Revista CEFAC, Volume: 23, Issue: 4, Published: 2021
  • International Classification of Functioning, Disability, and Health in adult and older users of audiology services ORIGINAL ARTICLES

    Souza, Valquíria Conceição; Lemos, Stela Maris Aguiar

    Abstract in Portuguese:

    RESUMO Objetivo: descrever aspectos da funcionalidade e incapacidade, relacionados à audição e fatores sociodemográficos de usuários de um serviço de audiologia. Métodos: estudo exploratório com amostra probabilística composta por 152 indivíduos que responderam um questionário socioeconômico e assistencial. A funcionalidade e incapacidade foram analisadas por meio da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Foram realizadas análises descritivas dos dados. Resultados: a maior parte dos usuários do Serviço de Saúde Auditiva considerou ter deficiência ligeira 41,2% e moderada 34,2% em b1560Percepção Auditiva e deficiência ligeira 36% e moderada 35,1% em b230Funções Auditivas. Em Atividades e Participação os usuários do Serviço de Saúde Auditiva obtiveram melhores resultados em d330Falar 83,3%, d315Comunicar e receber mensagens não verbais 65,8% e d760Relacionamentos familiares 65,1%. O Aparelho de Amplificação Sonora Individual foi um facilitador na interação social desses sujeitos com o ambiente. A maioria dos indivíduos atendidos no Ambulatório de Audiologia não apresentou deficiência ou dificuldades nas atividades e participação e o ambiente atuou como um facilitador. Conclusão: a maior parte dos participantes atendidos no Serviço de Saúde Auditiva apresentou deficiência na percepção auditiva e funções auditivas, porém essa deficiência não atuou como um fator limitante no desempenho da maioria das atividades e participações avaliadas.

    Abstract in English:

    ABSTRACT Purpose: to describe aspects of functioning and disability related to hearing and sociodemographic factors of audiology service users. Methods: an exploratory study with a probabilistic sample comprising 152 participants who answered a socioeconomic and assistance questionnaire. The functioning and disability were analyzed by means of the International Classification of Functioning, Disability, and Health. Descriptive data analyses were conducted. Results: most users of the Hearing Health Care Service considered they had mild (41.2%) or moderate (34.2%) disability in b1560 Auditory perception, and mild (36%) and moderate (35.1%) disability in b230 Hearing Functions. In Activities and Participation, the users of the Hearing Health Care Service obtained better results in d330 Speaking (83.3%), d315 Communicating with and receiving nonverbal messages (65.8%), and d760 Family relationships (65.1%). The hearing aid was a facilitator in these subjects’ social interaction with the environment. Most of those attending the Audiology Outpatient Center did not have disabilities or difficulties in the activities and participation, and the environment was a facilitator. Conclusion: most of the participants attending the Hearing Health Care Service had a disability in auditory perception and hearing functions. However, such a disability was not a limiting factor in the performance of most of the activities and participations assessed.
  • Maximum phonation time in the pulmonary function assessment ORIGINAL ARTICLES

    Moreno, Edvania Gomes Henrique; Calassa, Bianca Teixeira; Oliveira, Daniela Vitoria Silva; Silva, Maylanne Iris Nascimento; Albuquerque, Laienne Carla Barbosa de Barros; Freitas-Dias, Ricardo de; Silva, Bruno Rafael Vieira Souza; Araújo, Rodrigo Capatto de; Costa, Eduarda Lubambo; Costa, Emília Chagas; Correia, Marco Aurélio de Valois

    Abstract in Portuguese:

