Holistic approach in muscle tension dysphonia (MTD) therapy: Rehabilitation program for people with deviation in the field of phonation after Kosmač

摘要

Some renowned methods and techniques for voice therapy by foreign authors such as Alexander Technique (AT), Smith’s Accent method and breath-rhythmic-adapted Phonation by authors Coblenzer and Muhar as well as Rehabilitation program for persons with a deviation in phonation by Slovenian speech and language therapist Dušanka Kosmač have in common integrated i.e. holistic approach. Namely, all of them stress the importance of the body's natural posture, eutonus and diaphragm breathing as prerequisites for quality phonation. udWith AT we learn, mainly through verbal guidance, more useful and beneficient ways of body movement, therefore it is also benefitious for the physically disabled, athletes, elite voice performers, etc. Smith outlined The Accent Method as speech therapy for stuttering and voice disorders, whose main elements are abdominal - diaphragmatic breathing, stressed pronounciation of vocals (phonation) in different rhythms and speech as well as body and hands movements. Contrary, Coblenzer and Muhar did not formulate an exact therapy, but have introduced practical advices and presented variety of exercises for breath-rhythmic-adapted phonation in their book "Breath and voice". udCompared to the techniques and methods of foreign authors Alexander, Coblenzer and Muhar and Smith Rehabilitation programme by Slovenian speech and language therapist Kosmač could be simply described as the synthesis of:ud- Alexander’s mentality of eutonus (i.e. most economical tonus of all muscles and muscle groups involved as prerequisite for optimal phonation) which is the basis of the program and manner of self-control with the help of a large mirrorud- form od exercises modeling where patient repeats after the therapist in the same rhythm, however amount of verbal interpretation is small, as Svend Smith, the author of Accent method envisaged itud- content of »Breath and voice«, because exercises resemble to the key to the breath-rhythmic-adapted phonation as Coblenzer and Muhar described it. udThe aim of this work is to collect and edit exercises of Rehabilitation program by Kosmač, compare it with each of the foreign techniques and determine which elements are common, especially what importance do the authors attribute to body posture, diaphragmatic breathing, phonation and articulation as prerequisites for producing quality voice. udData are based on the study and interpretation of books, manuals and publications, by observing and questioning speech therapist Kosmač in the period from March 1, 2012 to July 1, 2012 and by observing the voice therapy of approximately seventy clients in the same period.ud