RESUMO
Objective: to compare the immediate effects of low-frequency TENS employment on vocal quality in women with behavioral dysphonia before and after vocal exercises.Methodology: 30 women (mean = 31.3 years old), diagnosed with behavioral dysphonia received low-frequency TENS before (TENS + VE Group) and after vocal exercises (VE + TENS Group) with a 1-week washout. They had their sustained vowel/a/and running speech recorded before and after each procedure for auditory-perceptual analysis and acoustic measures. The low-frequency TENS parameters applied were symmetrical biphasic quadratic pulse, 200 µs phase, 10 Hz frequency, intensity on the motor threshold, and the electrodes were positioned on the submandibular and superior fibers of the trapezius muscle region. The vocal exercises: tongue trill, humming, finger kazoo, and water resistance therapy were performed totalizing 20 min.Results: intragroup analysis of sustained vowel/a/showed reduction in both groups of strain parameter and increased the breathiness; only VE + TENS Group increased the instability parameter, decreased fundamental frequency, and increased in SPI values; the running speech analysis showed an increase in the overall degree, roughness, and breathiness parameters. However, in VE + TENS Group, there was a statistically significant decrease in the intensity of the strain and an increase in breathiness. The acoustic measures showed that VE + TENS Group had a higher variation than TENS + VE Group regarding NHR.Conclusion: vocal exercises followed by low-frequency TENS have more immediate positive effects on voice quality than the low-frequency TENS followed by vocal exercises. This is a preliminary immediate effects study, and these effects could be verified through long-term assessments.
RESUMO
PURPOSE: To verify the influence of work characteristics and the occupational voice use on the self-perception of vocal fatigue symptoms in individuals working in the home office during the COVID-19 pandemic. METHODS: This was a cross-sectional, observational, and descriptive study. The sample consisted of 206 individuals (123 women and 83 men), with an average age of 34 years, working exclusively in a home office mode due to the pandemic. Through an online form, all participants responded to the Vocal Fatigue Index (VFI) protocol and the questionnaire on the characterization of work and the occupational voice use during the pandemic, developed by the authors of this study. Multiple linear regression using the backward elimination technique was performed. RESULTS: The variables the interlocutor does "not listen to me in home office work," "noise in the home office work environment," "the daily workload in home office," "vocal quality worsened in home office work," "increased vocal loudness in home office work" and "lack of training about voice use in home office work" are predictors of the dependent variable vocal fatigue symptoms. CONCLUSION: The characteristics of work and occupational voice use influence the self-perception of vocal fatigue symptoms in individuals working in the home office mode during the COVID-19 pandemic.
Assuntos
COVID-19 , Doenças Profissionais , Saúde Ocupacional , Distúrbios da Voz , Masculino , Feminino , Humanos , Adulto , Qualidade da Voz , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Fatores de Risco , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/epidemiologia , Inquéritos e QuestionáriosRESUMO
PURPOSE: To review systematically the literature and to analyze the effectiveness of surface electromyographic biofeedback in the rehabilitation of adults with behavioral dysphonia. RESEARCH STRATEGIES: Two authors performed an independent search in the following databases: Clinical Trials, Cochrane Library, Embase, LILACS, PubMed, and Web of Science. A specific search strategy was developed for each database. SELECTION CRITERIA: The review included studies that examined the effectiveness of surface electromyographic biofeedback compared to other direct vocal therapy intervention in adults with behavioral dysphonia. There were no restrictions in regard to language or date of publication. DATA ANALYSIS: Analysis of the risk of bias, heterogeneity, quantitative and qualitative data, sensitivity, subgroups, and publication bias. RESULTS: 51 studies were identified, but only two cohort studies remained as prospects for analysis. The studies showed 100% uncertain risk of selection, performance, and detection bias. There was a high degree of clinical heterogeneity. The descriptive analysis showed a reduction in muscle electrical activity and improvement in vocal self-assessment using electromyographic biofeedback; however, it was not possible to calculate the effect size of the interventions. The present study was limited by the fact that it was unable to show a consensus for the majority of data analyzed. CONCLUSION: The available literature does not support a conclusive finding about the effectiveness of surface electromyographic biofeedback compared to other direct interventions used in the rehabilitation of adults with behavioral dysphonia. The studies analyzed vary widely in their clinical procedures and methodology, making it impossible to determine the procedure's effectiveness.