Angela Ruviaro Busanello

A relação da postura corporal com a prosódia na doença de parkinson: estudo de caso

PORPOSE: to investigate the relationship between body posture and prosody in patients with Parkinson Disease. METHODS: the study was carried out with five patients (four males and one female) from Santa Maria, Rio Grande do Sul, Brazil, by means of cross-section study, in 2006. Evaluations of linguistic and emotional prosody as well as analysis of body posture were carried out. The statistical analysis was descriptive. RESULTS: the subjects of this study were four men and one woman aged between 37 and 53 years. Three of these patients were classified in stage I of the disease; one in the stage III and the other one in the stage IV, according to the classification of Hohen & Yahr motor function. All of them were under medication and presenting the signals of the characteristic triad of such pathology: rigidity, tremor and bradykinesia, as well as the typical alterations of body posture. In the comparison between linguistic prosody and emotional prosody, subjects showed the best performance in emotional prosody and no associations among the stages of the disease and the alterations on body posture and prosody were evidenced. CONCLUSION: body posture alterations are the characteristic signals of Parkinson Disease as well as the disorders related to linguistic and emotional prosody. The occurrence of posture alterations was high in patients with Parkinson disease. Subjects showed better performance in emotional prosody. There were no evidences that the stages of the disease were related to prosody or body posture alterations.

Alterações no modo respiratório, na oclusão e na fala em escolares: ocorrências e relações

PURPOSE: to check the occurrence of articulation disorders, alterations in breathing mode and malocclusion as well as the relation among theses variables in public-school children. METHODS: 308 female and male children aged between 6 and 11 years were submitted to speech pathologic and orthodontic evaluations, being selected 235. From the information collected in the evaluations, we considered: breathing mode, malocclusion by Angles classification and transverse alterations, as well as articulation disorder. RESULTS: 60.43% children had presented breathing mode alterations; 97.02% Angle malocclusion; 28.94% transverse occlusion alterations and 14.89% articulation disorder. Statistically significant relations were found between articulation disorder and transverse occlusion alterations, breathing mode and Angle malocclusion and between Angle malocclusion and transverse occlusion alterations. CONCLUSION: the malocclusions and alterations referring to breathing mode were frequent in the studied group. The found relationships reinforce the idea that there is a narrow relationship between the structure and the function of the stomatognathic system, and for that reason they deserve attention from several health professionals.

Relação entre dor e atividade elétrica na presença de bruxismo

OBJETIVO: mensurar a atividade eletrica dos musculos masseter e temporal, verificar a graduacao de dor a palpacao e sua correlacao com a atividade eletrica em sujeitos com bruxismo. METODO: todos os sujeitos do estudo foram selecionados apos avaliacao por meio do instrumento Criterios de Diagnostico em Pesquisa para Desordens Temporomandibulares (RDC/TMD) alem de avaliacao odontologica e fonoaudiologica. A atividade eletrica dos musculos mastigatorios foi avaliada por meio da eletromiografia de superficie nas situacoes de repouso, maxima intercuspidacao e mastigacao habitual ritmada. Para a coleta e analise dos sinais eletromiograficos foram usados os Software BioInspector®, 1.8 (Lynx®), e software AqDAnalysis®. 7.0 (Lynx®), respectivamente, quantificados em RMS (raiz quadrada media) e expressos em µV (microvolts). A analise estatistica dos dados foi realizada por meio do Coeficiente de Spearman com significância de p<0,05. RESULTADOS: os resultados mostraram que o padrao eletromiografico dos musculos estudados apresentou-se proximos aos niveis de normalidade, no repouso, maxima intercuspidacao e na mastigacao habitual ritmada. A maioria dos sujeitos apresentou queixa de algum tipo de dor, sendo mais evidenciado o grau severo e, principalmente, no musculo masseter. Nao evidenciou-se correlacao estatisticamente significante entre dor e atividade EMG, uma vez que esta ultima mostrou-se proxima aos niveis de normalidade. CONCLUSAO: a analise dos resultados indicou que, apesar da presenca da dor nos musculos mastigatorios, a maioria das correlacoes entre dor e EMG apresentou-se fraca e sem significância estatistica, indicando que a dor nao interferiu no desempenho da atividade eletrica dos musculos estudados nas situacoes avaliadas.

