Eduardo Matias dos Santos Steidl

SÍNDROME DE TENSÃO MUSCULOESQUELÉTICA, MUSCULATURA LARÍNGEA EXTRÍNSECA E POSTURA CORPORAL: CONSIDERAÇÕES TEÓRICAS

The theme of this study is the musculoskeletal stress syndrome, extrinsic laryngeal muscles and body posture. The purpose is to describe, from the literature review, the characteristics of the extrinsic muscles of the larynx; posture; vocal implications of musculoskeletal stress syndrome; evaluation and physical therapy and voice therapy. We performed a literature review of the last 13 years which included articles aimed and/or body textwere in line with the objectives of this study. The research was conducted in the databases of Literatura Latino-Americana e do Caribe em Ciencias da Saude, Biblioteca Regional de Medicina, Public Medline, Medical Literature Analysis and Retrieval System on Line, Scientific Electronic Library Online and Google Schoolar. Were established important relationships within the physical therapy and voice therapy, among which stand out the relationships muscular, postural and functional synergy in the vocal apparatus. In physical therapy to reduce muscle tension, the literature indicates use of transcutaneous electrical stimulation, low level laser, laser acupuncture, cryotherapy, manual therapy and traction, massage, cervical manipulations and mobilizations, associated or not to exercise, stretching, isometric relaxation , assisted soft tissue mobilization, therapeutic exercises aimed at correcting balance and muscle, diaphragm and respiratory rehabilitation therapy craniocervical flexion. In speech therapy, studies found only through digital manipulation of the larynx and semi-ocluded vocal tract exercises.

Relationship between Dysphagia and Exacerbations in Chronic Obstructive Pulmonary Disease: A Literature Review

Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease.

Premature: growth and its relation to oral skills

OBJECTIVE To evaluate the influence of oral motor skills of premature infants on their oral feeding performance and growth, during neonatal hospitalization. METHODS Fifty-one newborns hospitalized in the neonatal intensive care unit of a hospital in Southern Brazil, between July 2012 and March 2013, were evaluated. The evaluation of oral feeding skills, according to Lau and Smith, was applied after prescription for starting oral feeding. The oral feeding performance was analyzed using the following variables: days taken to start independent oral feeding and hospital discharge. Growth was measured by weight, length, and head circumference, using the curves of Fenton, at birth, first and independent oral feeding, and hospital discharge. RESULTS At birth, 71% preterm infants were proper for gestational age, most of them were males (53%), with average of 33.6 (±1.5) weeks of gestational age. The gestational age in the assessment did not influence the oral feeding performance of the premature infant and did not differ between levels. Time of transition from tube feeding to oral feeding and hospital stay was shorter when the oral skills were higher. At birth, there was a tendency of low weight and low oral feeding performance. Level IV premature infants in the release of oral feeding presented higher weights. CONCLUSION The level of oral skills of the premature infant interfered positively on time of feeding transition from tube to independent oral feeding and hospital stay. Growth, represented by weight gain, was not affected by the level of oral skill.

Deglutição orofaríngea, nutrição e qualidade de vida no indivíduo com doença pulmonar crônica

PURPOSE Describe efficacy and safety of deglutition, nutritional risk, and quality of life in deglutition, and associate nutritional risk with quality of life in individuals with chronic pulmonary disease. METHODS The participants were 17 individuals with chronic pulmonary disease evaluated using the following instruments: Volume-Viscosity Swallow Test (V-VST), Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire, Mini Nutritional Assessment (MNA), and body mass index (BMI). RESULTS Changes in efficacy were observed in nine (52.94%) individuals and impairments in efficacy and safety were found in two (11.77%) individuals. All individuals were considered eutrophic by the nutritional assessment. Correlation was observed between nutritional risk and domains 3 (r=-0.803; p=0.05) and 5 (r=0.636; p=0.026) of the SWAL-QOL questionnaire. CONCLUSION Changes in efficacy and safety of deglutition were observed; however, no nutritional risk was evidenced in the sample evaluated. Correlation between nutritional risk and quality of life in deglutition was also observed.

