You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
autonomic dysfunction presents with heterogeneous clinical features and is a multi - system condition affecting nervous , cardiac , gastrointestinal , musculoskeletal and vocal cord function .
autonomic dysfunction is often a result of an imbalance in the sympathetic and parasympathetic nervous system .
this case study demonstrates the association of vocal cord disorders in autonomic dysfunction and the role of yoga to modulate autonomic balance .
a 23-year - old female with a past medical history of severe gastroesophageal reflux disease presented with shortness of breath and fatigue .
i do not feel like i am getting enough oxygen to my brain ,  being suffocated in closed spaces and with certain smells .
shortness of breath was associated with inspiratory wheeze , fatigue , chest pain , lightheadedness , headache , numbness / tingling in the arms and legs , and exercise intolerance .
alternative lifestyle changes such as using a cold mist humidifier , sleeping flat , and breathing with mouth open were helpful .
orthostatic vitals recorded in the supine , sitting , and standing positions at 3 min intervals were positive [ figure 1 ] .
work - up included normal electrocardiogram , chest x - ray , chest computed tomography , and echocardiogram .
complete blood count , comprehensive metabolic panel , and thyroid - stimulating hormone levels were normal .
arterial blood gas showed respiratory alkalosis with compensatory metabolic acidosis both before and after exercise .
pulmonary function tests showed hyperventilation and flattening of the inspiratory portion of the volume flow loop .
exercise stress test showed an exercise capacity of 59% of normal [ figure 2 ] .
she was counseled to increase fluid intake and referred to speech therapy for breathing exercises .
orthostatic vital signs recorded at three - minute intervals volume flow loop and exercise stress test results on follow - up , her shortness of breath improved after 6 weeks of a yoga training program including isometric and diaphragmatic breathing exercises .
initially , she used to have daily symptoms ; after the yoga program , she had symptoms only a couple of times a week . at times ,
when she did have shortness of breath , she took deep breaths with her mouth open ( pursed lip inspiration ) , and her shortness of breath improved .
this case report demonstrates the association of vocal cord dysfunction with dysautonomia and the central role of an imbalanced autonomic system in the pathophysiology of both , where yoga may provide a therapeutic role in their management .
autonomic dysfunction was demonstrated by positive orthostatic vitals and a complex of autonomic symptoms , including headaches , lightheadedness ,  brain fog ,  chest pain , gastroesophageal reflux , and numbness / tingling .
vocal cord dysfunction was demonstrated by flattening of the inspiratory portion of the flow volume loop and dyskinesia of the vocal cords by laryngoscopy . a multifactorial approach including increased fluid intake , breathing , and isometric exercises resulted in the improvement of symptoms .
vocal cord dysfunction is associated with autonomic disorders , including shy - drager syndrome and multiple system atrophy ( msa ) .
upper airway obstruction due to vocal cord dysfunction has been observed via laryngoscope in 8 of 10 patients with progressive pan - autonomic failure of shy - drager syndrome .
the mechanism of the selective involvement of abductor muscle ( posterior muscle ) of the vocal cord in autonomic dysfunction is unknown .
the key to the pathophysiology of both autonomic and vocal cord dysfunction is the role of the vagus nerve in interfacing homeostasis .
vocal cord dysfunction , abnormal adduction of vocal cords , and laryngeal hyper - responsiveness are suggested to be the functions of altered autonomic balance .
the vagus nerve influences autonomic functions  respiratory , cardiac cycles , and gut motility .
an inflammatory insult can disrupt the normal functioning of the vagus nerve resulting in an altered autonomic function with paroxysmal movement of the vocal cords .
stimuli such as exercise or odors induce parasympathetic reflexes causing airway narrowing at the glottis level .
given the central role of the vagus nerve , breathing and isometric exercises may be therapeutic in the management of autonomic dysfunction . inspiratory muscle training ( imt )
is therapeutic for both vocal cord and autonomic dysfunction . in a case report of a patient with exercise - induced paradoxical vocal fold motion ( pvfm ) ,
imt for 5 weeks resulted in no pvfm symptoms at the end of the study .
the results showed increased inspiratory muscle strength , improved maximal exercise capacity , and reduced exercise - induced dyspnea .
respiratory maneuvers and isometric exercises are also beneficial in autonomic failure . in a study measuring mean arterial pressure , isometric exercises such as leg muscle tensing reduced orthostatic hypotension .
respiratory maneuvers including inspiratory - pursed lips breathing and inspiratory sniffing reduced orthostatic hypotension in autonomic failure via activation of the respiratory pump .
the inter - relationship between vocal cord and autonomic dysfunction may have profound implication in the diagnosis and management of autonomic disorders .
more correlative data studying the relationship between vocal cord dysfunction and autonomic disorders need to be analyzed .
given breathing and isometric exercises are therapeutic to both vocal cord and autonomic dysfunction , there is a need for well - designed clinical trials investigating the role of breathing and isometric exercises in the role of autonomic dysfunction .
vocal cord dysfunction is often associated with dysautonomia . given the central role of the vagus nerve in autonomic and vocal cord dysfunction , breathing and isometric exercises aid in the regulation of physiologic responses and
a 23-year - old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors . 
 she reported the symptoms of autonomic dysfunction including fatigue , chest pain , lightheadedness , headaches , numbness / tingling in the arms and legs , and exercise intolerance . 
 vital signs were significant for orthostatic intolerance . 
 volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction . 
 laryngoscopy showed dyskinesia of the left vocal cord , especially after exercise . 
 multifactorial approach was used including increased fluid intake and breathing exercises . 
 after 6 weeks of breathing and isometric exercises , the patient reported improvement in dyspnea after exercise . 
 this case report demonstrates the therapeutic role of breathing and isometric exercises in the management of vocal cord and autonomic dysfunction .