THE EFFECT OF POSTURAL ALİGNMENT AND DEEP CERVICAL MUSCLE TRAINING ON VOICE FUNCTION IN OLDER ADULTS WITH PRESBYPHONIA

Age‐related changes in the voice mechanism can significantly affect voice quality andcommunication in older adults. Presbyphonia is one of the most common age‐related voicedisorders, resulting from structural and functional changes in the laryngeal tissues.Degeneration of the vocal cord muscles, decreased elasticity of the lamina propria, andreduced neuromuscular control can lead to symptoms such as shortness of breath, decreasedvoice intensity, and decreased phonation efficiency (1,2). These changes can negativelyimpact speech communication and overall quality of life in older individuals (3).Voice production is a complex motor activity requiring coordination between therespiratory, laryngeal, and supralaryngeal systems. Efficient phonation depends not onlyon the laryngeal muscles but also on the alignment and stability of surroundingmusculoskeletal structures, particularly the cervical spine and upper thoracic region (4;5). Postural alignment optimizes respiratory mechanics and laryngeal function, whilechanges 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 cervicalstability, which can increase muscle tension and alter the biomechanical relationshipbetween the hyoid, larynx, and surrounding muscles (8,9). These postural deviations cancontribute to inefficient phonation and reduced vocal performance. Previous studies haveshown that head and neck posture can affect acoustic voice parameters, includingfundamental frequency, vibration, and brightness, highlighting the importance ofmusculoskeletal alignment in voice production (3,6).The deep cervical muscles are critical for maintaining head and neck stability. Weaknessor dysfunction in these muscles can compromise cervical control, respiratory support, andlaryngeal biomechanics (8). Rehabilitation programs targeting deep cervical muscleactivation and postural control have been used in physiotherapy to improve neuromuscularcoordination and spinal stability (8,9). These interventions can indirectly affect voiceproduction by optimizing the biomechanical environment necessary for efficient phonation.Postural and cervical muscle training has been shown to improve neck stability, posturalalignment, and respiratory function (5,10). Improved diaphragmatic breathing and thoracicexpansion associated with improved posture can enhance vocal efficiency by providingbetter phonation support (1,4). However, the direct effects of posture and cervicalstabilization exercises on voice function in older adults with presbyphonia have largelybeen understudied.Given the interactions between posture, cervical stability, and voice production,musculoskeletal interventions may provide a complementary approach to managingage‐related voice disorders (11,12,13). Understanding these effects could shed light onmultidisciplinary rehabilitation strategies aimed at improving vocal performance andcommunication in older adults.Therefore, the aim of this study is to investigate the effects of posture and deepcervical muscle training on voice function in older adults with presbyphonia.