Article Sidebar

PDF
Issue: Vol. 71 No. 79 (2026)
Section: Articles
Views 11
Downloads 1
How to Cite
Phung, T. H., Nguyen, M. D., & Nguyen, T. Q. T. CURRENT ADVANCES IN VOICE THERAPY FOR POST-STROKE LARYNGOPHARYNGEAL DYSPHONIA: A SYSTEMATIC CLINICAL REVIEW. Vietnam Journal of Otorhinolaryngology - Head and Neck Surgery, 71(79). Retrieved November 2, 2026, from https://tapchitaimuihong.vn/index.php/tmh/article/view/490

CURRENT ADVANCES IN VOICE THERAPY FOR POST-STROKE LARYNGOPHARYNGEAL DYSPHONIA: A SYSTEMATIC CLINICAL REVIEW

Thi Hoa Phung1, , Minh Duc Nguyen2, Thi Quynh Trang Nguyen1
1 VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
2 Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam

Main Article Content

Abstract

Objective: To review contemporary therapeutic modalities for post-stroke laryngopharyngeal dysphonia, focusing on emerging sensory-motor interventions. Methods: A comprehensive review of clinical trials, pilot studies, and professional guidelines was conducted to evaluate the efficacy of neuromuscular electrical stimulation (NMES), LSVT LOUD, and visual-guided glottal closure exercises. Key outcome metrics analyzed included maximum phonation time (MPT), Voice Handicap Index (VHI) scores, and physiological glottal closure efficiency. Symptom Review: Post-stroke dysphonia frequently presents as a breathy, hoarse voice caused by unilateral or bilateral vocal cord palsy or pharyngeal muscle weakness. This dysfunction compromises glottal closure, shortening MPT and increasing VHI scores. Beyond communication barriers, inadequate glottal closure impairs airway protection, causing a high overlap with dysphagia and substantially increasing the risk of aspiration pneumonia. Conclusions: Traditional sound-imitation exercises offer limited recovery due to disrupted central sensorimotor loops. Conversely, combining physiological interventions—such as NMES, LSVT LOUD, and visual glottal feedback—significantly improves glottal closure, lengthens MPT, and enhances the overall quality of life for post-stroke patients. Keywords: Post-stroke dysphonia; Laryngopharyngeal paralysis; Neuromuscular electrical stimulation; LSVT LOUD; Visual glottal closure training.

Article Details

References

1. Hanoi Rehabilitation Hospital. Essential aspects of speech rehabilitation after stroke [Internet]. Hanoi: Hanoi Rehabilitation Hospital; 2025 [cited 2026 Jul 19]. Available from: http://bv-phuchoichucnanghanoi.vn/mot-so-dieu-can-biet-ve-phuc-hoi-chuc-nang-noi-sau-tai-bien/
2. Cohen SM, Elackattu A, Noordzij JP, Walsh MJ, Langmore SE. Palliative treatment of dysphonia and dysarthria. Otolaryngol Clin North Am. 2009;42(1):107-121.
3. Song C, Wang F, Cheng X. The Impact of Different Rehabilitation Training Modes on VHI Scores and MPT in Patients with Post-Stroke Dysphonia: A Case Study of Visual Glottal Closure Training. Clin Neurosci Res. 2025;3(4):77-85.
4. Ko KR, Park HJ, Hyun JK, Seo IH, Kim TU. Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study. Ann Rehabil Med. 2016;40(4):600-610.
5. El Sharkawi A, Ramig L, Logemann JA, Pauloski BR, Rademaker AW, Smith CH, et al. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry. 2002;72(1):31-36.
6. Cohen SM, Dupont WD, Courey MS. Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis. Ann Otol Rhinol Laryngol. 2006;115(2):128-134.
7. Sackley CM, Rick C, Brady MC, Woolley R, Burton C, Patel S, et al. Lee Silverman voice treatment versus NHS speech and language therapy versus control for dysarthria in people with Parkinson’s disease (PD COMM): pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial. BMJ. 2024;386:e078341.
8. Rehabilitation Medicine. Voice rehabilitation protocols following vocal fold paralysis [Internet]. 2023 [cited 2026 Jul 19]. Available from: https://yhocphuchoi.com/thu-vien-tai-lieu/cac-quy-trinh-ky-thuat-vltl-phcn-4/cac-quy-trinh-ky-thuat-am-ngu/tap-phuc-hoi-giong-sau-liet-day-thanh/
9. Noorani M. Vocal Function Exercises: The Bread and Butter of Voice Therapy [Internet]. MedSLPCollective; 2020 [cited 2026 Jul 19].
10. Dr.Oracle. What are the guidelines for decannulation post tracheostomy in a patient with a history of stroke and unilateral vocal cord palsy? [Internet]. 2026 [cited 2026 Jul 19]. Available from: https://www.droracle.ai/articles/804134/what-are-the-guidelines-for-decannulation-post-tracheostomy-in
11. Lagorio LA, Carnaby-Mann GD, Crary MA. Cross-system effects of dysphagia treatment on dysphonia: a case report. Cases J. 2008;1:67.
12. McFarland DH, Tremblay P. Clinical implications of cross-system interactions. Semis Speech Lang. 2006;27(4):300-309.
13. Yoon YS, Lim JT, Yun SB, Ohm BY, Kang JY, Lim HY, et al. The effect of functional electrical stimulation on swallowing function in stroke patients with dysphagia. J Korean Acad Rehabil Med. 2006;30:417-423.
14. Byeon H. Voice change associated with swallowing disorder caused by a stroke after neuromuscular electrical stimulation. J Korea Acad Ind Coop Soc. 2012;13(4):1665-1671.
15. Stemple JC, Lee L, D'Amico B, Pickup B. Efficacy of vocal function exercises as a method of improving voice production. J Voice. 1994;8(3):271-278.