What interventions and education are taught by speech therapy to patients with vocal cord dysfunction?

Speech Therapy Interventions for Vocal Cord Dysfunction

Speech therapy provides comprehensive education and interventions that effectively treat vocal cord dysfunction through breathing retraining, vocal exercises, and psychological techniques to reduce symptoms and improve quality of life. 1

Educational Components

Speech therapists provide critical education to patients with vocal cord dysfunction that includes:

• Clear explanation of the nature of vocal cord dysfunction, emphasizing that abnormal vocal cord movements are reversible habitual patterns, not structural abnormalities 1
• Review of laryngoscopy images with patients to help them understand their condition 1
• Explanation that excessive muscle tension can prevent normal function but can be brought under patient control 1
• Education about the relationship between anxiety and symptoms, particularly important for patients with exercise-induced vocal cord dysfunction 1, 2

Breathing Techniques and Exercises

Speech therapists teach several breathing techniques to manage vocal cord dysfunction:

• Relaxed throat breathing techniques that focus on abdominal/diaphragmatic breathing rather than upper chest breathing 2
• Techniques to reduce excessive musculoskeletal tension in speech and non-speech muscles of the head, neck, and shoulders 1
• Exercises that emphasize slow, controlled inhalation to prevent paradoxical vocal cord closure 3
• Specific breathing patterns to use during exercise for those with exercise-induced vocal cord dysfunction 4

Vocal Exercises and Techniques

A variety of vocal exercises are employed to normalize vocal cord function:

• Natural, reflexive behaviors with sound production:

  • Coughing and throat clearing with voice present
  • Yawning followed by sighing
  • Producing comfort sounds (moaning, grunting)
  • Gargling with firm sounds 1

• Vocal techniques to reduce tension:

  • Slow, easy onset with prolonged speech sounds
  • Phonation on inhalation while maintaining relaxed posture
  • Producing low-pitched glottal fry at the bottom of vocal range
  • Singing with rising and falling scales 1

Physical and Postural Maneuvers

Speech therapists incorporate physical techniques to improve vocal cord function:

• Reposturing/repositioning/lowering of the larynx including circumlaryngeal massage with concurrent vocalization 1
• Postural manipulations such as phonating while bending over or looking at the ceiling 1
• Redirection of attentional focus through activities like bubble blowing with vocalization 1
• Large body movements combined with vocalization to facilitate release of tension 1

Psychological Approaches

Psychological components of speech therapy for vocal cord dysfunction include:

• Communication counseling addressing predisposing, precipitating, and perpetuating issues related to symptoms 1
• Identification and gentle addressing of avoidance patterns 1
• Support for reducing anxiety in feared situations 1
• Collaborative work with mental health professionals when needed for structured psychotherapy 1, 3

Treatment Structure and Outcomes

Research indicates specific patterns for effective treatment:

• Typical treatment involves 1-2 therapy sessions weekly for 4-8 weeks, with duration determined by symptom severity 5
• Success depends heavily on patient commitment to practicing techniques outside therapy sessions 5
• Most insurance plans, including Medicare, cover voice therapy when provided by certified speech-language pathologists 5
• Recent research shows mean maximal symptom improvement of 72.5% with voice therapy 6
• Improvement increases with each therapy session, even when controlling for comorbid conditions 6
• Patients with concomitant asthma and those who play sports show higher rates of improvement 6

Important Considerations

• Laryngoscopy must be performed before voice therapy begins, with results documented and communicated to the speech-language pathologist 1, 5
• Voice therapy is particularly effective for muscle tension dysphonia, which may accompany vocal cord dysfunction 1, 5
• Patients should be prepared for possible symptom recurrence and have a plan for managing setbacks 5
• For severe, treatment-resistant cases, additional interventions beyond speech therapy may be necessary, though these are rare 7

Speech therapy represents the first-line treatment for vocal cord dysfunction, with high rates of success when patients actively participate in the therapeutic process and practice the techniques consistently.