voice THERAPY along with yoga therapy IN vocal cord palsy: a case report

PADMA PAI
3RD BASLP
Supervisor: Dr. Gopee Krishnan
SCHOOL OF ALLIED HEALTH SCIENCES,MAHE, MANIAPL

INTRODUCTION RESULTS
• Vocal cord paralysis (VCP) occurs when the nerve impulses to the Maximum Phonation Pre voice Post voice therapy
Duration therapy
voice box (larynx) are disrupted
/a/ 3 7
• VCP can be both unilateral or bilateral
/i/ 2 7
• Causes: nerve damage during surgery, idiopathic, viral infections
/u/ 3 7
or certain tumors
• Treatment: surgery or voice therapy PRE VOICE THERAPY POST VOICE THERAPY
• Voice therapy: is the equivalent of physical therapy for large ON ON ON ON
PHONATION CONVERSATIO PHONATION CONVERSATIO
muscle paralysis. N N
• The therapist asks patients to do special exercise and activities to
• strengthen their vocal cords G 2 3 1 1
R 1 1 1 0
• breath control while speaking
B 3 3 1 1
• prevent unusual tensions in other muscles near the A 2 2 0 0
affected vocal cords. S 1 1 0 0
• Yoga therapy: Yoga therapy utilizes poses, breathing techniques,
Pitch: High Pitch: Low
and meditation to benefit and improve overall health.
Loudness: Reduced Loudness: Loudness variation+
Quality: Hoarse, predominately breathy Quality: Mild breathiness
• The phonatory gap before the treatment was 3-4mm
and after 1 month of therapy it was found to be 2-3mm
AIM • Four months after therapy the phonatory gap was
found to be <1m.
• There was a notable improvement in the mobility of
To highlight on the need for further systematic investigation on
the vocal cord and from the videofluroscopy it was
the effect of adjunct yoga therapy with voice therapy in persons
seen that compensatory movement from opposite
with vocal cord palsy.
vocal cord was seen.
• Fo prior to therapies was 164.42H and after the
CASE REPORT therapies for 1 month it was found to be 153.28Hz.

• A 67year-old male, presented with a complaint of sudden loss of DISCUSSION

voice.
• had a history of chronic persistent bronchial asthma and a
history of right vocal cord palsy with a phonatory gap of 3-4mm.
• was referred for voice evaluation following worsening of his
voice.
• On voice evaluation the patient was diagnosed as having severe
hoarse voice (predominately breathy).
• The patient was advised to undergo voice therapy
• He was advised for yoga therapy for improving the breathing
patterns by the consulting physician.
• The patient underwent both therapies (voice + yoga)
simultaneously for 1 month daily ( 6 days in a week).
• The voice therapy included closure enhancement techniques,
head rotation and breathing exercises
• Voice therapy was done for 45 min with sufficient amount of
breaks.
• Yoga therapy was done for 20 min. The patient went for these
therapies for a period of 1 month.
• The yoga therapy included pranayama.
• The current subject exhibited improvement in the voice
quality.
• The patient underwent simultaneous yoga and voice
therapies for a month.
• The simultaneous trainings smudges the independent
effect of voice therapy and yoga therapy as well as the
combined effects of these therapies.
• This necessities further systematic enquiry on the
effect of yoga therapy as well as its effect when
clubbed with conventional voice therapy in vocal fold
palsy.
CONCLUSION
• This case report highlights the importance of future systematic
investigations on the independent effects of yoga therapy as well
as the combined effects of yoga and voice therapies in vocal fold
palsy.

ASSESSMENT
• Perceptual assessment was carried before the treatment and
was also carried out after 6 months of treatment. Speech skills
were checked pre and post treatment.
• Acoustic measure were also carried out and there was a
notable difference in the values of fundamental frequency.
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