech-Language Pathology

Background:

  • Inducible laryngeal obstruction (ILO) causes episodic shortness of breath, significantly impacting quality of life.
  • Respiratory retraining therapy (RRT) is the current standard of care, but limited data exist on treatment efficacy.
  • No randomized clinical trials have directly compared different treatments for ILO.

Purpose of the Study:

  • To compare the effectiveness of video biofeedback against RRT for treating inhalational dyspnea in patients with ILO.
  • To evaluate if visual feedback of laryngeal anatomy during breathing exercises improves ILO symptoms.

Main Methods:

  • A pilot randomized clinical trial was conducted at a single laryngology clinic.
  • 54 patients with ILO were randomized to either video biofeedback or RRT.
  • The primary outcome was the change in Dyspnea Index (DI) score one month post-treatment.

Main Results:

  • Both video biofeedback and RRT groups showed reductions in DI scores, with no statistically significant difference between them (mean difference: 0.61).
  • Most patients in both groups reported some level of improvement on the Clinical Global Impressions-Improvement scale.
  • Completion rates differed, with 25 participants finishing biofeedback and 20 completing RRT.

Conclusions:

  • Video biofeedback and RRT demonstrated comparable effectiveness in treating inducible laryngeal obstruction.
  • Video biofeedback offers potential advantages due to its accessibility and lack of additional cost.
  • Clinical decisions should consider individual patient factors like comorbidities and access to care when recommending treatment.