Ana Lúcia de Magalhães Leal Chiappetta

Teste de fluência verbal no adulto e no idoso: verificação da aprendizagem verbal

PURPOSE: to check verbal learning in normal subjects submitted to a verbal fluency test, considering age, schooling and sex. METHODS: 200 subjects, from 40 to 80-year old, submitted to a semantic and phonologic verbal fluency test, 1 minute long, taking place twice in a 24 hours period. RESULTS: after longitudinal analysis of the data obtained from the semantic test (1st day versus 2nd day) G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. For G2 the level from 0 to 4 years of schooling was significant. In phonologic test G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. And for G2, the level from 5 to 8 years of schooling was significant. Transversal analysis of the data (G1 versus G2) indicated no significant semantic test results and considering the phonologic test, just the second day was significant, observing the subjects from 0 to 4 years of schooling. Comparing both genders, among all groups and combinations of days, considering the semantic test, G1 gave evidence of significant data during the first and the second day. CONCLUSION: both tests attest that verbal learning was more effective for adults than for elderly people. However, there were no significant statistical differences among all groups, except from a decrease in words creation as long as age increased and schooling decreased. By comparing both genders, men performance improved in the semantic test.PURPOSE: to check verbal learning in normal subjects submitted to a verbal fluency test, considering age, schooling and sex. METHODS: 200 subjects, from 40 to 80-year old, submitted to a semantic and phonologic verbal fluency test, 1 minute long, taking place twice in a 24 hours period. RESULTS: after longitudinal analysis of the data obtained from the semantic test (1st day versus 2nd day) G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. For G2 the level from 0 to 4 years of schooling was significant. In phonologic test G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. And for G2, the level from 5 to 8 years of schooling was significant. Transversal analysis of the data (G1 versus G2) indicated no significant semantic test results and considering the phonologic test, just the second day was significant, observing the subjects from 0 to 4 years of schooling. Comparing both genders, among all groups and combinations of days, considering the semantic test, G1 gave evidence of significant data during the first and the second day. CONCLUSION: both tests attest that verbal learning was more effective for adults than for elderly people. However, there were no significant statistical differences among all groups, except from a decrease in words creation as long as age increased and schooling decreased. By comparing both genders, men performance improved in the semantic test.

Análise da consistência alimentar e tempo de deglutição em crianças com paralisia cerebral tetraplégica espástica

PURPOSE: to evaluate the alimentary consistency and the deglutition time in children with Cerebral Palsy. METHODS: 30 children between 0 and 12 years, with Cerebral Paralysis of the quadriplegic spastic type been evaluated, that were under speech pathology follow-up. RESULTS: the collected data showed that the verbal phase demonstrated to be inefficient or absent in the majority of the children, as well as in the pharyngeal phase of deglutition. More of the half of the evaluated children have shown between moderate to acute verbal motor dysfunction. In relation to the consistency of food and deglutition times, the children with deeply compromised OMF (Oral Motor Function) took more 14.2 times to swallow liquid foods and more 6.4 times for the pasty food. CONCLUSION: before the study, it is possible to conclude that the major difficulty of the child with cerebral paralysis is the verbal phase of deglutition and as bigger the verbal motor dysfunction, the bigger is the time elapsing for swallowing foods in the three studied consistencies. The relations between OMD (Oral Motor Dysfunction) and deglutition time are directly related.

Swallowing disorders after ischemic stroke

OBJECTIVE To investigate occurrences of swallowing disorders after ischemic stroke. METHOD This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS 50.5% were men and 49.5% women; mean age 65.3 years (SD= ± 11.7) (p ≤ 0.001). Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p ≤ 0.001) and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p ≤ 0.001). CONCLUSION Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

Avaliação da fluência verbal em crianças com transtorno da falta de atenção com hiperatividade: um estudo comparativo

PURPOSE: to compare the performances of individuals with ADHD and control group, in verbal fluency tests, from 7 to 12 years, without cognitive deficit. METHODS: 22 children with ADHD and 34 control group had been evaluated, students of a public school in the State of Rio de Janeiro. A verbal fluency test was applied, subdivided in evaluation of the phonological fluency, using the letter F and semantics, using Animal category in the semantic test. The verbal fluency tests evaluate the number of verballyproduced words, in just one minute period. Four intervals of 15 seconds had been created looking for setting up the relation of words said in each interval for each group. The participants had been divided by age to make easier the analysis of the results. RESULTS: no difference between genders was found. The average number of words in phonological and semantics tests had been compared. The performance of the phonological test had been lower than semantics in both groups. The ADHD group presented similar results to the control group in both tests, but with different latency periods. CONCLUSION: the performances of ADHD in phonological verbal fluency and semantics had been similar to the control group, and the higher results had occurred in the semantics tests in both groups.

