Methodological Procedures to Acquire and Analyze Ultrasound Images of Swallowing: A Scoping Review.

This scoping review aimed to identify methodological procedures for acquiring and analyzing ultrasound images related to swallowing in adults and older adults. The inclusion criteria were based on the PCC strategy (participants, concept, and context), as follows: population (adults and older adults), concept (ultrasound assessment), and context (swallowing assessment). The review included observational, experimental, descriptive, and analytical studies and excluded those that were not available in full, animal studies, in vitro studies, letters to the editor, errata, study protocols, and those that used ultrasound for purposes other than swallowing. There were no language and time restrictions. Two independent blinded professionals selected 81 articles that met the inclusion criteria from different databases. The most evaluated parameters included tongue morphology and movements, hyoid bone displacement, swallowing muscle area, and pharyngeal residue detection, such as pharyngeal wall mobility. They used convex and linear transducers (3 MHz to 8 MHz) positioned in the submental, laryngeal, and lateral regions of the neck. The subjects were seated and instructed to eat different food volumes and consistencies. The literature mapping showed that ultrasound is a promising diagnostic tool, helping clinicians understand swallowing disorders, as it provides static and dynamic images in different modes and positions. Also, patients receive real-time biofeedback of changes related to dysphagia.

Hyoid Bone Movement During Swallowing in Female Thyroidectomy Patients: A Kinematic Ultrasound Study.

The aim of this study was to investigate the measures of displacement, time and velocity of hyoid bone movement in female thyroidectomy patients. Fifty-eight ultrasound videos of 29 women during swallowing were analyzed. The sample was divided into experimental group (EG), composed of 12 women following total or partial thyroidectomy; and control group (CG) of 17 healthy women. The kinematic measures of displacement, time and velocity of hyoid bone displacement were tracked during swallowing of 10 ml of liquid (water) and 10 ml of thickened liquid (honey) in both groups for comparisons. Additional analysis included bolus consistency effect and relationship with clinical characteristics. Ultrasound videos were analyzed according to a standardized protocol using ImageJ software. Displacement, time and velocity of hyoid movement during swallowing of 10 ml of liquid or thickened liquid were not statistically different between female thyroidectomy patients and healthy women. There is no bolus consistency effect on kinematic measures in both groups, but among thyroidectomy patients, velocity of hyoid bone movement is significantly faster in those with swallowing complaints.

Performance of the phonatory deviation diagram in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease. / Desempenho do diagrama de desvio fonatório no monitoramento da qualidade vocal pré e pós exercício vocal em indivíduos com Doença de Parkinson.

PURPOSE: To assess the performance of the phonatory deviation diagram and its measurements in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease. METHODS: Retrospective and documentary study. A sample of 30 subjects was used, 50% male, with a mean age of 62.13 ± 9.05 years. The results of the phonatory deviation diagram were analyzed, in the moments before and after vocal exercise with the pushing technique associated with plosive sounds, considering the area, density, shape and location of the diagram in the quadrants. For comparison purposes, the acoustic parameters of jitter, shimmer, glottal to noise excitation ratio and results of the auditory-perceptual analysis, carried out in previous research, were also considered, in the pre- and post-technical moments. RESULTS: Despite the fact that there was no difference in the distribution of samples in the diagram, after performing the vocal technique, a change in the displacement of the diagram towards the area of normality was identified in the visual qualitative analysis, and there was an association between the general degree of vocal deviation in the analysis auditory perception and the area of the diagram. There was an improvement in the shimmer values after the vocal technique. CONCLUSION: The displacement of the phonatory deviation diagram towards the area of normality corroborated the results in relation to the general degree of dysphonia, evaluated by the auditory-perceptual analysis and the shimmer results, after the vocal technique. Thus, the diagram shows good performance in monitoring voice quality of individuals with Parkinson's.

