THE EFFECT OF POSTURAL ALIGNMENT AND DEEP CERVICAL MUSCLE TRAINING WITH PRESBYPHONIA

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.