Traumatic Spinal Injury: Preliminary Results of Respiratory Function, Voice and Quality of Life.

OBJECTIVES: Assess respiratory muscle strength, voice and the quality of life of patients with traumatic cervical and thoracic spinal cord injury. METHODS: Preliminary analytical case control study of 28 adult men, aged between 18 and 65 years, divided into two groups: a research group consisting of 14 patients with cervical and thoracic spinal cord injury, and control group (CG) with 14 noninjured individuals. The subjects had their maximum inspiratory and expiratory pressures measured, underwent voice handicap index-10 assessment, had their voices recorded for auditory perception analysis, using the voice deviation and GRBASI scales, and for acoustic analysis, based on extraction of the parameters selected and completed a quality-of-life questionnaire (WHOQOL-bref protocol). RESULTS: Intergroup comparison indicated that the research group exhibited lower respiratory muscle strength in relation to the CG, MIP and MEP P-values < 0.001 and < 0.001, respectively; and in relation to the device's reference value, MIP and MEP P-values < 0.001 and < 0.001, respectively; the patients reported no voice handicaps according to the voice handicap index; overall vocal deviation severity on the voice deviation was higher in the CG, P = 0.040; there was greater occurrence of roughness and instability on the GRBASI scale, P= 0.040; there was greater difficulty in modulating vocal frequency (P= 0.002) and resonance, with a laryngopharyngeal focus; the acoustic parameters were normal; and lower scores were obtained in the physical domain of quality of life (P< 0.001). CONCLUSION: The individuals with traumatic spinal cord and thoracic injury exhibited changes in respiratory measures, vocal deviation and dissatisfaction in the physical domain of the WHOQOL-bref protocol.

Vocal Parameters in Individuals with Traumatic Spinal Cord Injury: A Systematic Review.

OBJECTIVE: To analyze and assess studies on the topic and to describe the vocal parameters of patients with traumatic spinal cord injury (SCI) based on the literature. METHOD: Studies were identified and selected by searching for articles on the subject published in any journal, using pre-established descriptors: "spinal cord injury," "speech," "lang$," "speech-lang$," and "voice" ("traumatismos da medula espinal," "fala," "fona$," "fonoaud$," and "voz" in Brazilian Portuguese). All the phases of the study were conducted independently by the researchers and in the event of disagreement, a final decision was reached by consensus. The articles selected were critically assessed based on their objectives, treatment, and assessment criteria and methods, results and conclusions, as well their level of scientific evidence. RESULTS: A total of 70 scientific articles were identified, eight of which were considered valid based on the inclusion criteria. Research on the contribution of speech therapy to patients with SCI is scarce, particularly regarding voice assessment and treatment. Descriptive and observational studies predominated, with a small sample. Data collection was predominated cross-sectional, which made it possible to identify evaluation and intervention techniques, but the methodologies described preclude generalizations. The results indicated that the parameters of the respiratory function and vocal production in patients with traumatic SCI were reduced lung capacity, presence of voice problems, presence of perceived voice problems, and altered activation of accessory respiratory muscle. CONCLUSION: The vocal parameters of the patients with traumatic SCI can be described, considering the lack of information available. Disorders related to speech therapy vary in accordance with the type and level of injury. It is important to increase scientific production in this area, particularly randomized trials, in order to establish assessment criteria and treatment techniques and improve levels of evidence.