Nekoprichting en Stemgeving

Demmink-Geertman, E.G. & W.J.H. Jolink-van Keulen (1993). Nekoprichting en Stemgeving. Logopedie en Foniatrie, nr 1, p. 15-20.
(Article in Dutch)

Correlation between head posture and voice problems
Introduction
Anatomically, there are specific structural divisions which, when hyperto­nic or imbalanced in their tonicity, act as areas of functional restricti­on. As a result, effects of head position on the dynamics of the pharynx and the upper oesophageal sphincter will next influence swallo­wing, breat­hing, articulation and phonation. Aberrations of head posture are too much extension, too much flexion or wryness of the neck by dystonia of the m. sternocleidomastoideus.
Also lordo­sis, often seen together with a wrong head position, will inhibit the slight swelling of the lumbar region accompanied by a good deep diaphragmatically inspiration. The spinal column is relatively rigid, except for the cervical and lumbar vertebrae. Any bending of the body almost entirely takes place within the five large lumbar vertebrae and many muscles employed for the support of the body as well as in speech are concentrated in this critical area. The majority of the muscles in the lumbar area are employed in respiration and therefore, they are involved in speech.

Therapy
To improve posture, alternating movement of the extremities (extension and flexion) is executed in supine position. (Therapists can learn these exercises in our workshops. They are very comforting to the patient.).
Next follows training of the four stages of breathing in rest:
* Lengthened, very slow expiration with diaphragm relaxation and release of the muscles of the waist. N.B . Mind that the patient does not mobilize ‘inadequately helping muscles’ by exhaling too long in the form of inducing too much pressure in the belly area. * Expiration space at first of one second and later on after training two or three seconds. * Lengthened, very slow inspiration with straining the diaphragmatic muscles and the muscles of the waist. N.B. Mind that the patient does not mobilize ‘ inadequately helping muscles’ by inhaling too long by pulling up shoulders and chest. * Short inspiration space with change-over from inhaling to exhaling.

Now follows the correction of posture in sitting and standing with emphasis on the correction of head posture. The neck muscles are too slack and the throat muscles too tensed.
Correction is done by applying massage and special exercises.

Demmink-Geertman, E.G. (1995).