Dysarthria and dysphagia in amyotrophic lateral sclerosis with spinal onset: a study of quality of life related to swallowing

Dysarthria and dysphagia are the most common clinical problems encountered in Amyotrophic Lateral Sclerosis and may reduce the quality of life. Evaluate the association of dysarthria and dysphagia and to evaluate the impact of dysphagia on swallowing quality of life in patients with ALS with spinal onset. Seventeen patients underwent to speech and swallowing evaluation and filled out self-report assessment of the Swallowing Quality of Life (SWAL-QOL). The dysarthria severity was graded using the Speech Subscale of ALS Severity Scale. The dysphagia severity was graded using a scale proposed by Dziweas et al., and the Functional Oral Intake Scale. Over 70% of the ALS patients with spinal onset had dysarthria and dysphagia. The correlation of dysarthria and dysphagia scales was statistically significant (p < 0.001). The correlation between dysarthria and dysphagia severity and SWAL-QOL outcomes was significant for the same domains: "symptom frequency", "communication" and "fear of eating". The SWAL-QOL domains presented a mild to moderate impact on quality of life. Disease duration did not impact on SWAL-QOL. Dysarthria and dysphagia were common symptoms in patients with spinal onset of ALS and the swallowing quality of life decrease was directly related to with severity of dysarthria and dysphagia36112713

Vocal effects in military students submitted to an intense recruit training: a pilot study

Objectives. This study aims at evaluating the vocal parameters of military officers before and after an Intense Recruit Training (IRT), consisting of a 48-hour exercise protocol involving high vocal demand combined with physical effort, lower body hydration levels, and fewer hours of sleep. Study Design. Eighty-three young male military officers (aged between 18 and 22 years) were recorded on three occasions: before, immediately after, and 2 weeks after the IRT. Methods. Maximum phonation times (MPTs) using vocalization of the vowel /a/, the fricative consonants /s/ and /z/, and connected speech samples were collected. A number of acoustic parameters were analyzed: mean fundamental frequency, mean intensity, jitter, shimmer, harmonics-to-noise ratio, spectral emphasis (acoustic correlate of vocal effort), H1 - H2 (difference between the amplitude of the first and the second harmonic), and the frequency and intensity ranges. For the immediate effects, statistical analyses were conducted using a paired sample t test (P = 0.05) to compare two moments: before and after the IRT. For the long-lasting effect, statistical analyses were conducted using a one-way analysis of variance (ANOVA) test (P = 0.05) to compare between all three moments (before, immediately after, and 2 weeks after the IRT). Results. The MPTs of /a/, /s/, and /z/, the acoustic parameters as spectral emphasis, and the mean of intensity showed statistically significant changes between the data from before and immediately after training took place. The MPT of /a/ and the intensity range showed statistically significant changes between the measurements taken immediately after training and the ones taken 2 weeks after training; there were significant differences in the comparisons between the three groups of data acquired. Conclusions. Some of the acoustic parameters were able to identify changes in the vocal conditions of the military students as consequence of high intensity voice and physical military training. The changes in the vocal intensity and MPT parameters seem to be related to general fatigue and lower hydration. The absence of impact in some parameters, specially 2 weeks after the IRT, may reveal that the students' voice is getting used to the military activities3016169sem informaçã

Influence of smoking isolated and associated to multifactorial aspects in vocal acoustic parameters

Introduction:Smoking affect voice quality in a long period of time, but other factors may compromise it, such as professional using of voice, habits, alcohol dependence and GERD. The aim was associate the influence of these factors on vocal parameters.Study design:Contemporary cohort study with cross-sectional.Materials and methods:Eighty adults of 35 to 60 years old had participated in this study, they had been divided into two groups, smokers (GF) and control (GC). There was application of questionnaire and voices were recorded. Praat software has been used for voice assessment and Man-Whitney, chi-square and logistic regression has been used for statistical analysis.Results:The GF had a higher incidence of alcohol dependence, coughing, throat clearing and professional voice using. Respecting to the acoustic parameters: noise-to-harmonic ratio (NHR), jitter and shimmer, the GF presented higher values. Relating these data to the questionnaire, it's noticed that female gender have influence over all acoustic parameters, GERD have influence over jitter and smoking can affect fundamental frequency, jitter, shimmer and NHR.Conclusion:Smoking interferes in acoustics parameters isolated and associated with alcohol dependence, GERD, cough, throat clearing, gender and professional using of voice.Introdução:O fumo pode interferir negativamente na qualidade vocal e outros fatores associados, como o uso profissional da voz, hábitos, etilismo e refluxo gástrico-esofágico, podem potencializar essa interferência. O objetivo do estudo foi analisar a associação do tabagismo e dos demais fatores aos parâmetros acústicos vocais.Forma de estudo:Estudo de coorte contemporâneo com corte transversal.Materiais e métodos:Participaram do estudo 80 adultos, entre 35 e 60 anos, classificados nos grupos fumante (GF) e controle (GC). Foi realizada aplicação de questionário e gravação das vozes. A avaliação acústica foi realizada com o software Praat. Foram utilizados os testes Mann-Whitney, qui-quadrado e regressão linear simples.Resultados:O GF apresentou maior prevalência de etilismo, tosse, hábito de pigarrear e uso profissional da voz, assim como apresentou valores aumentados para relação ruído-harmônico (NHR), jitter e shimmer. Foi estabelecida correlação entre o gênero feminino e todos os parâmetros acústicos, assim como entre o RGE, o aumento do jitter e o hábito de fumar, o agravamento da frequência fundamental, o aumento do jitter, o shimmer e a NHR.Conclusão:O fumo interfere nos parâmetros acústicos de modo isolado e/ou associado ao etilismo, tosse, hábito de pigarrear, RGE e uso profissional da voz