Análisis acústico de la deglución como método auxiliar para evaluar la disfagia en la enfermedad de Parkinson

Objective: To measure the accuracy of DeglutiSom as an auxiliary method to assess swallowing in patients with Parkinson's disease (PD). Methodology: Accuracy study. Among 248 individuals, 91 participants met the inclusion criteria, with a mean age of 64.9 years (SD 7.7), 53.8% male and 46.2% female, with a mean disease duration of 12.6 years (SD 3.8 years). Two instrumental studies were performed: An acoustic analysis with Sonar Doppler via the DeglutiSom Software, and a videofluoroscopic swallow study. Three judges analyzed the swallowing sounds in the DeglutiSom software and the instrumental examination findings. Results: The inter-rater reliability was 90.1%, with 4.4% degree of partial agreement and 5.5% disagreement. Sensitivity resulted in 90.0% and specificity in 90.0%. A sensitivity of 97.0% and specificity of 91.0% are indicators of a high validity for the dysphagia screening method, with predictive value (+) of 97.0% and predictive value (-) of 91.0%, with an accuracy method of 96.0%. The validity indicator values for screening aspiration were also high, with a sensitivity of 90.0%, specificity of 90.0%, predictive value (+) of 82.0%, predictive value (-) of 95% , 0% and 90.0% accuracy. Conclusion: The method proposed is considered appropriate for oropharyngeal dysphagia and tracheal aspiration screening in patients with Parkinson's Disease.info:eu-repo/semantics/publishedVersio

Instrumento multiprofesional para decanulación traqueal en adultos: validación de contenido

Introduction: Tracheal decannulation needs multiprofessional evaluation observing success predictor criteria. A validated instrument can increase the safety of the procedure, reduce the length of stay and ensure better quality of life. Objective: To develop and perform the content validity of a multiprofessional instrument for tracheal decannulation in adults. Method: Cross-sectional descriptive study, with 24 judges: doctors, physiotherapists, speech therapists and nurses. The instrument was developed and presented through an electronic form where the judges took their notes. The Content Validity Index by item (CVI-I) and total (CVI-T) were calculated to verify evidence of validation. In unverified items, adjustments were made pointed out by the judges and submitted to the new evaluation phase in order to obtain complete validation of the instrument. Results: First evaluation phase, the items: Identification, Ventilatory History, Vital Signs, Consciousness/Collaboration, Ventilatory Data, Opinion and Legend obtained CVI-I > 0.78, were considered validity. The items Muscular Performance and Speech and Swallowing did not obtain adequate validity CVI-I 0.67 and 0.17, respectively. Therefore, they were submitted to the second phase of evaluation. In this phase, these items were validated obtaining CVI-I=0.83 in the item Muscular Performance and CVI-I=1.0 in the item Speech and Swallowing. From the mean of CVI-I, the value CVI-T=0.9 was obtained, validity all the instrument. Conclusion: Multiprofessional instrument that can help in the process of tracheal decannulation in adults was developed and validity in content post two phases of evaluation by a group of expert judges in the area.info:eu-repo/semantics/publishedVersio

Prevalence of orofacial pain in adults with cleft lip/palate

Objective: Functional disorders in individuals with cleft lip and palate (CL/P) can compromise structures of the stomatognathic system, which is one of the causes of orofacial pain in this group of patients. Numerous mechanisms of orofacial pain, particularly painful temporomandibular disorders (TMD-P), may be related to these conditions and have the potential to be the cause of diffuse. So, the objective of research wasdetermine the prevalence of orofacial pain using validated instruments on individuals with CL/P. Materials and Methods: a observational study was conducted with an intentional random sample of patients with CL/P (n = 80). Two questionnaires were administered: a screening scale for painful TMD (AAOP) and the Graded Chronic Pain Scale (GCPS). Results: In the AAOP screening questionnaire, 75% of individuals with CL / P answered affirmatively to at least one question. The most significant questions were those related to noise (p = 0.007), mandibular movement (p = 0.032) and orofacial pain region (p = 0.044) demonstrated the importance of investigating TMD-P. Regarding the impact of chronic pain in relation to activities of daily living (GCPS), although no significant, it showed that for most individuals with CL / P, it has a low disability, regardless of its intensity (low / high), being more prevalent in older individuals (p = 0.013). Conclusions: the investigation of orofacial pain should be part of the routine at services that work with CL/P patients and should be counseled to seek help for such pain, which can affect their daily living.info:eu-repo/semantics/publishedVersio

Balance rehabilitation with a virtual reality protocol for patients with hereditary spastic paraplegia: protocol for a clinical trial

info:eu-repo/semantics/publishedVersio

Efecto de la terapia respiratoria en pacientes con bruxismo del sueño y eventos respiratorios asociados: protocolo de estudio para un ensayo clínico controlado aleatorizado

