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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been acknowledged that for many patients with spastic dysphonia, reflexive phonation remains essentially free of the spasticity that characterizes this disorder. The purpose of this paper is to document the extent to which various phonatory tasks change the patient's voice. We retrospectively reviewed 37 patients with spastic dysphonia evaluated at the Center for Communication Disorders of Lenox Hill Hospital, New York, between 1977 and 1981. The patients' responses to various phonatory tasks were observed. These tasks were grouped into the following ten categories: noncommunicative vocalization, primitive communication, speech superimposed on noncommunicative phonation, communicative phonation with varied mode of vocal fold vibration, normal communicative phonation with unusual pitch, normal communicative phonation with unusual emphasis, normal communicative phonation with normal laryngeal adjustments, use of the vocal folds in an artistic manner, speech in which normal auditory feedback was eliminated, and speaking with whisper which was not associated with vocal fold vibration. The results are summarized as follows: 1) whispered speech always resulted in an improvement of the symptom, in most cases markedly; 2) there was a tendency for a task that was more effective in reducing spasticity to be reduced in communicative function; 3) there was a tendency for a task that was more effective in reducing the spasticity to deviate more from the normal mode of phonation; and 4) there were some patients in whom an improvement occurred with elimination of auditory feedback.
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PMID:Symptom improvement of spastic dysphonia in response to phonatory tasks. 397 May 5

Cerebral palsy affects movement and posture causing activity limitation; it is a lifelong condition, with foreseeable complications. There are evidence-based interventions that will prevent participation restriction. Childhood interventions are generally delivered within multidisciplinary rehabilitation programs. Sadly young adults are often not transferred to an appropriate multidisciplinary adult neurodisability service. An unexplained neurological deterioration should warrant further investigation. Pain is an important underreported symptom and musculoskeletal complaints are prevalent. Disabled adults have less participation socially, in employment, marriage, and independent living related to health problems, discrimination, or lack of access to information, support, and equipment. Evidence-based interventions include a variety of modalities at all International Classification of Functioning, Disability, and Health levels to include support and adaptations. Rehabilitation interventions that have been shown to be effective include surgery in childhood, ankle-foot orthoses, strength training, and electrical stimulation. Management of spasticity is beneficial and has an evidence base. Orthotics and casting are also used. Systematic reviews of upper limb therapies also show the benefit of physical therapy exercise, strengthening, fitness training, and constraint therapy. Occupational therapy has a weaker evidence base than in other disabling conditions but many modalities are transferable. Speech therapy is effective although no specific intervention is better. Psychological wellbeing interventions, including improving self-efficacy, health knowledge, and coping skills, are beneficial. Management of continence, nutrition, and fatigue promote wellbeing.
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PMID:Cerebral palsy. 2331 63