OBJECTIVE: To verify the superiority of motor imagery acupuncture in improving muscle tension for patients with upper limb hemiplegia in early stroke. METHODS: A total of 64 patients of stroke hemiplegia with upper limb flaccid paralysis were randomly divided into an observation group (32 cases, 1 case dropped off ) and a control group (32 cases, 4 cases dropped off ). The observation group was treated with motor imagery acupuncture (both acupuncture and motor imagery therapy at affected upper limb were performed).The control group was treated with acupuncture plus motor imagery therapy at affected lower limb, 2 h later after acupuncture, motor imagery therapy was applied to upper limb. Baihui (GV 20) to Taiyang (EX-HN 5) of healthy side, Fengchi (GB 20) and Jianyu (LI 15), Jianjing (GB 21), Quchi (LI 11), Waiguan (TE 5) on the affected side, ect. were selected in both groups, once a day, 5 times a week for 4 weeks. Before and after treatment, 4, 8 weeks after treatment, the modified Ashworth scale (MAS) grade and Brunnstrom stage were compared in the two groups. RESULTS: Compared before treatment, the muscle tension of shoulder, elbow and wrist each time point after treatment was increased in the two groups ( CONCLUSION Motor imagery acupuncture could promote hemiplegia upper limb muscle tension recovery in patients of stroke hemiplegia with upper limb flaccid paralysis, make the patients gradually shift to the separate fine movement mode, inhibit and relieve the appearance and development of spasm.
Acupuncture Therapy ; Hemiplegia/therapy* ; Humans ; Muscle Tonus ; Stroke/therapy* ; Treatment Outcome ; Upper Extremity

Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.
Dysphonia ; Glottis ; Larynx ; Muscle Tonus ; Neurofibroma ; Vocal Cords

BACKGROUND AND OBJECTIVES: The goal of this study is to present a strategy for improving the self-regulation (SR) ability and facilitating the change of vocal behavior by applying voice therapy using the SR concept to the patients with vocal cord nodule and muscle tension dysphonia. MATERIALS AND METHOD: The subjects were 80 patients and 80 patients who were diagnosed with muscle tension dysphonia and vocal nodules. As a control group, the results were compared among patients with the same dysphonia without using SR strategies. The concept of SR before voice therapy was explained to the patients, and the treatment was divided into three stages according to the goal of voice therapy. The treatment stages consist of 1) skill acquisition, 2) habit formation, and 3) habit changes. voice therapy was performed by applying SR strategies such as goal implementation intentions and a less routine behavior. Patient's dropout rates were measured to compare the adherence of voice therapy. RESULTS: Significant improvement was seen in all groups receiving voice therapy. However, in the group using the SR strategy, the voice analysis results showed a relatively low dropout rate of voice therapy. In the generalization confirmation stage, patients who applied SR concept showed better results. SR strategy did no longer be necessary to maintain newly adopted vocal behavior. CONCLUSION: The results of this study show that SR is one of the cognitive factors that can have a significant impact on the outcome of voice therapy, and also has a positive impact on the acquisition and generalization of new skills. A better understanding of SR and the development of therapeutic strategies using it will play an important role in solving voice problems in clinical settings.
Dysphonia ; Generalization (Psychology) ; Humans ; Intention ; Methods ; Muscle Tonus ; Self-Control ; Vocal Cords ; Voice

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.
Botulinum Toxins ; Dysphonia ; Fatigue ; Humans ; Lidocaine ; Muscle Tonus ; Otolaryngology ; Pathology ; Vocal Cords ; Voice ; Voice Disorders