    RESUMO Objetivo: avaliar a concordância do tempo máximo de fonação (TMF) com a Capacidade Vital, intra e interexaminador, por meio da técnica de contagem numérica em uma única respiração (TC) e do fonema /a/ sustentado e da capacidade vital lenta (CVL). Métodos: trata-se de um estudo de concordância realizado em três grupos de indivíduos saudáveis, cada grupo com 30 voluntários, alocados de acordo a idade. A CVL foi mensurada por meio do espirômetro, enquanto o TMF foi avaliado pela emissão do fonema/a/ e da TC. Os dados foram analisados pelo programa SPSS versão 20.0. Inicialmente utilizou-se estatística descritiva e para concordância dos dados foi utilizado o coeficiente de correlação intraclasse (CCI). Resultados: os Coeficientes de Correlação Intraclasse (CCI) intraexaminadores foram considerados excelentes, com resultados significantes acima de 0,92 para a CVL e maiores que 0.79 para a TC e fonema/a/. Em relação à avaliação interexaminadores, os CCIs também foram significantes tanto para a CVL com valores maiores que 0,96 quanto para a TC e o fonema/a/ com valores maiores que 0,85. O erro inerente a técnica foi avaliada por meio do erro padrão da medida para as analises intra e interexaminadores com valores que variaram de 1,79 a 3,29 para fonema/a/, 3,20 a 6,58 para TC e 65,05 a 206,73 para CVLml. Conclusão: as técnicas de fonação com o fonema /a/ e TC, assim como a CVL, demonstraram uma excelente concordância intra e interexaminadores.

    Abstract in English:

    ABSTRACT Purpose: to evaluate the reliability of the maximum phonation time (MPT) and Vital Capacity intra and inter-examiner, by means of the single-breath counting test (CT) and the sustained /a/ phoneme, and the slow vital capacity (SVC). Methods: a reliability study carried out in three groups of healthy individuals, each group with 30 volunteers, allocated according to age. SVC was measured using a spirometer, while the MPT was assessed by the phoneme /a/ and CT. The data were analyzed using SPSS version 20.0. Initially, descriptive statistics were used and for data reliability, the intraclass correlation coefficient (ICC). Results: the Intraclass Correlation Coefficients (ICC) were considered excellent, with significant results above 0.92 for SVC and greater than 0.79 for CT and phoneme /a/. Regarding the inter-examiner evaluation, the ICCs were also significant for both SVC with values greater than 0.96, and for CT and the phoneme /a/ with values greater than 0.85. The error inherent in the technique was assessed using the standard error of the measurement for intra and inter-examiner analyses with values ranging from 1.79 to 3.29 for phoneme /a/, 3.20 to 6.58 for CT and 65, 05 to 206.73 for SVCml. Conclusion: phonation techniques with the phoneme /a/ and CT, as well as SVC, have an excellent reliability, due to intra and inter-examiner agreement measures.
  • Pediatric voice-related quality of life and acoustic analysis of voice: a study in schoolchildren ORIGINAL ARTICLES

    Reis, Suelene Cibelle Silva dos; Nascimento, Giselle Frutuoso; Lira, Zulina Souza de; Gomes, Adriana de Oliveira Camargo

    Abstract in Portuguese:

    RESUMO Objetivo: avaliar a qualidade de vida em voz pediátrica autorreferida em escolares, sem queixas vocais e correlacioná-la aos parâmetros acústicos vocais. Métodos: a população desta pesquisa foi constituída por 31 crianças, com média de idade de 6,5 (±0,17) anos. Para verificar a percepção das crianças sobre a qualidade de vida em voz, foi aplicado o protocolo Qualidade de Vida em Voz Pediátrico composto por dez questões fechadas e três domínios. Os parâmetros acústicos avaliados foram frequência fundamental, jitter, shimmer, glottal-to-noise excitation ratio e índice de ruído, além do diagrama de desvio fonatório, a partir da análise da emissão da vogal /ɛ/ sustentada por cinco segundos. Resultados: os três domínios do protocolo Qualidade de Vida em Voz Pediátrico apresentaram escores próximos a 100% para todas as crianças. Quanto aos parâmetros acústicos, a maioria apresentou valores fora da normalidade, no diagrama de desvio fonatório e nos valores de shimmer. Observou-se diferença entre as meninas e os meninos apenas na frequência fundamental. Conclusão: a qualidade de vida em voz pediátrica autorreferida, nas crianças estudadas, apresentou impacto positivo, a despeito das alterações acústicas vocais encontradas. Não houve correlação entre a qualidade de vida em voz pediátrica e os parâmetros acústicos vocais, no grupo estudado.

