Search

The aim of this study was to review systematically the literature and to investigate the effects of electrical stimulation in treating dysphonia. This is a systematic review. The publications indexed on the MEDLINE, LILACS, PubMed, Web of Science, and SciELO databases were searched. Original articles with experimental, clinical trial and randomized studies involving a control group and approaching dysphonia treatment with electrical stimulation in humans, regardless of age, gender, or race were included. Those excluded were theses, editorials, comments and opinions, reflexive articles, case studies, experimental studies with animals, models, projects, reports and technical reports, and review articles, as well as articles approaching other alterations, not related to dysphonia. Eleven articles were found and it evaluated the effects of neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation on dysphonia caused by vocal fold paralysis, spasmodic dysphonia, behavioral dysphonia, and in patients with vocal fold nodules. The methodological analysis of the articles through the PEDro scale resulted in a mean score of 5.18; the studies were classified as either high quality (N = 3) or fair quality (N = 8). The results indicated that electrical stimulation had a therapeutic effect on various aspects of dysphonia. However, due to the high risk of bias and the heterogeneity of the studies, it is not possible to state the effectiveness of electrical stimulation in treating dysphonia. Using electrical stimulation as an evidence-based conventional rehabilitation therapy in the treatment of dysphonia cannot yet be done. [ABSTRACT FROM AUTHOR]

Patients undergoing maxillectomies may present alterations in the stomatognathic functions involved in oral communication. Rehabilitative treatment should favor the rescue of these functions, through surgical flaps, obturator prostheses or both. The present study aims to present the impact of the use of the palatal obturator on the oropharyngeal geometry and on the voice of patients undergoing maxillectomies, after adaptation to trans-surgical palatine obturators (TPO). Twelve patients treated at a Cancer Hospital, submitted to maxillectomy and rehabilitated during surgery were evaluated. The oropharyngeal geometry was measured by acoustic pharyngometry and the vocal parameters were evaluated through auditory-perceptual and acoustic analyses. The comparison between the results with and without TPO was analyzed using the Wilcoxon test and the correlation between oropharyngeal measurements and acoustic parameters using Spearman's correlation coefficient, all with a significance level of 5%. There was a decrease in the following oropharyngeal measurements with the use of TPO: length of the pharyngeal cavity and vocal tract, volume of the oral cavity, pharyngeal and vocal tract and area of ​​the oropharyngeal junction. There was no difference in the length of the oral cavity and in the glottic area between situations with and without TPO. In the vocal evaluation, changes in intelligibility and resonance were observed in the situation without TPO and, in only one case, mild hypernasality was detected in the situation with TPO. It is concluded that the use of TPO brought the oropharyngeal measurements closer to normal values ​​and provided an improvement in speech intelligibility and vocal resonance in maxilectomized individuals. [ABSTRACT FROM AUTHOR]

The aim of this study was to verify the immediate effect of a flexible resonance tube in water and of lip trill on oropharyngeal geometry and vocal acoustic parameters of singers without vocal symptoms. Twenty-two adult singers participated in the study. They had an average age of 27 (±4.8) years. Participants were split into two groups: a group composed of 12 singers who performed the flexible resonance tube (FRT) exercise and a group of 10 singers who performed the Lip Trill technique (LTT). Acoustic pharyngometry and acoustic analysis of the voice were used to assess oropharyngeal geometry before and after the exercises. After performing the techniques, the vocal tract length was longer in the group that performed the FRT, compared to the one that performed the LTT. In the acoustic evaluation, there was an improvement in the glottal to noise excitation ratio and a decrease in noise in the group of singers who performed the LTT. In the analysis by sex men had a longer oral cavity compared to women and after application of the techniques greater volume of the vocal tract. There was variation in the oropharyngeal geometry with the FRT, while the LTT had a positive effect on the vocal acoustic parameters related to glottal noise. [ABSTRACT FROM AUTHOR]

