Texas Christian University’s Chris Watts, Ph.D., the Marilyn & Morgan Davies Dean of the Harris College of Nursing & Health Sciences and professor of communication sciences and disorders is the principal investigator on a $340K federal grant from the National Institutes of Health (NIH) to investigate the application of innovative technology for treating muscle tension dysphonia (MTD) associated with voice disorders.
“Voice disorders, especially MTD, are prevalent in society and are a public health concern due to the disability they cause, and the health care expenditures associated with their care,” Watts explains. “Through this project, we aim to improve upon contemporary voice rehabilitation approaches to reduce handicap associated with dysphonia and increase an individual’s activity participation, quality of life and the cost burden associated with voice impairments.”
The grant is associated with the National Institute on Deafness and Other Communication Disorders, one of the 27 institutes of NIH. Watts is collaborating with Dr. Benjamin Barsties von Latoszek, a professor of speech therapy at the SRH University of Applied Health Sciences in Germany.
TCU alum Kristie Knickerbocker ’08 (MS ’10) is also a collaborator on the project and will serve as the lead clinician delivering the novel voice treatment through her clinical practice, a Tempo Voice Center in Fort Worth.
MTD is one of the most diagnosed voice disorders encountered in clinical otolaryngology and speech-language pathology practice. The condition arises secondary to dysregulated muscle activation in the larynx (aka “voice box”) and leads to a chronic state of increased muscle tension that negatively influences how the vocal folds vibrate, leading to a persistent hoarse or strained voice.
“Previous research has demonstrated that voice rehabilitation has a positive impact on MTD, although the voice often does not return to a normal range at treatment discharge for many patients,” says Watts. “The level of remaining impairment and handicap experienced by many people justifies the development of novel approaches to improve clinical outcomes of voice rehabilitation, a problem which this project directly addresses.”
The grant will fund research investigating the novel application of low frequency vibration to the laryngeal muscles as patients produce targeted voice exercises. The technology and technique, called local translaryngeal vibration (LTLV), has previously been investigated by Watts and Dr. Barsties von Latoszek in several published studies.
“Vibration as a therapeutic modality has been used in physical rehabilitation for many decades, but is not routinely used in voice rehabilitation,” Watts said. “Our project will utilize a hand-held tool to deliver low-frequency vibration to the hyperactivated muscles involved in MTD, with our hypothesis being that vibration will inhibit hyperactive muscle activity to facilitate the release of muscle tension, which we have found on a small scale in our earlier studies. We believe low frequency vibration promotes this deactivating effect through modulation of sensory mechanoreceptors linked to muscle activation and facilitation of blood flow to the laryngeal area.”
The research associated with this project has been approved by the TCU Institutional Review Board and Watts’ team will begin recruiting participants in fall 2024. The three-year funded project will seek to recruit 40 individuals diagnosed with MTD, who will receive five to eight weeks of LTLV voice rehabilitation. The federal grant includes funding for TCU undergraduate research assistants, and Watts will be offering this opportunity to students looking for a strong research experience in the health sciences.
The voice rehabilitation research begins in September and will continue through April of 2027.