ABSTRACT
Abstract Introduction There is evidence that all the complex machinery involved in speech acts along with the auditory system, and their adjustments can be altered. Objective To present the evidence of biofeedback application for treatment of vocal disorders, emphasizing the muscle tension dysphonia. Methods A systematic review was conducted in Scielo, Lilacs, PubMed and Web of Sciences databases, using the combination of descriptors, and admitting as inclusion criteria: articles published in journals with editorial committee, reporting cases or experimental or quasi-experimental research on the use of biofeedback in real time as additional source of treatment monitoring of muscle tension dysphonia or for vocal training. Results Thirty-three articles were identified in databases, and seven were included in the qualitative synthesis. The beginning of electromyographic biofeedback studies applied to speech therapy were promising and pointed to a new method that enabled good results in muscle tension dysphonia. Nonetheless, the discussion of the results lacked physiological evidence that could serve as their basis. The search for such explanations has become a challenge for speech therapists, and determined two research lines: one dedicated to the improvement of the electromyographic biofeedback methodology for voice disorders, to reduce confounding variables, and the other dedicated to the research of neural processes involved in changing the muscle engram of normal and dysphonic patients. Conclusion There is evidence that the electromyographic biofeedback promotes changes in the neural networks responsible for speech, and can change behavior for vocal emissions with quality.
Resumo Introdução Há evidências de que o complexo aparato envolvido no ato da fala, juntamente com o sistema auditivo, e seus ajustes podem ser alterados. Objetivo Apresentar evidências da aplicação de biofeedback (biorretroalimentação) para tratamento de distúrbios vocais, enfatizar a disfonia de tensão muscular. Método Realizou-se uma revisão sistemática nas bases de dados de Scielo, Lilacs, PubMed e Web of Sciences, utilizando a combinação de descritores e admitindo como critérios de inclusão: artigos publicados em revistas com comitê editorial, relatos de casos ou pesquisas experimentais ou quase experimentais sobre o uso debiofeedbackem tempo real como fonte adicional de monitoração de tratamento de disfonia de tensão muscular ou para treinamento vocal. Resultados Trinta e três artigos foram identificados em bases de dados, e sete foram incluídos na síntese qualitativa. O início dos estudos de biofeedbackeletromiográficos aplicados à terapia fonoaudiológica foram promissores e indicaram um novo método que permitiu bons resultados na disfonia de tensão muscular. No entanto, a discussão dos resultados carecia de evidências fisiológicas que pudessem servir de base. A busca por tais explicações tornou-se um desafio para os fonoaudiólogos e determinou duas linhas de pesquisa: uma dedicada à melhoria da metodologia de biofeedbackeletromiográfico para distúrbios da voz, para reduzir as variáveis de confusão e outra dedicada à pesquisa de processos neurais envolvidos na alteração do engrama muscular de pacientes normais e disfônicos. Conclusão Há evidências de que o biofeedback eletromiográfico promove mudanças nas redes neurais responsáveis pela fala e pode mudar o comportamento para emissões vocais com qualidade.
Subject(s)
Humans , Male , Female , Speech Therapy/methods , Biofeedback, Psychology , Dysphonia/therapy , Voice Quality , ElectromyographyABSTRACT
Objective To evaluate the therapeutic effects of electromyography feedback functional electrical stimulation (FES) on plan-tar pressure of stroke patients. Methods 18 subjects were included in this study, who were with drop foot resulting from stroke, but could partly dorsiflex the paretic limb's ankle (Manual Muscle Test>2). They were tested on the RS-footscan plate before and after stimulation. The plantar pressure data of paretic foot and walking velocity before and after stimulation were compared. Results The initial touchdown points of most paretic foot were changed from Meta (metatarsal) 5 to heel;the time of initial touchdown of heel medial and heel lateral sig-nificantly improved, while that of Meta 3, Meta 4 and Meta 5 significantly delayed;the peak force, impulse and contact area of the heel sig-nificantly improved after stimulation (P<0.05). At the same time, the time of initial touchdown of heel medial and heel lateral of nonparetic foot significantly improved (P<0.05). Conclusion Electromyography feedback functional electrical stimulation can improve the gait pattern and the stability of patients with stroke.
ABSTRACT
@#Objective To evaluate the therapeutic effects of electromyography feedback functional electrical stimulation (FES) on plantar pressure of stroke patients. Methods 18 subjects were included in this study, who were with drop foot resulting from stroke, but could partly dorsiflex the paretic limb's ankle (Manual Muscle Test >2). They were tested on the RS-footscan plate before and after stimulation. The plantar pressure data of paretic foot and walking velocity before and after stimulation were compared. Results The initial touchdown points of most paretic foot were changed from Meta (metatarsal) 5 to heel; the time of initial touchdown of heel medial and heel lateral significantly improved, while that of Meta 3, Meta 4 and Meta 5 significantly delayed; the peak force, impulse and contact area of the heel significantly improved after stimulation (P<0.05). At the same time, the time of initial touchdown of heel medial and heel lateral of nonparetic foot significantly improved (P<0.05). Conclusion Electromyography feedback functional electrical stimulation can improve the gait pattern and the stability of patients with stroke.