To verify the immediate effects of voiced gargling on the electrical activity of extrinsic laryngeal muscles and vocal self-assessment. A sample of 20 individuals of both sexes, mean age of 31.95 (±11.57) years, were equally divided in two groups according to the presence or absence of vocal complaint. Both groups were evaluated by surface electromyography of the suprahyoid (SH) and infrahyoid (IH) muscle areas during rest, phonation of the sustained vowel [Ɛ] in habitual and strong intensities; phonation of rising and falling glissando; and counting from 1 to 10. Surface electromyography was assessed before and after the voiced gargling exercise, which lasted 1 minute. All participants self-rated their voice and phonatory comfort after the exercise. Wilcoxon and Mann-Whitney tests were applied, as well as Fisher's exact test and linear-to-linear test. The level of significance was 5%. The percentage of electrical activity of the SH muscle area decreased in the glissando and counting tasks in the group with vocal complaint, as well as in phonation of sustained vowel in strong intensity in the group without complaint. Decrease was also observed in the right IH muscle area at rest and during sustained vowel phonation at habitual and strong intensities. Percentage of muscular electrical activity was lower in the group with complaint in the following situations: IH muscle area on both sides, at rest and during habitual phonation of sustained vowel and glissando before and after the exercise; right IH muscle area, during counting and strong phonation of sustained vowel before and after exercise; left IH muscle area, in the counting task, just after intervention. Most participants noticed improvement in voice (70%) and phonatory comfort (65%). Voiced gargling during 1 minute promotes immediate effects on the electrical activity of the extrinsic laryngeal muscles in individuals with or without vocal complaint. Most individuals reported improved voice and phonatory comfort after exercise. [ABSTRACT FROM AUTHOR]

To verify whether the dimensions of different segments of the oropharyngeal cavity have different proportions between Parkinson's disease patients and vocally healthy subjects and investigate whether the measurements of these subjects' oropharyngeal geometry associate with their acoustic measurements of voice. Quantitative, descriptive, cross-sectional, and retrospective study with secondary data, approved by the Human Research Ethics Committee under no. 4.325.029. We used vocal samples and data from the oropharyngeal geometry of 40 subjects – 20 with Parkinson's disease stages I to III and 20 who formed the control group, matched for sex and age. Each group had 10 males and 10 females, mean age of 61 years (±6.0). Formant (F1, F2, and F3) and cepstral measures of the sustained vowel /ε/ were extracted and arranged in the database to determine their values using Praat software. The data were descriptively analyzed, with statistics generated with R software. The proportion of oropharyngeal geometry measurements was arranged by mean values and coefficients of variation. Pearson's linear correlation test was applied to relate voice parameters to oropharyngeal geometry, considering P < 0.05, and linear regression test, to justify F2. The Parkinson's disease group showed a linear relationship between oral cavity length and F1 in males (P = 0.04) and between glottal area and F2 in females (P = 0.00); linear relationships were established according to age in both groups, and a regression model for F2 was estimated (R2 = 0.61). There was no difference between pathological and healthy voices; there was a difference in the proportional relationship of oropharyngeal geometry between the groups. The proportional relationship of oropharyngeal geometry differs between the Parkinson's disease group and the control group, as well as the relationship between oropharyngeal geometry and formant and cepstral values of voice according to the subjects' sex and age. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of transcutaneous electrical nerve stimulation (TENS) associated with vocal therapy in women with behavioral dysphonia. Seventeen women with behavioral dysphonia were divided into an experimental group (n = 8) and a placebo group (n = 9). All were submitted to six sessions of vocal therapy, according to the Comprehensive Voice Rehabilitation Program. In the experimental group, therapy was associated with TENS (30 minutes) and in the placebo group, the electrodes were placed and the equipment remained off. The vocal handicap, the voice through the acoustic and auditory perception evaluation, the electrical activity, and the superficial temperature of the suprahyoid and infrahyoid muscles were evaluated. Pre and post data were compared by parametric and nonparametric tests. There was a decreased in vocal handicap of the placebo group (P = 0.002) and a decreased in the percentage of electrical activity of the right (P = 0.036) and left (P = 0.017) infrahyoid muscles of the experimental group in vowel emission and sequential speech (P = 0.036). There was an increase in temperature in the right infrahyoid region in vowel emission (P = 0.027) and the temperature difference decreased quantitatively between the supra and infrahyoid regions in the experimental group. TENS associated with vocal therapy reduced the electrical activity of the infrahyoid muscles and balance the temperature between the supra- and infrahyoid regions in women with behavioral dysphonia. [ABSTRACT FROM AUTHOR]

To verify the immediate effect of the flexible resonance tube vocal technique on the oropharyngeal geometry and vocal acoustic parameters of individuals with Parkinson's disease (PD) and to study the correlation between oropharyngeal geometry and the intensity and fundamental frequency (f0) parameters of the voice. Forty individuals participated—20 with PD and 20 healthy individuals, with a mean age of 60.95 (± 5.69) years. There were 10 men and 10 women in each group. All underwent pharyngometric analysis of the vocal tract and voice acoustics parameters before and after use of the vocal technique with a flexible resonance tube. After the technique, there was a reduction in pharyngeal cavity volume only in females in the healthy group, a reduction in shimmer values in females in both groups and males in PD group and an improvement in noise parameters in females in the PD group. There was a negative correlation between vocal tract volume and intensity, between f0 and vocal tract volume, between f0 and oropharyngeal junction area, between f0 and oral cavity volume as well as a positive correlation between oral cavity length and f0. The vocal technique with the flexible resonance tube applied to individuals with PD improved the subjects' voice quality in the perceptual and acoustic voice parameters. Regarding the oropharyngeal geometry, it was possible to observe its correlation with the parameters of vocal intensity and frequency in the studied population. [ABSTRACT FROM AUTHOR]

