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PURPOSE: To verify whether measurements of maximal phonation times are biomarkers of forced vital capacity in patients with chronic obstructive pulmonary disease, and to characterize the vocal aspects of these patients, taking into account variables, such as age, body mass index, use of bronchodilators, presence of symptoms, and quality of life related to voice. METHODS: Complete records of 25 subjects with chronic obstructive pulmonary disease, both sexes, aged 31 to 85 years, evaluated by forced vital capacity, maximum phonation times of /a/, and numerical count and number reached at this count, Vocal Symptom Scale, Voice Quality of Life. Data were presented descriptively and statistically analyzed using Student's t test for independent samples and Mann-Whitney U test. A significance level of 5% was accepted. The receiver operating characteristic curve was plotted and the standardized value of forced vital capacity <80% was considered as an indicator of pulmonary dysfunction. RESULTS: Patients exhibited reduced maximum phonation times for /a/, numeric counting, and reached digits in counting; discrepancies in Vocal Signs and Symptoms and Voice Quality of Life Scale scores. Numeric counting times of up to 12.5 seconds indicated that forced vital capacity may be impaired. CONCLUSION: The patients with chronic obstructive pulmonary disease examined in this study exhibited vocal deviations as evidenced by reduced maximum phonation times of /a/, numeric counting, and the digit reached during counting, as well as deviations in vocal self-assessment. Maximum phonation time in numerical counting was considered a biomarker of pulmonary function impairment.
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OBJECTIVE: To investigate whether there is a relationship between voice-related quality of life, pulmonary function, risk of dysphagia, symptoms of dyspnea, and the different degrees of Chronic Obstructive Pulmonary Disease, and to verify which factors may be associated to voice-related quality of life. METHODS: Complete records of 37 individuals diagnosed with Chronic Obstructive Pulmonary Disease, of both sexes, aged between 35 and 89, assessed using the Voice-Related Quality of Life Questionnaire, Questionnaire for Dysphagia Screening, Modified Medical Research Council, Index of Body Mass, Peak Expiratory Flow, COPD Assessment Test and Global Initiative for Chronic Obstructive Lung Disease classification. RESULTS: There was a significant, moderate, and negative correlation between the total scores and the physical domain scores of the Voice-Related Quality of Life as a COPD Assessment Test. In the multivariate linear regression analysis, the coefficient of determination explained 51.1% of the relationship between the total Voice-Related Quality of Life score and the independent variables: Peak Expiratory Flow and Questionnaire for Dysphagia Screening. CONCLUSION: In the analyzed group, voice-related quality of life was negatively influenced by Chronic Obstructive Pulmonary Disease, risk of dysphagia, and changes in Peak Expiratory Flow.
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ABSTRACT Objective To evaluate the nutritional and functional status, swallowing disorders, and musculoskeletal manifestations of patients with Post-Covid-19 Syndrome, stratified by the Appendicular Skeletal Muscle Mass Index. Methods This is a cross-sectional study with patients diagnosed with Post-Covid-19 Syndrome after discharge from the intensive care unit of a university hospital. The evaluated outcomes were: nutritional status (Mini Nutritional Assessment, bioimpedance and anthropometry), swallowing disorders (Dysphagia Risk Evaluation Protocol), functional status (Post-Covid-19 Functional Status Scale), and musculoskeletal manifestations. According to the Appendicular Skeletal Muscle Mass Index, patients were stratified in terms of loss or not loss of muscle mass. Results Thirty-eight patients were included in the study, 20 stratified into the no loss of muscle mass group (17 females; 49.45±12.67 years) and 18 into the loss of muscle mass group (18 males; 61.89±12.49 years). Both groups were at risk of malnutrition (Mini Nutritional Assessment scores between 17-23.5 points; No Loss of Muscle Mass Group: 21.82±3.93; Loss of Muscle Mass Group: 23.33±3.41) and obesity (No Loss of Muscle Mass Group: 33.76±6.34; Loss of Muscle Mass Group: 30.23±3.66). The groups differed in terms of bioimpedance parameters (except fat mass) and age. However, there were no differences in swallowing alterations, functional status, and musculoskeletal manifestations. Conclusion Patients with Post-Covid-19 Syndrome, stratified according to the Appendicular Skeletal Muscle Mass Index, were at risk of malnutrition and obesity. The persistence of fatigue, weakness, myalgia and arthralgia at 6 months after hospital discharge is noteworthy. These findings emphasize the importance of comprehensive care for patients with Post-Covid-19 Syndrome.
RESUMO Objetivo Avaliar o estado nutricional, status funcional, alterações de deglutição e manifestações musculoesqueléticas de pacientes com Síndrome Pós-Covid-19, estratificados pelo Índice de Massa Muscular Esquelética Apendicular. Métodos Estudo transversal composto por pacientes diagnosticados com a Síndrome Pós-Covid-19 que estiveram internados na Unidade de Terapia Intensiva de um hospital universitário. Os desfechos avaliados foram: estado nutricional (Mini Avaliação Nutricional; bioimpedância e antropometria), alterações de deglutição (Protocolo Fonoaudiológico de Avaliação do Risco de Disfagia), status funcional (Post-Covid-19 Functional Status Scale) e manifestações musculoesqueléticas. Os pacientes foram classificados, quanto à perda de massa muscular conforme o Índice de Massa Muscular Esquelética Apendicular, em grupo sem e com perda de massa muscular. Resultados Foram inseridos no estudo 38 pacientes, 20 no grupo sem perda de massa muscular (17 deles do sexo feminino; 49,45±12,67 anos) e 18 no grupo com perda de massa muscular (todos do sexo masculino; 61,89±12,49 anos). Os pacientes de ambos os grupos apresentaram risco de desnutrição (escores Mini Avaliação Nutricional entre 17-23.5 pontos; Grupo Sem Perda de Massa Muscular: 21,82±3,93; Grupo Com Perda de Massa Muscular: 23,33±3,41) e obesidade (Grupo Sem Perda de Massa Muscular: 33,76±6,34; Grupo Com Perda de Massa Muscular: 30,23±3,66). Os grupos diferiram quanto aos parâmetros da bioimpedância (exceto massa gorda) e idade. Entretanto, não foram observadas diferenças na deglutição, status funcional e manifestações musculoesqueléticas. Conclusão Os pacientes com Síndrome Pós-Covid-19, estratificados conforme o Índice de Massa Muscular Esquelética Apendicular, apresentaram risco de desnutrição e obesidade. Destaca-se a persistência de fadiga, fraqueza, mialgia e artralgia após seis meses da alta hospitalar. Esses achados ressaltam a importância do cuidado integral ao paciente com a Síndrome Pós-Covid-19.