Síndrome de Goldenhar: uma abordagem fonoaudiológica

BACKGROUND: the purpose of this paper is to tell the case of a child with Goldenhar Syndrome in speech-language treatment at a clinical school. PROCEDURES: data were collected from the patients records, through signature of the Free and Clarified Consent Term and approval in the Ethics Committee of the institution, during approximately 11 months of treatment. This case relates a child with 5 years and 11 months old, male gender, with a birth malformation at the right ear and mandibular condyle, as well as spina bifida. For this description, the patient passed through evaluations of hearing, stomatognathic system, face anthropometric measures, articulation examination, phonological assessment and hearing discrimination, before and after intervention. RESULTS: we noted changes as for conductive hearing loss in a moderate degree at the right ear; modifications in the mobility of lips and tongue; alterations in deglutition, mastication and respiration; reduced face anthropometric measures, mainly at the mandibular ramus; as well as the articulatory (distortions) and the phonological disorders (devoicing). From these data, we set out a therapeutic planning, with positive results in the mentioned period, mainly as for the mastication function. CONCLUSION: the patient showed several speech-language alterations arising from the oculoauriculovertebral spectrum, that is being increased in the association with Mouth Breathing, the deleterious oral habits and the environmental factors of the patient. New studies with more details and higher number of subjects are important to corroborate such results.

Estudo eletromiográfico dos músculos faciais de respiradores nasais, respiradores orais viciosos e obstrutivos

PURPOSE: to check, through an electromyographic evaluation, the electrical activity pattern of the orbicular oral, masseter and temporal muscles on nasal breathers, obstructive and vicious oral breathers in order to compare them. METHODS: 59 children, 15 nasal breathers (NB); 23 vicious oral breathers (VOB) and 21 obstructive oral breathers (OOB) were studied. All were submitted to an otorhinolaringological and speech-language patology evaluation and to an electromyographic exam in rest, masticatoric and labial isometries. We developed a Kruskal-Wallis variance analysis in order to make a comparison between the groups and the two-by-two groups and the Wilcoxons test in order to compare between the muscles (p<0,05). RESULTS: after comparing the three groups, there were no relevant difference in the studied muscles, except for the right masseter muscle while resting, when the VOB and NB were compared; and to the lower orbicular muscle while resting and left temporal muscle in the masticatoric isometry, when NB and OOB were compared. In the comparison between VOB and OOB, any muscle has showed a relevant difference. The lower orbicular muscle was more active than the upper orbicular muscle while resting and on labial isometry, mainly in VOB and OOB. The relation of the muscles on the opposed sides of face in the masticatoric isometry revealed asymmetry. The temporal muscle demonstrated being more active than the masseters while resting and in masticatoric isometry. CONCLUSION: the breathing mode did not modify the behavior of the evaluated muscles when comparing the groups; oral breathing etiology did not change the electrical activity of the evaluated muscles when comparing VOB and OOB.

Disartria e doença de Machado-Joseph: relato de caso

The aim of this study was to describe the essential speech aspects of Machado-Joseph disease in a male patient with this diagnosis, selected among others with the same disease that received treatment at the Speech-Language Pathology and Audiology department of Hospital de Clinicas de Porto Alegre (Brazil). Regarding the speech process, it was observed ataxic dysarthria, which worsened from light to severe with the evolution of the disease. These results allowed the conclusion that speech alterations become more and more significant for Machado-Joseph patients, together with deficits in breathing, articulation, phonation and resonance. Finally, it was possible to suggest that Speech Pathology treatment is essential in Machado-Joseph disease, although more studies are necessary, with larger samples, in order to better characterize the speech alterations observed this study.

ANÁLISE ELETROMIOGRÁFICA DO MÚSCULO MASSETER EM INDIVÍDUOS RESPIRADORES ORAIS

Objetivo: Analisar a funcao mastigatoria, atraves da avaliacao clinica e eletromiografica, em individuos respiradores orais. Metodos: Foram estudados 2 individuos respiradores nasais e 3 respiradores orais, com idades entre 13 e 17 anos, que realizaram avaliacao clinica e avaliacao eletromiografica do musculo masseter. Resultados: em repouso nao foi observada diferenca na atividade eletrica do musculo masseter nos individuos avaliados. Porem, embora nao se tenha encontrado diferenca estatisticamente significante, observou-se atividade eletrica inferior nos respiradores orais no teste de maxima intercuspidacao e, atividade eletrica inferior no masseter direito dos respiradores orais na funcao de isotonia. Na avaliacao clinica, observaram-se alteracoes estruturais e funcionais nos individuos respiradores orais que podem justificar tais achados. Conclusoes: A partir da analise dos resultados, observou-se que, de modo geral, existe uma diminuicao da atividade eletrica dos musculos masseteres nos respiradores orais, evidenciada tambem na avaliacao clinica, o que demonstra, portanto, prejuizo da funcao mastigatoria desses individuos. Descritores: Eletromiografia, Respiracao Bucal, Musculo Masseter, Mastigacao, Musculos Mastigatorios