Digital Repository at the University of Maryland (DRUM)  >
Theses and Dissertations from UMD  >
UMD Theses and Dissertations 

Please use this identifier to cite or link to this item: http://hdl.handle.net/1903/12688

Title: RESPIRATORY RESISTANCE AND THE EFFECT OF EXERCISE IN FEMALE TEEN ATHLETES WITH PARADOXICAL VOCAL FOLD MOTION
Authors: Gallena, Sally
Advisors: Tian, Wei
Solomon, Nancy P
Department/Program: Hearing and Speech Sciences
Type: Dissertation
Sponsors: Digital Repository at the University of Maryland
University of Maryland (College Park, Md.)
Subjects: Speech therapy
Medicine
Physical education
Keywords: airflow perturbation device
dyspnea in athletes
paradoxical vocal fold motion
respiratory resistance
sports-induced asthma
vocal cord dysfunction
Issue Date: 2012
Abstract: Paradoxical vocal fold motion (PVFM) disorder, often referred to as vocal cord dysfunction (VCD), interferes with breathing because the vocal folds adduct during inspiration making it difficult to inhale. When PVFM is triggered by exercise, it can impact competitive play. Athletes with PVFM are often misdiagnosed as having exercise-induced asthma, but do not respond to asthma treatment. Directly visualizing the larynx (laryngoscopy) when symptoms are present is the current "gold standard" for diagnosing PVFM. However, laryngoscopy is invasive and expensive. Standardized noninvasive alternative methodologies are needed for clinically feasible assessment of PVFM by the speech-language pathologist. Respiratory resistance (Rr), measured with the Airflow Perturbation Device (APD), may be useful for assessing PVFM because vocal fold adduction can increase Rr markedly. This research comprises three studies with an overarching goal to validate an objective, non-invasive measure of Rr for identifying abnormal constriction of the laryngeal airway associated with PVFM disorder. Study 1 compared APD-measured Rr to glottal area (GA) assessed through laryngoscopy in a healthy subject feigning PVFM-type breathing. Study 2 assessed intra- and intersession test-retest reliability of APD-determined Rr for a control group of 12 healthy female teenage athletes during resting tidal breathing (RTB) and post-exercise breathing (PEB). Study 3 examined differences between the same 12 healthy athletes with 12 athletes diagnosed with PVFM matched for sex, age, and activity level, for Rr, exercise duration, and dyspnea ratings for RTB and PEB. The results revealed: 1) a strong negative correlation (r = -0.824) between Rr and GA suggesting that the APD can indirectly measure changes in the laryngeal airway; 2) strong test-retest reliability for APD-measured inspiratory (Ri) and expiratory (Re) resistance during RTB (ICC > .95), and PEB (ICC >.85); and 3) in control athletes, Ri and Re decreased during PEB as compared with RTB, whereas in athletes with PVFM, both Ri and Re increased during PEB with statistical significance reached for Ri (p <.001). During exercise, athletes with PVFM reported severe dyspnea and exercised for shorter durations. This research demonstrates that a diagnostic protocol for PVFM should include measures of Rr, exercise duration, and perceived dyspnea.
URI: http://hdl.handle.net/1903/12688
Appears in Collections:UMD Theses and Dissertations
Hearing & Speech Sciences Theses and Dissertations

Files in This Item:

File Description SizeFormatNo. of Downloads
Gallena_umd_0117E_13079.pdf1.24 MBAdobe PDF617View/Open

All items in DRUM are protected by copyright, with all rights reserved.

 

DRUM is brought to you by the University of Maryland Libraries
University of Maryland, College Park, MD 20742-7011 (301)314-1328.
Please send us your comments