    Abstract in English:

    ABSTRACT Purpose: to assess the self-reported voice-related quality of life of schoolchildren without voice complaints and correlate it to acoustic parameters of voice. Methods: the research population comprised 31 children, mean age 6.5 (±0.17) years. The children’s perception of their voice-related quality of life was verified with the Pediatric Voice-Related Quality of Life Survey, which has 10 closed-ended questions and three domains. The acoustic parameters assessed were fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, and noise rate, besides the phonatory deviation diagram, based on the analysis of the emission of the sustained vowel /ɛ/ for 5 seconds. Results: all the children obtained scores close to 100% in the three domains of the Pediatric Voice-Related Quality of Life Survey. As for the acoustic parameters, most of them presented abnormal values in the phonatory deviation diagram and in shimmer. There was a difference between girls and boys only in fundamental frequency. Conclusion: the pediatric self-reported voice-related quality of life of the children studied had a positive impact, despite the acoustic changes found in the voices. There was no correlation between the pediatric voice-related quality of life and the acoustic parameters in voice in the group studied.
  • Association between speech and dental occlusion changes in children with cleft lip and palate and time of primary plastic surgeries ORIGINAL ARTICLES

    Schilling, Gabriela Ribeiro; Cardoso, Maria Cristina de Almeida Freitas; Silva, Paulo Sérgio Gonçalves da; Maahs, Marcia Angélica Peter

    Abstract in Portuguese:

    RESUMO Objetivos: descrever alterações de fala e dento-oclusais em crianças com fissuras labiopalatinas, verificar a associação entre si e destas com a época das cirurgias plásticas primárias. Métodos: estudo transversal, com coleta de dados de identificação, idade nas cirurgias primárias, avaliação clínica dento-oclusal e da fala. Utilizou-se o teste Qui-quadrado, teste exato de Fisher e teste t para verificar as associações entre as variáveis, com um nível de significância de 5% (p < 0,05). Resultados: amostra composta por 11 crianças entre seis e dez anos, sendo a maioria do sexo masculino, etnia autodeclarada branca e fissura transforame incisivo (com prevalência de acometimento do lado esquerdo). A média da realização da labioplastia foi aos seis meses e palatoplastia aos treze meses. Dentre as principais alterações dento-oclusais, destacam-se: mordida cruzada posterior e mordida cruzada anterior. Todos os sujeitos apresentaram alteração de fala com prevalência de alterações em casos com deformidades dentoalveolares e palatinas, seguidas pelas alterações passivas e alterações ativas. Houve tendência dos sujeitos que apresentaram mordida cruzada anterior terem sido submetidos à labioplastia primária, em média, quatro meses antes dos sujeitos sem mordida cruzada anterior. Conclusões: as associações entre alterações de fala e dento-oclusais e destas com a época das cirurgias plásticas primárias não foram estatisticamente significantes, e ainda que se saiba que a labioplastia precoce é o ideal para favorecer funções orais e estética, os resultados demonstraram tendência a mordida cruzada anterior nestes sujeitos.

    Abstract in English:

    ABSTRACT Purpose: to describe the changes in speech and dental occlusion in children with cleft lip and palate and verify their association with each other and with the time of primary plastic surgeries. Methods: a cross-sectional study with collected data on the subjects’ identification, age at the time of primary surgeries, and clinical assessment of speech and dental occlusion. The chi-square test, Fisher's exact test, and t-test were used to verify the associations between the variables at the 5% significance level (p < 0.05). Results: the sample comprised 11 children aged 6 to 10 years, most of whom were males, self-reported white, with trans-incisive foramen cleft, predominantly on the left side. The mean age at lip repair surgery was 6 months, and 13 months at palatoplasty. Among the main dental occlusion changes, posterior and anterior crossbite stood out. All the subjects presented changed speech, with a prevalence of cases with dentoalveolar and palatine deformities, followed by passive and active changes. Subjects with anterior crossbite tended to have undergone primary lip repair surgery at a mean of four months earlier than the subjects without anterior crossbite. Conclusions: the associations between speech and dental occlusion changes, and between these and the time of primary plastic surgeries were not statistically significant. Even though it is known that early lip repair surgery is ideal to favor oral functions and aesthetics, the results revealed a tendency towards anterior crossbite, in these subjects.
  • Occurrence and remission of loss of sensitivity of inferior alveolar nerve in mandibular fractures ORIGINAL ARTICLES

