Effects of Head and Neck Postural Correction and Muscle Strengthening Exercises on Voice Improvement in Patients with Hypertensive Pontine Hemorrhage and Forward Head Posture

Purpose: This study aimed to examine the effects of head and neck posture correction and muscle strengthening exercises on voice improvement in patients with pontine hemorrhage and forward head posture. Research design, data, and methodology: The study was conducted with three patients, five sessions per week, for a total of 32 sessions, each lasting 30 minutes. Muscle strengthening and posture correction were performed using the Kaltenborn joint mobilization technique, a pressure biofeedback device, McKenzie stretching exercises, and proprioceptive neuromuscular facilitation (PNF). To evaluate the effects on voice improvement, Visi-Pitch and MDVP were used to analyze each patient’s voice and assess task performance. Results First, acoustic evaluations before and after posture correction and muscle strengthening exercises were conducted, focusing on fundamental frequency, frequency variation rate, amplitude variation rate, and noise-to-harmonic ratio (NHR). Second, speech motor coordination was assessed through articulation alternation exercises. Third, maximum phonation duration was compared and analyzed to measure breathing control, phonation patterns, and phonation endurance. The results indicated that all of these factors positively influenced voice improvement. Conclusions: In patients with hypertensive pontine hemorrhage and forward head posture, head and neck posture correction and muscle strengthening exercises had positive effects on voice improvement.