Summary Objective To compare dysphonic individuals to nondysphonic with regards to electrical activity of extrinsic laryngeal muscles related to perceptual and acoustic vocal parameters. Hypothesis Dysphonic individuals have higher electrical activity in the supra and infrahyoid muscles than those nondysphonic. Study Design Prospective, cross-sectional, case series study. Methods Forty-one subjects, divided into two groups according to the presence of dysphonia, underwent evaluation of surface electromyography, auditory-perceptual, and acoustic evaluations of voice during the vocal rest and sustained emissions of the vowel /ε/ and count of 20 to 30 at usual and strong intensities. Results The dysphonic group differed significantly from the nondysphonic by (1) lower electrical activity normalized by the maximum sustained voluntary activity evaluated in all tasks of phonation in the suprahyoid group; (2) lower recruitment of electrical activity in emissions of strong intensity compared with those of usual intensity in the suprahyoid muscles to emit the vowel /ε/ (13.66 ± 5.17 in dysphonic group and 35.20 ± 7.60 in the nondysphonic group, P = 0.029) and in the infrahyoid muscles in the count of 20 to 30 (14.90 ± 4.69 vs 42.01 ± 6.15; P < 0.001) and to emit the vowel /ε/ (11.47 ± 6.52 vs 22.66 ± 9.05, P < 0.001); (3) lower vocal intensity to produce the vowel /ε/ in usual and strong intensities and count in strong intensity. The electrical activities of the maximum sustained voluntary activity were reduced with increasing degree of dysphonia. Conclusions There was lower electrical activity of the extrinsic laryngeal muscles in dysphonic individuals compared with nondysphonic, and related to the degree of dysphonia. [ABSTRACT FROM AUTHOR]

Summary Purpose The aim of the study was to compare the different parameters, regarding the peak and mean, at different phonatory tasks for standardization of electromyography signal of electrical activity (EA) of the laryngeal extrinsic muscles on voice evaluation. Methods The electrical potentials of the suprahyoid (SH) and infrahyoid (IH) muscles of 35 voluntary nondysphonic subjects were evaluated using three evaluations of rest, two maneuvers to determine maximum voluntary sustained activity (MVSA), and usual and strong intensity of vowel /ɛ/ and 20–30 count emissions. The EA signal was converted using root mean square in microvolts and normalized by mean and peak of each task. The selected normalization task was that with minor coefficient of variation for all muscles. Results The tasks that provided minor coefficient of variation of EA in both muscle groups were the peak of vowel /ɛ/ (mean potentials equal to 43.31 ± 2.97 for right IH, 36.27 ± 2.76 for left IH, and 42.11 ± 2.57 for SH) and the 20–30 count emissions (mean potentials equal to 31.30 ± 308 for right IH, 30.56 ± 2.76 for left IH, and 30.43 ± 4.22 for SH), both in usual intensity and MVSA, as second option. Conclusions The peak of vowel /ɛ/ and 20–30 count emissions is usual intensity, and the MVSA as second option should be considered for signal normalization in SH and IH muscles, and may provide conditions for using the surface electromyography in voice clinic. [ABSTRACT FROM AUTHOR]

Summary: Purpose: To investigate which muscular maneuvers provide larger electric activity (EA) of the suprahyoid (SH) and infrahyoid (IH) muscles to be used as surface electromyography (SEMG) signal normalization reference. Methods: The electrical potentials of the SH and IH muscles of 12 subjects were evaluated using six muscular maneuvers, involving the position of the tongue and effort. It was selected as maximum voluntary sustained activity maneuver, the one having the minor coefficient of variation and the smallest value for each muscle group. The EA signal was converted using the root mean square in microvolts. It was considered then the maximum signal of each maneuver as the difference between the mean of three measures and the resting potential. Results: The maneuvers that provided higher mean potentials with minor coefficient of variation and smallest P value were incomplete swallowing (IS) with effort (mean potential equal to 56.73±8.68 with coefficient of variation of 15.30%) in SH group, and tongue retracted with mouth open (TROM, mean potential equal to 46.57±7.83 with coefficient of variation of 16.81%) in IH group. Conclusion: The IS with effort and TROM maneuvers should be considered for signal normalization in these muscles, respectively, and may provide conditions for using the SEMG in voice clinic. Significance: The use of normalization standards in researches of SH and IH muscles in the voice area will allow comparisons among future works. [Copyright &y& Elsevier]