    Pellegrini, Washington Geraldo; Pavan, Eduardo Pipino; Luz, João Gualberto Cerqueira

    Abstract in English:

    ABSTRACT Purpose: to evaluate the occurrence of loss of sensitivity of the inferior alveolar nerve, and to monitor the remission of this change in patients with mandibular fractures subjected to surgical treatment. Methods: patients with mandibular fractures, surgically treated within one year, were prospectively evaluated. Data regarding etiology, fracture location, type and displacement, and surgical access, were obtained. The tactile and thermal tests were applied at eighteen points in the mental region, within a period of six months. Statistical tests were applied to compare the categories of variables and the period of observation (p ≤ 0.050). Results: during the study, 37 patients were included. There were 24 bilateral and 13 unilateral fractures. Sensory changes occurred in 56.8% of the patients in the preoperative period, in 83.8% of the patients, in the postoperative period, and 35.1% of the patients presented complete remission during the final period of the study. Conclusion: sensory changes occurred in about half of the patients, due to the fracture, increasing greatly in the postoperative period, with complete remission in about one third of the cases. The fracture type, degree of displacement and surgical access type influenced the occurrence of sensory alterations.
  • Profile of patients undergoing speech-language therapy in a physical and rehabilitation medicine hospital service ORIGINAL ARTICLES

    Prieto Farias, Paulo; Campo Rivas, Manuel Nibaldo del

    Abstract in Spanish:

    RESUMEN Objetivo: analizar el perfil y factores de riesgo de usuarios atendidos por fonoaudiólogos en un servicio hospitalario de medicina física y rehabilitación (SMFyR) de la red pública de salud. Métodos: se realizó un estudio de cohortes retrospectivo. Las variables fueron resumidas mediante frecuencias, proporciones y medidas de tendencia central. Los riesgos relativos (RR) se estimaron mediante razón de incidencias (IC:95%) y la prueba exacta de Fisher bilateral. Se consideró un nivel de significancia p<0,05. Resultados: 23.365 prestaciones fonoaudiológicas distribuidas en 8416 sesiones se realizaron entre los meses de septiembre de los años 2016 y 2018, en un SMFyR. Las prestaciones se concentraron en personas mayores de 60 años en las áreas de la deglución (28,6%) y cognición (11,7%). Se identificó como factor de riesgo para ingreso por enfermedad cerebrovascular la edad igual o superior a 60 años 1,36 (IC., 95%: 1,24-1,49; p = 0,001) y pertenecer al tramo B del fondo nacional de salud 1,37 (IC., 95%: 1,29-1,46; p =0,001). El RR por patología respiratoria fue mayor en el periodo invernal 1.63 (IC., 95%: 1,50-1,76; p= 0,001). Conclusión: las personas mayores y de bajos ingresos presentan mayor riesgo de requerir rehabilitación fonoaudiológica en el contexto de un SMFyR.

    Abstract in English:

    ABSTRACT Purpose: to analyze the profile and risk factors of patients attended by speech therapists in a hospital service of physical and rehabilitation medicine (P&RM) of the public health system. Methods: a retrospective cohort study was carried out. The variables were summarized using frequencies, proportions, and measures of central tendency. Relative risks (RR) were estimated, using the incidence ratio (IC:95%) and the bilateral Fisher's exact test. A level of significance was considered p <0.05. Results: 23,365 speech therapy activities distributed in 8,416 sessions were carried out between September 2016 to September 2018, with patients admitted to a P&RM service. The activities focused people over 60 years in the areas of swallowing (28.6%) and cognition (11.7%). Age equal to or greater than 60 years was identified as a risk factor for admission, due to cerebrovascular disease of 1.36 (95% CI: 1.24-1.49; p = 0.001), and belonging to section B of the National Health Fund (FONASA), 1.37 (95% CI: 1.29-1.46, p = 0.001). The RR for respiratory pathology was greater in the winter period: 1.63 (95% CI: 1.50-1.76; p = 0.001). Conclusion: elderly and low-income people are more likely to need speech therapy rehabilitation in the context of P&RM service.
  • Proposal of a questionnaire to investigate social communication skills of children with typical development and communication disorders ORIGINAL ARTICLES

