Effects of Back Pressure on the Feasibility and Tolerability of Laryngeal Diadochokinetic Exercise: A Pilot Study.
Christopher S Apfelbach, Mary Sandage, Katherine Verdolini Abbott
PMID 38969542WHAT IT FOUND
Healthy adults tolerated laryngeal diadochokinesis against 0 and 5 cm H2O back pressure, completing nearly all trials.
At 10 and 15 cm H2O, lightheadedness and difficulty rose sharply, with most failing to complete trials against 15 cm H2O.
Key findings
01Participants tolerated the lowest back pressure levels well, completing full trials in 21 of 24 possible attempts at 0 and 5 cm H2O while rating difficulty as minimal.
02Tolerability collapsed at higher pressures, as nine participants completed zero intervals at 15 cm H2O and lightheadedness occurred in 38.9% of all trials.
03Auditory-perceptual strength of the exercise declined at higher pressures, with expert raters finding most pulses strong and distinct only at 0 and 5 cm H2O.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 12 healthy young adults participated, so tolerability and safety in clinical voice populations are unknown. No inferential statistics or power analyses were conducted, so findings are descriptive. High dropout at 10 and 15 cm H2O created survivorship bias, meaning results from those conditions reflect only the most capable participants. Perceived exertion was rated as a single composite score, which may not distinguish between vocal effort, respiratory strain, and lightheadedness. Respiratory capacity and cardiopulmonary variables were not measured, leaving individual differences in tolerance unexplained.
Declared interests
The authors declared no conflicts of interest. No funding source is reported.
The easy way to misread this
Do not interpret the good tolerability at 0 and 5 cm H2O as evidence that this task is safe or feasible for patients with voice disorders. The sample consisted entirely of healthy young adults who passed rigorous screening, and the study was a feasibility pilot with no inferential statistics.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →