The VivaVoce case: Riablo for the treatment of stuttering


According to a definition by the WHO (World Health Organization) stuttering is defined as a disorder of the rhythm of the word, in which the person knows precisely what he would like to say, but at the same time is unable to say.

It affects about 1% of the world population, in Italy there are almost 1 million stutterers with peaks of 5% in preschool age equal to about 250 thousand children.

Considered as one of the most widespread language disorders, it consists of a combination of alterations in the rhythm and fluidity of verbal expression and is experienced by those affected with great suffering and discomfort.

Stuttering is a language disorder that has its roots in the behavioral, emotional and communicative sphere: it therefore represents an extremely complex condition, as well as therapeutic approaches to healing.

The VivaVoce Medical Center has developed an innovative approach to give a concrete, effective and lasting solution to those who suffer from stuttering: the MRM-S Method


The Vivavoce medical centre, founded in 2011 by Giovanni Muscarà, a former stutterer, he developed an innovative approach to give a concrete, effective and lasting solution to stutter sufferers:  the MRM-S Method (Muscarà Rehabilitation Method for Stuttering).

The Method is based on a theoretical interpretative model of the causes of stuttering called the DIVA model. According to this theory stuttering would be caused by a disturbance in motor control.

Speaking, in fact, is a motor act, which implies a series of movements that are generally automatic for us, that is, they follow precise programs, precisely the motor patterns that we have acquired during the language development phase. However, if the schemes acquired for the execution of a certain movement are not correct, the same error will be repeated involuntarily, which, in the case of language, translates into a non-fluent eloquence.

The most classic methods of overcoming stuttering involve voluntary control over secondary aspects of language such as rhythm, the hyper-articulation of sounds, the emission of breath, leading to an unnatural and tiring way of speaking.

The MRM-S Method, on the other hand, aims to” reprogram “the motor patterns of language production , associating them with the acquisition of movements of other groups muscle. “

The Method does not act directly on the voice (and therefore on the modification of sounds as a blockage at the base of stuttering), but has the aim of resuming motor control of all the parts related to phonation (tongue, lips, diaphragm, etc.). ), working on the areas mainly involved in the problem.

In practice, physiotherapy is applied to the field of stuttering with interventions aimed at correcting posture and breathing. Furthermore, physiotherapy treatment is preparatory to a neuromotor reprogramming, because it helps to modify maladaptive patterns, proposing new and more functional motor schemes.

In essence, the method is based on the principle of motor learning, or on the permanent change of behavior through practice and experience.

The basic idea is that the repeated performance of relevant motion sequences leads to greater precision in the preparation of motor commands for the correct production of words.

To do this, the MRM-S Method acts on all levels of the motor system of the language:

  1. Breathing
  2. Phonological
  3. Articulation
  4. Behavior

In a fragmented cultural and rehabilitative context, linked to outdated theories and clichés that have long since been overcome, the MRM-S Method stands out worldwide as one of the few methods for the treatment of stuttering demonstrated scientifically and at the center of a scientific validation project .


The MRM-S method aims to improve the articulatory performance of language through a work on the motor system that underlies it.

How can Riablo fit into a rehabilitation program of this kind?

As already mentioned, the MRM-S Method acts on all levels of the motor system of language: breathing, phonation, articulation and behavior.

As far as phonation is concerned, the primary objective is to reach a greater awareness of the phonatory movement, the one more properly linked to the production of sounds related to language.

There is scientific agreement that those who stutter cannot effectively coordinate the engine plans during the speech act.

The person who stutters does not lose control exclusively of the phonatory muscles but, with different intensities and manifestations, also of numerous other muscles of his own body (irregular and uncontrolled movements of the neck, but also of the mouth or eyes).

“The patient is guided in the execution of simple motor patterns with elementary motor syntax, repeated through the use of cutting-edge equipment, Riablo in the first place.”

Through the use of Riablo’s biofeedback exercises, we work on improving the coordination of certain movements (such as those of the prehensile organs of the upper limbs), consequently improving the control of the muscles used for phonation and, therefore, of the eloquence itself.

An original and interesting application case of Riablo, to help people suffering from stuttering to regain control of their movements, and consequently of their voice, to reach a new psycho-physical balance and be ready to pass both daily life tests and the most stressful ones that those who stutter tend to avoid.


CoRehab srl
via Solteri 38
38121, Trento, Italia
Telefono: 0461 960157

Assistenza tecnica:
Whatsapp: +39 389 5868799
Telefono: +39 0461 1812188

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.