Efeitos do exercício muscular respiratório na biomecânica da deglutição de indivíduos normais

Purpose: to analyze the effects of the respiratory exercise in the biomechanics of swallowing in normal subjects. Methods: the muscle respiratory exercise in normal subjects was performed for seven consecutive days by the incentive spirometer flow (three sets of ten repetitions for inspiration and expiration).The biomechanics of swallowing was evaluated by video fluoroscopy through temporal variables (pharyngeal transition time) and visual-perceptual (number of swallows, waste in the pyriform sinuses and vallecula, penetration/aspiration). For statistical analysis, the Wilcoxon test, Equality of Two Proportions and Kappa were used. Results: 16 young women with a mean age of 21,2±3,4 years were evaluated. In visual-perceptual variables it was observed almost perfect agreement between evaluators (p<0,001) and in temporal variable (p=1,00). After the training period there was a significant reduction in the pharyngeal transition time (p=0,02). Conclusion: the use of incentive spirometer flow significantly influenced the biomechanics of swallowing, especially in reducing the pharyngeal transition time.

ANÁLISE DAS VARIÁVEIS CLÍNICAS DA MANOBRA DE HIPERINSUFLAÇÃO MANUAL EM RECÉM-NASCIDOS PRÉ-TERMOS SOB VENTILAÇÃO MECÂNICA

Nas Unidades de Terapia Intensiva Neonatal (UTINeo) a Fisioterapia tem ganho um espaco de plena ascensao junto da equipe que presta assistencia aos recem-nascidos pre-termos (RNPTs). Entre as tecnicas utilizadas pelos fisioterapeutas encontra-se a Hiperinsuflacao Manual (HM), conhecida tambem como bag squeezing ou bagging, que consiste na desconexao do RNPT do ventilador mecânico, no qual sao aplicadas insuflacoes manuais, que consistem em inspiracoes lentas e consecutivas, seguidas de pausa inspiratoria e rapida liberacao de pressao, objetivando o aumento do Pico de Fluxo Expiratorio (PFE), remocao de secrecoes e expansao de areas colapsadas. O presente estudo teve por objetivo analisar as condicoes hemodinâmicas e respiratorias em RNPTs antes e apos a aplicacao da tecnica. No periodo de outubro a dezembro de 2009 foram avaliados nove recem-nascidos na UTINeo do Hospital de Caridade Astrogildo de Azevedo (HCAA) de Santa Maria/RS. Para tanto foi preenchida uma ficha contendo as variaveis clinicas de FC, FR e SatO2, pre-aplicacao da tecnica, um minuto apos, 5 minutos e 10 minutos apos a aplicacao da HM. Constatou-se com os resultados que a FR e a FC nao diferenciaram significativamente pre e pos a aplicacao da HM, mas a SatO2 mostrou aumento significativo em relacao ao tempo.

DISTROFIA MUSCULAR DE DUCHENNE ASSOCIADA À PNEUMONIA ASPIRATIVA: RELATO DE CASO E ABORDAGEM FISIOTERAPÊUTICA

A Distrofia Muscular de Duchenne (DMD) e uma doenca que gera alta incapacidade, devido sua rapida progressao e complicacoes associadas, principalmente as respiratorias. O artigo relata o caso de um adolescente de 19 anos portador de DMD, internado na UTI Pediatrica do Hospital de Caridade Astrogildo de Azevedo (HCAA), com diagnostico de pneumonia aspirativa e insuficiencia respiratoria aguda, bem como a abordagem fisioterapeutica. A atuacao da fisioterapia altera as perspectivas de qualidade e expectativa de vida, assim conhecer a doenca favorece a elaboracao de objetivos e intervencao de forma mais objetiva e eficiente. Nosso objetivo com este trabalho foi fornecer conhecimentos atraves de uma breve revisao bibliografica sobre a doenca e como a fisioterapia podera conduzi-la no agravamento do quadro.