Aim: The aim of this study will be to perform respiratory physiotherapy on patients with sleep bruxism and associated respiratory events (apnea and hypopnea). Methodology: The study will be a randomized, controlled, doubleblind, clinical trial with a sample of individuals with sleep bruxism and associated respiratory events. Respiratory (inspiratory and/or expiratory) physiotherapy will be performed using the THRESHOLD IMT and PEP and the results will be compared to a placebo group. Discussion: Regarding respiratory events, there is a broad variety of possible treatments for sleep apnea depending on the physiopathology, severity and patient preference, with CPAP considered the gold standard. However, data on CPAP are inconsistent, with adherence to therapy reported to be between 45 and 89%. Thus, other forms of treatment are proposed, including respiratory training. Understanding obstructive sleep apnea syndrome as the loss of the dilation strength of the pharynx and the inability to maintain the path open for air, respiratory muscle training could assist in increasing dilation strength, enabling the passage of air during sleep. Taking into consideration that sleep bruxism may be associated with events of apnea and hypopnea, the intervention to treat obstructive respiratory events related to sleep may have a positive impact on events related to sleep bruxism (rhythmic activity of the masticatory muscles). To determine this, we will measure the apnea/hypopnea index (AHI) and number of contractions of the masseter muscle (characteristic of the activity of bruxism) before and after the intervention using polysomnography.info:eu-repo/semantics/publishedVersio

Validación de un instrumento multiprofesional para el cribado del riesgo de broncoaspiración en un entorno hospitalario

Objetivo: Desenvolver e validar em conteúdo um instrumento multiprofissional para rastreio do risco de broncoaspiração. Método: Trata-se de um estudo transversal, quantitativo de validação de conteúdo que seguiu as seguintes etapas: elaboração de um instrumento de rastreio do risco de broncoaspiração com base em uma revisão bibliográfica e validação desse instrumento de acordo com concordância e relavância entre juízes. Para esta fase, 6 profissionais especialistas na area foram convidados (1 médico, 1 fisioterapeuta, 1 fonoaudiólogo, e 3 enfermeiros) a avaliar o instrumento e informar concordância baseadas em um questionário do tipo Likert. Para análise de concordância entre os juízes foi utilizado o Indice de Validade de Conteúdo para cada item (IVC-I) e total (IVC-T). Resultados: O instrumento foi composto por 10 itens: idade (≥60 anos); doença pregressa; Escala de Glasgow <13; intubação orotraqueal; tempo de intubação orotraqueal (≥24h); traqueostomia; sensação de dispneia, higiêne oral inadequada; via alternativa de alimentação e tosse/engasgo. Há concordância entre juízes com relação a cada item (IVC-I 1,0) e também na totalidade (IVC-T 1,0) do instrumento. Conclusão: O instrumento multiprofissional para rastreio do risco de broncoaspiração em ambiente hospitalar foi desenvolvido e apresenta validade de conteúdo, assegurado por uma equipe de profissionais experientes na área.info:eu-repo/semantics/publishedVersio

Evaluación del sonido del patrón de deglución en pacientes con trastorno temporomandibular

Objectives: The impairment of the temporomandibular joint and masticatory muscles has a negative impact on functions of the stomatognathic system, such as swallowing. Thus, an atypical swallowing pattern may contribute to the development of temporomandibular disorder (TMD). The aim of the present study was to evaluate acoustic aspects of swallowing and determine the occurrence of atypical swallowing dynamics. Methods: Sixty-two individuals [16 males (25.8%) and 46 females (74.2%); mean age 39.84 (± 9.40); 47 with TMD and 15 without TMD] were evaluated using an ultrasound detector during the swallowing of three consistencies: liquid, pasty and solid. The acoustic signals were recorded and subsequently analyzed using the DeglutiSom® software. Results: The majority of the sample (81%) with TMD presented atypical swallowing biodynamics, with a significantly greater frequency of food residuals for the three consistencies. The signal suggestive of aspiration was more frequent with the liquid consistency (37% of the group). Conclusion: There is a relation between TMD and an atypical swallowing pattern, which underscores the need for the multidisciplinary evaluation of individuals with this disorder.info:eu-repo/semantics/publishedVersio

Análisis acústico de los sonidos de la deglución con el uso de Sonar Doppler en bebés prematuros durante la transición alimentaria

Objective: To define the acoustic parameters and the feasibility of using swallowing acoustic analysis as an auxiliary method for the transition from nasogastric or orogastric tube feeding to oral breastfeeding. Methodology: A cross-sectional study, which consisted of the following steps: 1. Data collection: Thirty-two newborns participated in this study (16 preterm and 16 full-term); 2. Clinical speech-language pathology evaluation: Clinical data were collected using Sonar Doppler used to assess the readiness of preterm infants to start oral feeding and swallowing sounds. Swallowing sounds were captured during breastfeeding and analyzed according to the frequency, intensity, and time of swallowing, as well as the pause time between swallows and the number of swallows. Results: The control and study groups presented significant differences in the mean wave time and swallowing per minute variables. Conclusion: Sonar Doppler, as an instrument used to capture sounds, is a viable auxiliary resource to evaluate the transition from nasogastric or orogastric tube to oral breastfeeding.info:eu-repo/semantics/publishedVersio