Vocal, laryngeal and self-perception measurements of dysphonic teachers: analysis after voice therapy
Parâmetros vocais, laríngeos e de autopercepção de professoras disfônicas: análise após tratamento fonoaudiológico
Mariah Batalha Ribeiro; Ana Cristina Côrtes Gama; Iara Barreto Bassi; Letícia Caldas Teixeira
Abstract
Purpose: to analyze the results of evaluations vocals, laryngeal and self-perception after speech therapy in a group of dysphonic teachers.
Method: this is a retrospective study carried out using a handbook review of 42 patients with hyperfunctional dysphonia, yielding data of hearing-perceptual and acoustic analysis, laryngeal exams and Voice Activity and Participation Profile (VAPP) before and after speech therapy. Patients were treated by students of speech language therapy, under supervision of a single professional using direct therapy, which consists in vocal techniques, and indirect, with exposure about vocal health care.
Results: in respect to hearing-perceptual assessment, 73,8% of voice samples were described as better in post treatment situation. The parameters grade of dysphonia (G) and roughness (R) most contributed for voice improvement. In acoustic analysis, there was significantly change after therapy for jitter, perturbation of frequency, shimmer and perturbation of amplitude parameters. Laryngeal analysis demonstrated that 43% have improved in visual-perceptual assessment after vocal therapy; 38% of the exams had no change with therapy and 19% were worst at discharge moment. Considering VAPP, was possible to verify significant improvement in post treatment situation for all parameters, and the biggest difference between the averages before and after vocal therapy refers to "effects of this alteration at work".
Conclusions: there was an improvement of hearing-perceptual parameters grade of dysphonia (G) and roughness (R), acoustic parameters of perturbation of frequency and amplitude, in larynx image and a positive impact of voice in evaluated patient's quality of life after voice therapy.
Keywords
Resumo
Objetivo: analisar os resultados das avaliações vocais, laríngeas e de autopercepção após tratamento fonoaudiológico em um grupo de professoras disfônicas.
Método: trata-se de estudo retrospectivo com revisão de 42 prontuários de mulheres portadoras de disfonia comportamental, com coleta de dados referente à análise perceptivo-auditiva, acústica, de avaliação laríngea e de protocolo de autopercepção vocal (PPAV) nas situações pré e pós-fonoterapia. As professoras foram atendidas por estudantes do curso de Fonoaudiologia supervisionados por um único profissional. Foram utilizadas terapia direta com a realização de técnicas vocais e indireta com orientação sobre cuidados com a saúde vocal.
Resultados: com relação à análise perceptivo-auditiva, 73,8% das vozes foram descritas como melhores após a fonoterapia. Os parâmetros que mais se modificaram foram o grau da disfonia (G) e a rugosidade (R). No que concerne à análise acústica, os parâmetros que melhoraram significantemente após o tratamento foram o jitter, quociente de perturbação de frequência, shimmer e quociente de perturbação de amplitude. A avaliação laríngea demonstrou que 43% das pacientes apresentaram melhora no exame após o tratamento fonoaudiológico; 38% dos exames não sofreram alteração com o tratamento e 19% pioraram no momento da alta. A partir do PPAV, constatou-se melhora estatisticamente significante para todos os domínios no momento pós-fonoterapia, sendo que a maior diferença entre as médias pré e pós-tratamento foi referente ao parâmetro "efeitos no trabalho".
Conclusão: observou-se melhora dos parâmetros perceptivo-auditivos de grau geral da disfonia e rugosidade, nas medidas acústicas de jitter e shimmer, bem como melhora da imagem laríngea e impacto positivo da voz na qualidade de vida das professoras avaliadas após o tratamento fonoaudiológico.
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Submitted date:
06/02/2012
Accepted date:
03/11/2013
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