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[Rehabilitation strategies of dysfunctional dysphonias in relation to posture].

OBJECTIVE
To improve rehabilitation strategies of functional dysphonias in relation to posture after clinical asssessment and recordings of posture obtained using a stabilometric platform and EquiTest.


MATERIAL AND METHOD
2 groups were compared: group 1 (58 dysphonic patients; 44 women and 14 men), group 2 (19 nondysphonic singers; 11 women and 8 men). They all had a vocal assessment, a test of Freeman and an EquiTest. Their vocal handicap was evaluated by the Voice Handicap Index (VHI) and the WONCA questionnaire. The same assessment was repeated after rehabilitation.


RESULTS
In dysphonic subjects before rehabilitation, the center of gravity during vocal projection and without vocal projection is rather off-set forwards and their postural stability is worse than the group 2 subjects. Vestibular information is less used with a less effective balance strategy. After vocal rehabilitation the voice is improved, vestibular information and the balance strategy are more effective. The VHI Score after rehabilitation goes from 40.36 to 26.35 for a total score of 120.


CONCLUSION
Rehabilitation must be focused on the training of new gestures allowing better postural control thus releasing the phonatory potentials. This is actually possible with several known or modified exercises.