This study examined whether posture exercises and deep neck muscle training can improve voice quality in older adults with presbyphonia, an age-related voice disorder. Older adults with presbyphonia participated in a rehabilitation program that included posture correction and exercises to strengthen the deep neck muscles. The program aimed to improve head and neck alignment, posture control, and breathing support, which are important for healthy voice production. Voice evaluations were performed before and after treatment using voice recordings, breathing-related measurements, and questionnaires about voice-related difficulties. After the exercise program, participants showed improvements in voice quality and vocal stability. They were able to sustain their voice for a longer time and reported fewer voice-related problems in daily life. Improvements in posture and neck control were also associated with better vocal performance. These findings suggest that posture and deep neck muscle exercises may help improve voice function in older adults with presbyphonia. Such exercises may be a useful supportive treatment option for age-related voice problems. Further studies with larger groups are needed to confirm these results.
Age-related changes in the voice mechanism can significantly affect voice quality and communication in older adults. Presbyphonia is one of the most common age-related voice disorders, resulting from structural and functional changes in the laryngeal tissues. Degeneration of the vocal cord muscles, decreased elasticity of the lamina propria, and reduced neuromuscular control can lead to symptoms such as shortness of breath, decreased voice intensity, and decreased phonation efficiency (1,2). These changes can negatively impact speech communication and overall quality of life in older individuals (3). Voice production is a complex motor activity requiring coordination between the respiratory, laryngeal, and supralaryngeal systems. Efficient phonation depends not only on the laryngeal muscles but also on the alignment and stability of surrounding musculoskeletal structures, particularly the cervical spine and upper thoracic region (4; 5). Postural alignment optimizes respiratory mechanics and laryngeal function, while changes in head and neck posture can affect vocal tract configuration, airflow control, and phonation efficiency (6,7). Aging is frequently associated with a forward-tilted head posture and decreased cervical stability, which can increase muscle tension and alter the biomechanical relationship between the hyoid, larynx, and surrounding muscles (8,9). These postural deviations can contribute to inefficient phonation and reduced vocal performance. Previous studies have shown that head and neck posture can affect acoustic voice parameters, including fundamental frequency, vibration, and brightness, highlighting the importance of musculoskeletal alignment in voice production (3,6). The deep cervical muscles are critical for maintaining head and neck stability. Weakness or dysfunction in these muscles can compromise cervical control, respiratory support, and laryngeal biomechanics (8). Rehabilitation programs targeting deep cervical muscle activation and postural control have been used in physiotherapy to improve neuromuscular coordination and spinal stability (8,9). These interventions can indirectly affect voice production by optimizing the biomechanical environment necessary for efficient phonation. Postural and cervical muscle training has been shown to improve neck stability, postural alignment, and respiratory function (5,10). Improved diaphragmatic breathing and thoracic expansion associated with improved posture can enhance vocal efficiency by providing better phonation support (1,4). However, the direct effects of posture and cervical stabilization exercises on voice function in older adults with presbyphonia have largely been understudied. Given the interactions between posture, cervical stability, and voice production, musculoskeletal interventions may provide a complementary approach to managing age-related voice disorders (11,12,13). Understanding these effects could shed light on multidisciplinary rehabilitation strategies aimed at improving vocal performance and communication in older adults. Therefore, the aim of this study is to investigate the effects of posture and deep cervical muscle training on voice function in older adults with presbyphonia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
90
Cervical stabilization exercises will be performed for approximately 50 minutes, three times a week for six weeks, under the guidance of an experienced physiotherapist. These exercises include stabilization training targeting the deep neck flexor muscle groups using a pressure biofeedback device, and progressively incorporating cervical and thoracic stabilization training.
Traditional exercises targeting the cervical region (neck isometric stretching, strengthening, and posture exercises) will be performed.
Acoustic sound analyses will be performed using the AVQI (Acoustic Sound Quality Index) script (v02.06) in Praat. Description: (Sound Efficiency Assessment, TEMPS-A (Memphis, Pisa, Paris and San Diego Temperament Assessment), Rosenbaum's Learned Helpless
(Voice Efficiency Evaluation, TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego), Rosenbaum's Learned Helplessness Scale (LHCS))
Time frame: 30dakika
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