Exercise-induced Paradoxical Vocal Fold Motion Disorder: Clinical Features and Potential Mechanisms
Disorder of Vocal Cord
About this trial
This is an interventional diagnostic trial for Disorder of Vocal Cord
Eligibility Criteria
Inclusion Criteria:
- Adolescents (ages 12-18yo)
- Exercise regularly (at least 40min 3x/week) in competitive athletic environment
- Inclusion criteria specific to E-PVFMD group: report of atypical dyspnea during exertion and associated decrements in athletic performance for more than 2 weeks prior to presentation; Score of > 10/40 on the Dyspnea Index
Exclusion Criteria:
- Developmental or cognitive disorder precluding ability to follow directions or read instructions
- Behavioral disorder that would disrupt study protocol or potentially affect outcome parameters (e.g., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD]).
- Neuromuscular disorders affecting the respiratory or phonatory system (e.g., ALS, Myasthenia Gravis)
- Supralaryngeal anatomical defects impeding airflow
- Cardiovascular conditions/disorders (e.g., hypertension)
- Poorly controlled obstructive pulmonary disorders (e.g., asthma)
- Use of the following medications: (a) antihypertensive, (b) cardiovascular, (c) psychotropic
- Identifiable (organic) vocal fold pathology occluding more than a 1/3 of the airway (e.g., lesions, nodules), found on laryngeal examination
- Intolerance to flexible nasoendoscopy
- E-PVFMD group only: absence of signs or symptoms of acute E-PVFMD attack with exercise provocation challenge at maximum exertion at or before the 3minute mark.
- At-Risk group only: Positive signs or symptoms of an acute E-PVFMD attack with exercise provocation challenge at maximum exertion.
Sites / Locations
- Mass Eye and Ear Infirmary
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Adolescent athletes with PVFMD
Adolescent athletes at-risk for PVFMD
participants must be adolescents (ages 12-18yo) who exercise regularly (at least 40 min 3x/week) and engage in athletic activities competitively by their report. Any participant who declares he or she is a competitive athlete and presents to the clinic reporting atypical dyspnea during exertion and associated decrements in athletic performance for more than 2 weeks prior to presentation will be considered for the study. Participants must score at least a 10 out of 40 on the Dyspnea Index
participants must be adolescents (ages 12-18yo) who exercise regularly (at least 40 min 3x/week) and engage in athletic activities competitively by their report. Participants in the at-risk group must report playing sports in a competitive environment, must report no symptoms of atypical dyspnea over the past 6 months, and must score less than 6 out of 40 on the Dyspnea Index.