Evidence map›Paper›PMID 41539905›Full record

ArticleJournal of voice : official journal of the Voice Foundation2026

Clinician Perceptions of Phonatory-Respiratory Kinematic Patterns in Primary Muscle Tension Dysphonia.

Denise Kim, Elizabeth D Young, Robert A Morrison, Julianna C Smeltzer, Adrianna C Shembel

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Article in Journal of voice : official journal of the Voice Foundation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Denise KimSchool of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas; Callier Center for Communication Disorders, Dallas, Texas.
Elizabeth D YoungSchool of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas; Callier Center for Communication Disorders, Dallas, Texas; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Robert A MorrisonSchool of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Julianna C SmeltzerSchool of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas; Callier Center for Communication Disorders, Dallas, Texas.
Adrianna C ShembelSchool of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas; Callier Center for Communication Disorders, Dallas, Texas; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: adrianna.shembel@utdallas.edu.

Funding

Paralaryngeal-Respiratory Spatiotemporal Patterns in Muscle Tension DysphoniaR01DC021694 · NIDCD · UNIVERSITY OF TEXAS DALLAS · PI Adrianna Shembel · 2024 to 2026
$1.8M
NIDCD NIH HHS R01 DC021694
6 · The paper itself

Abstract

objectivesAltered respiratory kinematics are thought to contribute to primary muscle tension dysphonia (pMTD) symptoms such as vocal effort, fatigue, and discomfort. Although speech-language pathologists (SLPs) often comment on respiratory patterns during voice evaluations, it remains unclear which visual-perceptual cues they rely on for clinical decision-making and how accurate these patterns are for identifying patients with pMTD. As such, this study aimed to (1) identify the respiratory patterns SLPs perceive in pMTD and (2) evaluate their diagnostic accuracy in distinguishing pMTD from vocally healthy controls.

methodsForty-six participants (21 pMTD, 25 controls) performed voice tasks varying in intensity and articulatory complexity, while six synchronized cameras captured perilaryngeal-respiratory movements. Five blinded, fellowship-trained SLPs rated breathing normality, severity (0-10), presence of pMTD (Y/N), and confidence (0-10). Open-ended responses were analyzed using natural language processing (NLP) and reflexive content analysis (RCA).

resultsNLP analysis identified five visual-perceptual respiratory features: abdominal, anterior neck tension, clavicular, thoracic, and suboptimal breathing-none of which reliably distinguished pMTD from vocally healthy controls (average diagnostic accuracy = 60%; d' ≤ 1.04). RCA methods yielded three categories: Observable Features of Movement and Breathing, Perceived Patient Experiences, and Interpreting and Evaluating Data.

conclusionObservable respiratory patterns were inconsistently linked to diagnostic accuracy. Visual observation alone appears insufficient for reliably identifying pMTD, underscoring the need for multimodal physiological approaches to improve diagnostic specificity.

Indexed as

Clinical decision-makingPerceptual assessmentPrimary muscle tension dysphoniaRespiratory kinematics

Identifiers

PMID41539905
PMCPMC13007046

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.