Disfunções orofaciais nos pacientes em tratamento ortodôntico

PURPOSE: to evaluate the need for speech therapy intervention in patients treated in the orthodontic clinic of the Federal University of Juiz de Fora. METHODS: clinical examinations, application of questionnaire and clinical medical register analysis of 42 patients under orthodontic treatment in the Federal University of Juiz de Fora had been carried out. The first phase of this study was made up by the evaluation of the habitual tongue position, breathing function, deglutition and speech. Soon afterwards, data were obtained on morphologic aspects of the dental occlusion and information on the presence of deleterious oral habits. RESULTS: one noticed that 92% of the examined ones presented alterations in the chew and the deglutition and 52% had some speech dysfunction. The graphical comparison of the measures for each variable suggests that it has the highest trend to have alteration in the chew in the individuals that are in orthodontic treatment for 19 months or above. The same is yet not valid for the subjects that showed alterations in speech and deglutition. CONCLUSION: the importance of speech intervention was noted in this study, especially in the alterations in chewing, the initial phase of orthodontic treatment.

Avaliação clínica, endoscópica e manométrica da deglutição em pacientes com miastenia grave autoimune adquirida

Dysphagia, or difficulty swallowing, is a common problem following myasthenia gravis (MG) and may lead to aspiration of saliva, food or liquids. We herein present 22 MG patients, with complaint of dysphagia, evaluated by phonoaudiological evaluation, nasofibrolaryngoscopical analysis and manometry of upper esophageal sphincter. The main objective was to evaluate the phases of the swallowing process and anatomical and functional aspects of oropharyngeal musculature. The age of patients varied from 19 to 74 years; being 19 female and 3 male. The main data were: (1) statistically significant relation between the phonoaudiological clinical evaluation and nasofibrolaryngoscopical one; (2) stomatognatical system disorders present in 100%; (3) swallowing and chewing disorders present in 100%, when clinically evaluated, and in 81,8% when evaluated by the nasofibrolaryngoscopy; (4) statistically significant relation between penetration/aspiration and antecedents of pneumonia; (5) stomatognatical muscles very altered, difficulty controlling the bolus, collection of food in the pharynx or larynx and presence of penetration and/or aspiration showed significant correlation with weakness of a pharyngeal muscles. These findings justify the necessity to evaluate clinically the swallowing phases in MG patients, with the main purpose to prevent both aspiration and dehidration from inadequate oral intake.Dysphagia, or difficulty swallowing, is a common problem following myasthenia gravis (MG) and may lead to aspiration of saliva, food or liquids. We herein present 22 MG patients, with complaint of dysphagia, evaluated by phonoaudiological evaluation, nasofibrolaryngoscopical analysis and manometry of upper esophageal sphincter. The main objective was to evaluate the phases of the swallowing process and anatomical and functional aspects of oropharyngeal musculature. The age of patients varied from 19 to 74 years; being 19 female and 3 male. The main data were: (1) statistically significant relation between the phonoaudiological clinical evaluation and nasofibrolaryngoscopical one; (2) stomatognatical system disorders present in 100%; (3) swallowing and chewing disorders present in 100%, when clinically evaluated, and in 81,8% when evaluated by the nasofibrolaryngoscopy; (4) statistically significant relation between penetration/aspiration and antecedents of pneumonia; (5) stomatognatical muscles very altered, difficulty controlling the bolus, collection of food in the pharynx or larynx and presence of penetration and/or aspiration showed significant correlation with weakness of a pharyngeal muscles. These findings justify the necessity to evaluate clinically the swallowing phases in MG patients, with the main purpose to prevent both aspiration and dehidration from inadequate oral intake.