    Lagus, Shelly; Fernandes, Fernanda Dreux Miranda

    Abstract in Portuguese:

    RESUMO Objetivo: verificar a possibilidade de uso de um questionário simples, aplicado a interlocutores familiares da criança, para identificar as características funcionais de comunicação de crianças com diferentes manifestações do desenvolvimento da linguagem. Métodos: foram realizadas 95 entrevistas individualmente com os responsáveis de crianças posteriormente diagnosticadas com Distúrbio de Linguagem (DL), com Distúrbio de Produção da Fala (DPF), com Transtorno do Espectro do Autismo (TEA) e com Desenvolvimento Típico (DT). Nas entrevistas foi aplicado o Questionário de Habilidades Comunicativas para caracterização do desempenho pragmático. Foram utilizados o teste t de Student e a Análise de Componentes Principais para análise estatística, considerando-se como significante p-valor<0,05. Resultados: as análises estatísticas evidenciam que o uso do questionário desenvolvido permitiu a diferenciação entre os grupos de crianças com diagnósticos de Transtorno do Espectro do Autismo e Distúrbio de Linguagem e o grupo de crianças com diagnóstico de Distúrbios de Produção da Fala e com desenvolvimento típico. Conclusão: o questionário proposto mostrou-se capaz de diferenciar e caracterizar, do ponto de vista pragmático, as crianças com diferentes manifestações do desenvolvimento de comunicação, evidenciando o comprometimento das habilidades pragmáticas de crianças com Transtornos do Espectro do Autismo e com Distúrbios de Linguagem.

    Abstract in English:

    ABSTRACT Purpose: to verify the possibility of administering a simple questionnaire to family members who communicate with their children to identify communication functional characteristics of children with different manifestations of language development. Methods: 95 parents/guardians were individually interviewed. Their children were afterwards diagnosed with language disorder (LD), speech production disorder (SPD), autism spectrum disorder (ASD), and typical development (TD). The interviews were conducted with the Communicative Skills Questionnaire to characterize the pragmatic performance. The Student’s t-test and the principal component analysis were used in statistical analysis, considering significant p-values < 0.05. Results: the statistical analyses reveal that the questionnaire distinguished the groups of children diagnosed with autism spectrum disorder and language disorder from the groups of children with speech production disorders and typical development. Conclusion: the questionnaire proved to be capable of distinguishing and characterizing, from the pragmatic standpoint, the children with different manifestations of communication development, revealing the impaired pragmatic skills of children with autism spectrum disorders and language disorders.
  • Comparison between rhinometric variables and nasal airing in children with mouth breathing ORIGINAL ARTICLES

    Melo, Ana Carolina Cardoso de; Gomes, Adriana de Oliveira Camargo; Cunha, Daniele Andrade da; Almeida, Wigna Rayssa Pereira Lima; Lima, Sandro Junior Henrique; Cunha, Renata Andrade da; Silva, Hilton Justino da

    Abstract in English:

    ABSTRACT Purpose: to analyze the correlation between the values of nasal aeration and geometry of the nasal cavities, before and after nasal cleansing in children with mouth breathing. Methods: 20 children aged 4 to 12 years old were chosen. The questionnaire Identification Index of Signs and Symptoms of Oral breathing was applied and nasal patency was assessed by nasal aeration, through the Altmann graded mirror, and the nasal geometry measured by acoustic rhinometry. After nasal cleansing and massage, the same aeration measurements and nasal geometry procedures were performed. Group normality was analyzed using the Shapiro-Wilk test considering the hypothesis of normal distribution whenever p>0.05. The Spearman’s test was applied to analyze the correlation between variables (p<0.05). Results: there was a strong and significant correlation between nasal aeration and the corresponding cross-sectional area of the front of the inferior turbinate (CSA2) in the left cavity before cleansing. There were no correlations between the nasal aeration and other rhinometric variables. Conclusion: there was a correlation between nasal aeration values and the anterior portion of the turbinates, before the massage and nasal cleansing technique, in mouth breathing children. There were no significant differences when the nasal aeration was correlated with other rhinometric variables.
  • ERRATUM: Maximum phonation time in the pulmonary function assessment ERRATUM

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