Inspiratory muscle strength training with behavioral therapy in a case of a rower with presumed exercise-induced paradoxical vocal-fold dysfunction.
Ruddy BH, Davenport P, Baylor J, Lehman J, Baker S, Sapienza C. - Int J Pediatr Otorhinolaryngol. 2004 Oct;68(10):1327-32.

Department of Communicative Disorders, University of Central Florida, HPA 2, Suite 101, Orlando 32816-2215, USA. bhruddy@mail.ucf.edu

Paradoxical vocal fold dysfunction (PVFD) with high effort exercise can result in disruptions to ventilation, dyspnea, inspiratory stridor, elevated heart rate, and syncope. This single subject study experimentally tested an inspiratory muscle strength training (IMST) program with behavioral therapy on a 15-year-old male crew member. Outcome variables were maximum inspiratory pressure (MIP), and dyspnea ratings. Following 5 weeks of IMST, MIP increased by 93% from baseline function while dyspnea ratings substantially decreased. Outcome included successful competition with his high-school crew team, a task he was previously unable to complete. Discussion focuses on IMST combined with traditional approaches of voice therapy for treating PVFD.