Patients with chronic cough are often surprised when their pulmonologists refer them for speech and language assessment. The etiology of cough can indeed involve myofunctional disorder. (This was the very experience recently in the family of the writer of this blog.) Patients are not only surprised, but skeptical. Interestingly, it turns out that their skepticism endures even when their treatment works.
A large retroactive study in the Journal of Voice (2021 Dec 27;S0892-1997(21)00408-2. doi: 10.1016/j.jvoice.2021.11.018) shows this. The study’s aims were to evaluate, against controls, the efficacy of speech-language pathology therapy in chronic cough, and patient’s own appraisal of its efficacy.
Adjusting for an uncertain risk of detection bias, and allowing for heterogeneity of data (Chi² (1) = 22.22, P < 0.001, I² = 95%), there emerged no difference between interventions in self-perception of cough severity (z = 0.09, P = 0.930; tau² = 0.65, I² = 90%), or in the self-perception of the effects of chronic cough on health status (z = 0.30, P = 0.77; tau² = 0.99, I² = 97%). The estimated mean difference was 0.97 to cough frequency, and it differed significantly from zero (z = 4.47, P < 0.001). Cough frequency diminished in speech-language therapy over control interventions. In the subjects' perception, there were no differences between the interventions.
The therapy worked, even if patients didn’t think it did.
MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.