Inspiratory muscle strength training with behavioral therapy in a case of a rower with presumed exercise-induced paradoxical vocal-fold dysfunction

Ruddy, Bari Hoffman; Davenport, Paul; Baylor, Jeffrey; Lehman, Jeffrey; Baker, Susan; Sapienza, Christine

doi:10.1016/j.ijporl.2004.04.002

Next »International Journal of Pediatric Otorhinolaryngology
Volume 68, Issue 10 , Pages 1327-1332, October 2004

Inspiratory muscle strength training with behavioral therapy in a case of a rower with presumed exercise-induced paradoxical vocal-fold dysfunction

Bari Hoffman Ruddy
- Department of Communicative Disorders, University of Central Florida, HPA 2, Suite 101, Orlando, FL 32816-2215, USA
- The Ear Nose Throat and Plastic Surgery Associates, Voice Care Center, 44 West Michigan Street, Orlando, FL 32806, USA
- Corresponding author. Tel.: +1-407-823-4804.
- Tel.: +1-407-422-4921.
Paul Davenport
- Department of Physiological Sciences, University of Florida, P.O. Box 117420, Gainesville, FL 32611, USA
- Tel.: +1-352-392-7400x3825.
Jeffrey Baylor
- The Ear Nose Throat and Plastic Surgery Associates, Voice Care Center, 44 West Michigan Street, Orlando, FL 32806, USA
- Tel.: +1-407-422-4921.
Jeffrey Lehman
- The Ear Nose Throat and Plastic Surgery Associates, Voice Care Center, 44 West Michigan Street, Orlando, FL 32806, USA
- Tel.: +1-407-422-4921.
Susan Baker
- Department of Communication Sciences and Disorders, Miami University of Ohio, P.O. Box 117420, Gainesville, FL 32611, USA
Christine Sapienza
- Department of Communication Sciences and Disorders, University of Florida, P.O. Box 117420, Gainesville, FL 32611, USA
- Tel.: +1-352-392-7400.

Received 11 December 2003; received in revised form 5 April 2004; accepted 6 April 2004.

Abstract

Paradoxical vocal fold dysfunction (PVFD) with high effort exercise can result in disruptions to ventilation, dyspnea, inspiratory stridor, elevated heart rate, and syncope. This single subject study experimentally tested an inspiratory muscle strength training (IMST) program with behavioral therapy on a 15-year-old male crew member. Outcome variables were maximum inspiratory pressure (MIP), and dyspnea ratings. Following 5 weeks of IMST, MIP increased by 93% from baseline function while dyspnea ratings substantially decreased. Outcome included successful competition with his high-school crew team, a task he was previously unable to complete. Discussion focuses on IMST combined with traditional approaches of voice therapy for treating PVFD.

Keywords: Paradoxical vocal fold dysfunction, Inspiratory muscle training, Dyspnea, Exercise