Disfagia orofaríngea na distrofia miotônica: avaliaçäo fonoaudiológica e análise nasofibrolaringoscópica

We here in present twenty myotonic dystrophy of Steinert patients with the main objective to evaluate and classify the oropharyngeal swallowing by the phonoaudiological clinical and nasofibrolaryngoscopical analysis. The age of the patients varied from 12 to 53 years, being 13 male and 7 female. The mean data: (1) statistically significant relation between the phonoaudiological clinical evaluation and nasofibrolaryngoscopical one; (2) stomatognatical system disorders present in 100%; (3) swallowing disorders present in 95%, when clinically evaluated, and in 70% when evaluated by the nasofibrolaryngoscopy; (4) higher difficulty to swallow consistent feed; (5) stomatognatical muscles very altered, pharyngeal phase disorders, cough after swallowing, antecedents of pneumonia and complaints of chewing/swallowing presented statistically significant correlation with severity of the sickness. The analysis were able to evaluate statical and functionally the involved structures in the swallowing, having got to take part of the routine of attendance to the patients with myotonic dystrophy of Steinert.

Linguagem e memória na doença de Alzheimer em fase moderada

OBJETIVO: analisar as alteracoes cognitivas (memoria e linguagem) no paciente com doenca de Alzheimer na fase moderada e verificar se as variaveis sexo, idade e escolaridade interferem nessas habilidades. METODOS: foi realizado um estudo observacional e prospectivo com 27 sujeitos com doenca de Alzheimer na fase moderada, frequentadores do Centro de Reabilitacao Regional de Araraquara (CRRA), com idade variando de 60 a 86 anos. O teste utilizado para a avaliacao foi o Consortium to Establish a Registry for Alzheimers Disease (CERAD) que contem varias provas, sendo selecionadas as seguintes: Teste de nomeacao de Boston, Memoria da lista de palavras, Fluencia verbal, Evocacao da lista de palavras e Reconhecimento da lista de palavras. RESULTADOS: as respostas obtidas nesta pesquisa permitiram observar que nao houve diferenca significante nas variaveis sexo e idade; ja na variavel escolaridade, obteve-se diferenca significante no subteste de nomeacao de Boston. CONCLUSAO: a amostra dos sujeitos desta pesquisa nao obteve diferenca significante nas variaveis sexo e idade. Ja na variavel escolaridade, os sujeitos com maior grau de instrucao tiveram melhor desempenho na prova de linguagem relacionada ao subteste de nomeacao de Boston.

Relação da memória visual com o desempenho ortográfico de crianças de 2ª e 3ª séries do ensino fundamental

PURPOSE: in this relate the visual memory to orthographic performance of childrens handwriting from 2nd and 3rd years of elementary school. METHODS: it was analyzed 61 children, male and female, with average age between 8 and 9 years old, were analyzed. The children were evaluated in classroom, by the examiner, during the 2nd semester of the school year, in 3 different stages: oral dictation valuation of isolated words, of silent reading valuation of isolated words and visual memory analysis through the Rey Complex Figure. RESULTS: it was noticed that orthographic mistakes reduces during visual dictation, when compared to oral dictation; children who make more orthographic mistakes during dictation, have worse performance on the Rey Complex Figure; children from 3rd year have less frequency of orthographic mistakes and better performance on the Rey Complex Figure, when compared to 2nd year children. CONCLUSION: visual memory is an important fact during orthographic development, helping children to understand better the acquisition of orthographic rules.

Perfil das habilidades cognitivas no envelhecimento normal

OBJETIVO: analisar as funcoes cognitivas em idosos no envelhecimento normal e verificar se variaveis como sexo, idade e escolaridade interferem no perfil dessas habilidades. METODOS: foi realizado um estudo prospectivo, observacional transversal, com uma amostra constituida por 50 idosos institucionalizados, sem comprometimento neurologico e queixa de memoria, com idade variando de 65 a 89 anos que possuiam grau de escolaridade variando de 0 a 15 anos. O teste utilizado neste estudo foi o Consortium to Establish a Registry for Alzheimers Disease (CERAD). RESULTADOS: o sexo feminino obteve diferenca significante nos subtestes de Memoria, Evocacao e Reconhecimento. A faixa etaria de 65 - 75 anos obteve diferenca significante no subteste de Evocacao. A faixa de escolaridade de 8 - 15 anos obteve diferenca significante nos subtestes de Boston e no de Fluencia. CONCLUSAO: as mulheres tiveram um melhor desempenho nos subtestes que envolviam memoria. Os idosos considerados jovens foram melhores na prova de memoria relacionada a evocacao. Os individuos que tiveram um maior grau de instrucao obtiveram um melhor desempenho nas habilidades que envolviam linguagem.