Laryngeal Movements During Inspiratory Muscle Training in Healthy Subjects

The Journal of Voice has just published online (17th May 2013), a study that looked at Laryngeal Movements During Inspiratory Muscle Training in Healthy Subjects.

As Inspiratory Muscle Training has been used to treat patients with exercise-induced vocal cord dysfunction, the theory behind this being the close relationship between the diaphragm and the posterior cricoarytenoid muscle, the study aimed to substantiate this theory by performing laryngoscopy in healthy subjects during standardized Inspiratory Muscle Training programs.

Conclusions showed that Inspiratory Muscle Training can produce laryngeal abduction in healthy subjects, and training programs may conceivably contribute positively in patients suffering from laryngeal adduction during exercise.

Here’s the Article in Press, the Abstract for which can be found online at the Journal of Voice.

Laryngeal Movements During Inspiratory Muscle Training in Healthy Subjects

Authors:
Astrid Sandnes, Tiina Andersen, Magnus Hilland, Thor Andre Ellingsen, Thomas Halvorsen, John-Helge Heimdal, Ola Drange Røksund

Summary

Background
Inspiratory muscle training (IMT) has been used to treat patients with exercise-induced vocal cord dysfunction (VCD); the theoretical basis being the close relationship between the diaphragm and the posterior cricoarytenoid muscle, which is the main abductor of the larynx. Before launching a treatment protocol in patients with VCD, we aimed to substantiate this theory by performing laryngoscopy in healthy subjects during standardized IMT programs.

Methods
Twenty healthy volunteers at mean age 24 years were examined with video-recorded continuous transnasal flexible laryngoscopy while performing standardized training programs using a resistive loading IMT device (Respifit S). All subjects were exposed to two modes of training, that is, the resistance set to generate mouth pressures ≥80% of the maximal attainable inspiratory mouth pressure (PImax) and 60–80% of PImax. Laryngeal movements were scored in retrospect from the video recordings by a senior laryngologist.

Results
At pressure settings of ≥80% of PImax, laryngeal movements could not be assessed in one subject. Abduction was observed in 10 (53%) subjects, six to a maximal extent and four to a moderate extent. At pressure settings of 60–80% of PImax, abduction was observed in 18 (90%) subjects, seven to a maximal extent and 11 to a moderate extent.

Conclusions
IMT can produce laryngeal abduction in healthy subjects, and training programs may conceivably contribute positively in patients suffering from laryngeal adduction during exercise. Individual response patterns varied between subjects and individualized programs seem crucial for effect. Use of high resistances seemed to be counterproductive.

Further evidence in Respiratory muscle strength training applications (which looked at the handful of studies discussing the use of strengthening techniques for the voice-disordered population), revealed how inspiratory muscle strength training showed promise for use with upper airway disorders including abductor vocal fold paralysis and paradoxical vocal cord dysfunction.

The purpose of this study, Inspiratory Muscle Training in Exercise-Induced Paradoxical Vocal Fold Motion, was to determine if IMT would result in increased inspiratory muscle strength, reduced perception of exertional dyspnea and improved measures of maximal exercise effort in an athlete with exercise-induced paradoxical vocal fold motion (PVFM). At end of the study, the findings suggested that Inspiratory Muscle Training may be a promising treatment approach for athletes with exercise-induced PVFM.

If you’re already using the POWERbreathe Inspiratory Muscle Training device to help with a voice or speech disorder, then please leave a comment here or on the POWERbreathe Forum as we’d love to hear from you. Read more about why IMT is a useful adjunct to your breathing exercises and breathing technique for Performing Arts. You might also find our blog for Singers and Vocal Exercises blog to be of interest too.

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