Stiff-person syndrome is a rare disorder, and the natural history of the syndrome has not been completely ascertained. The symptoms range from mild to severe and can progress over time: the final result can be significant disability. However, this syndrome is often misdiagnosed due to a lack of understanding of the clinical manifestations. We report the case of a patient who presented with slowly progressing gait disturbance and lower extremity pain and was later diagnosed as suffering from stiff-person syndrome. The patient experienced symptomatic improvement after the administration of benzodiazepines. No recurrence of symptoms has been reported. If the characteristic clinical features and electromyography findings of the syndrome are accurately interpreted, diagnosis of patients with abnormal muscle tension can be effectively done.
Autoantibodies ; Autoimmune Diseases ; Benzodiazepines ; Diagnosis ; Electromyography ; Gait ; Humans ; Leg ; Lower Extremity ; Muscle Tonus ; Natural History ; Recurrence ; Spasm ; Stiff-Person Syndrome

OBJECTIVE: To compare the clinical curative effect of muscle tension staged acupuncture and conventional acupuncture in the treatment of stroke hemiplegia. METHODS: Sixty-two patients with stroke hemiplegia were randomly divided into an observation group and a control group, 31 cases in each one. In the observation group, the muscle tension staged acupuncture was given, the six stages of Brunnstrom were classified as relaxation period and spasmodic period. The (consciousness-restoring resuscitation) combined with the hand and foot meridian acupuncture were applied at Shuigou (GV 26), Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Liangqiu (ST 34), Zusanli (ST 36), Shangjuxu (ST 37), Jiexi (ST 41) during relaxation period; mainly by hand and foot meridian and meridian, the acupoints were Jianliao (TE 14), Tianjing (TE 10), Waiguan (TE 5), Yangchi (TE 4), Houxi (SI 3), Huantiao (GB 30), Yanglingquan (GB 34), Chengshan (BL 57), Xuanzhong (GB 39), Shenmai (BL 62), Qiuxu (GB 40) during spasmodic period. In the control group, referring to 's , mainly by hand meridian, the governor vessel and foot meridian, phasing was not considered in the acupuncture treatment plan. Both groups were treated one time a day for 4 weeks. The neurological deficit scores were observed before and after treatment of the two groups and the efficacy was evaluated. RESULTS: There was one case dropped in each group. After treatment, the neurological deficit scores of the two groups was lower than those before treatment (both <0.05), and the observation group was lower than the control group (<0.05). The cured and markedly effective rate was 66.7% (20/30) in the observation group, which was higher than 36.7% (11/30) in the control group, the difference between the two groups was statistically significant (<0.05). CONCLUSION The muscle tension staged acupuncture is better than the conventional acupuncture for the treatment of stroke hemiplegia.
Acupuncture Points ; Acupuncture Therapy ; Hemiplegia ; therapy ; Humans ; Muscle Tonus ; Stroke ; Treatment Outcome

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg andEMGsignals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in theAMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas theAMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.
Exercise ; Healthy Volunteers ; Joints ; Knee* ; Leg ; Methods ; Muscle Fatigue* ; Muscle Tonus ; Quadriceps Muscle ; Rehabilitation*

BACKGROUND AND OBJECTIVES: Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. MATERIALS AND METHODS: From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0–3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. RESULTS: Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p < 0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p < 0.01). Well defined formants were not found different between two groups. CONCLUSION: The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.
Acoustics ; Compensation and Redress ; Diagnosis, Differential ; Dysphonia* ; Dystonia ; Humans ; Muscle Spasticity ; Muscle Tonus* ; Noise ; Voice ; Voice Disorders ; Voice Quality ; Weights and Measures

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.
Amyotrophic Lateral Sclerosis ; Central Nervous System ; Compensation and Redress ; Consensus ; Diagnosis ; Diagnosis, Differential* ; Dyskinesias ; Dysphonia* ; Dystonia ; Laryngeal Muscles ; Larynx ; Muscle Spasticity ; Muscle Tonus ; Myasthenia Gravis ; Parkinson Disease ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Disorders ; Voice Quality

This article addresses the roles of the speech language pathologist (SLP) for singers who require prompt and effective treatment when a voice problem arises. The causes of voice problem are often vocal abuse/misuse/overuse, muscle tension dysphonia and inappropriate singing technique. The SLP should conduct voice counseling and voice assessment for maintaining healthy voice of singer constantly.
Counseling ; Dysphonia ; Muscle Tonus ; Singing* ; Voice*