{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:56:55Z","timestamp":1777942615234,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2007,5,1]],"date-time":"2007-05-01T00:00:00Z","timestamp":1177977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:p>Purpose. This study investigated the effect of expiratory muscle strength training (EMST) on voice production, dysarthria, and voice-related quality-of-life issues in persons with multiple sclerosis (PwMS). It was hypothesized that PwMS would have improved voice production and reduced voice-related quality-of-life issues following EMST. Participants and Methods. Seventeen participants with MS and 14 healthy (H) controls completed 8 weeks of EMST, followed by 4 weeks of no training. Analyzed outcomes as a function of EMST were maximal expiratory pressure (MEP), sustained vowel prolongation (SVP), words per minute (WPM) measured from connected speech, and quality-of-life indices related to the presence of the dysarthria and dysphonia. Results. PwMS had lower MEPs, shorter SVP, and less WPM than the controls prior to training. Following EMST, both groups had significant improvement in MEPs that stayed above baseline after training halted. EMST did not improve voice production or voice-related quality of life for PwMS. Conclusion. Respiratory muscle weakness is present in PwMS having mild- to moderate-level disability. EMST improved expiratory muscle strength but did not statistically change objective and subjective components of voice\/speech production in PwMS.<\/jats:p>","DOI":"10.1177\/1545968306294737","type":"journal-article","created":{"date-parts":[[2007,4,23]],"date-time":"2007-04-23T14:58:12Z","timestamp":1177340292000},"page":"239-249","source":"Crossref","is-referenced-by-count":72,"title":["Expiratory Muscle Strength Training"],"prefix":"10.1177","volume":"21","author":[{"given":"T.","family":"Chiara","sequence":"first","affiliation":[{"name":"Malcom Randall VA Medical Center, Brain Rehabilitation Research Center, Gainesville, FL, , Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Sapienza","sequence":"additional","affiliation":[{"name":"Malcom Randall VA Medical Center, Brain Rehabilitation Research Center, Gainesville, FL, Department of Communication Sciences and Disorders, College of Liberal Arts and Sciences, University of Florida, Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,5,1]]},"reference":[{"issue":"5","key":"atypb1","first-page":"vl6","volume":"252","author":"Filippi M.","year":"2005","journal-title":"J Neurol."},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.72.6.511"},{"issue":"10","key":"atypb3","first-page":"675","volume":"66","author":"Beukelman DR","year":"1985","journal-title":"Arch Phys Med Rehabil."},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.1502.229"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.99.13244999"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-5003-6"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000184493.06254.a6"},{"key":"atypb8","volume-title":"Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment","author":"Colton R.","year":"1990"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1177\/000348948409300114"},{"key":"atypb10","volume-title":"Respiratory Function in Speech and Song","author":"Hixon T.","year":"1987"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7091-3737-6"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000048642.58419.1E"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1002\/j.2048-7940.1999.tb01840.x"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(00)90105-9"},{"issue":"7","key":"atypb15","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/S0003-9993(03)00133-3","volume":"84","author":"Klefbeck B.","year":"2003","journal-title":"Arch Phys Med Rehabil."},{"issue":"1","key":"atypb16","first-page":"46","volume":"140","author":"Olgiati R.","year":"1989","journal-title":"Schweiz Arch Neurol Psychiatr"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90281-6"},{"issue":"5","key":"atypb18","first-page":"1056","volume":"40","author":"Hartelius L.","year":"1997","journal-title":"Hear Res"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.3109\/02699209508985327"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1159\/000021531"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1159\/000021538"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1159\/000266286"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.29.4.323"},{"key":"atypb24","volume-title":"Howley. 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