OBJETIVO: Verificar o desempenho do diagrama de desvio fonatório e de suas medidas no monitoramento da qualidade da voz, pré e pós exercício vocal, em indivíduos com Doença de Parkinson. MÉTODO: Estudo retrospectivo e documental. Utilizou-se uma amostra de 30 sujeitos, sendo 50% do sexo masculino, com média de idade de 62,13 ± 9,05 anos. Foram analisados os resultados do diagrama de desvio fonatório, nos momentos pré e pós exercício vocal com a técnica de empuxo associada aos sons plosivos, considerando-se a área, densidade, forma e localização do diagrama nos quadrantes. Para fins de comparação, os parâmetros acústicos de jitter, shimmer, glottal to noise excitation ratio e resultados da análise perceptivo-auditiva, realizada em pesquisa anterior, também foram considerados, nos momentos pré e pós-técnica. RESULTADOS: A despeito de não ocorrer diferença na distribuição das amostras no diagrama, após realização da técnica vocal, foi identificada, na análise qualitativa visual, mudança no deslocamento do diagrama em direção à área de normalidade e houve associação entre o grau geral do desvio vocal da análise perceptivoauditiva e a área do diagrama. Houve melhora nos valores de shimmer, após a técnica vocal. CONCLUSÃO: O deslocamento do diagrama de desvio fonatório em direção à área de normalidade corroborou os resultados em relação ao grau geral de disfonia avaliado pela análise perceptivoauditiva e os resultados de shimmer, após a técnica vocal empregada. Desse modo, o diagrama de desvio fonatório apresentou bom desempenho no monitoramento da qualidade vocal de indivíduos com Parkinson.

Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles.

PURPOSE: To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding. METHODS: Observational study developed between October 2017 and June 2018 with a sample of 20 newborns and infants who attended a dental clinic and were diagnosed with ankyloglossia. Another 20 were excluded for meeting some of the following exclusion criteria: babies more than 6 months old, who were not on exclusive or mixed breastfeeding, who had other clinical impairments that interfered with breastfeeding, who had other foods introduced into their diet, who had neurological changes and/or craniofacial deformities, and/or who did not finish all the stages of the study. Breastfeeding was assessed with the UNICEF Breastfeeding Assessment and Observation Protocol, while the muscle electrical activity was assessed with the Electrical Activity Assessment Protocol for the Masseter and Suprahyoid Muscles in Newborns During Breastfeeding. The same speech-language-hearing therapist conducted the two assessments both before the conventional frenotomy and 7 days after it. RESULTS: The signs suggestive of breastfeeding difficulties changed 7 days after the surgery, with a p-value ≤ 0.002 for general observation of the mother, position of the infant, latch, and sucking. The maximum voluntary contraction of the masseter was the only integral parameter with a difference, as the electrical activity had decreased. CONCLUSION: Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.

Oropharyngeal geometry and acoustic parameters of voice in healthy and Parkinson's disease subjects. / Geometria orofaríngea e parâmetros acústicos vocais de indivíduos hígidos e com doença de Parkinson.

PURPOSE: to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population. METHODS: 40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry. RESULTS: geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values ​​were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume. CONCLUSION: individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.

OBJETIVO: verificar se existem diferenças nas medidas acústicas e da geometria orofaríngea entre indivíduos hígidos e pessoas com Doença de Parkinson, segundo a idade e sexo e investigar se há correlações entre as medidas geométricas orofaríngeas nessa população. MÉTODO: participaram 40 indivíduos, sendo 20 com diagnóstico de Doença de Parkinson e 20 indivíduos hígidos, pareados por faixa etária, sexo e índice de massa corporal. As variáveis acústicas estudadas foram frequência fundamental, jitter, shimmer, glottal-to-noise excitation ratio, ruído e média da intensidade. As variáveis geométricas da orofaringe foram aferidas por faringometria acústica. RESULTADOS: as variáveis geométricas foram menores no grupo com Doença de Parkinson e os idosos com Doença de Parkinson apresentaram menor área da junção orofaríngea que os idosos hígidos. Com relação aos parâmetros acústicos vocais, o valor da frequência fundamental foi menor no sexo masculino, no grupo com Doença de Parkinson e os valores de jitter foram maiores no grupo não idoso dos sujeitos com Doença de Parkinson. Houve correlação positiva moderada entre o comprimento e volume da cavidade oral, comprimento da cavidade faríngea e o comprimento do trato vocal e do volume da cavidade faríngea e o volume do trato vocal. CONCLUSÃO: indivíduos com Doença de Parkinson apresentaram menores valores de área glótica e área da junção orofaríngea, comparativamente aos hígidos. Quando distribuídos por faixa etária e sexo, a frequência fundamental foi menor no grupo com doença de Parkinson, na população masculina. Houve correlação positiva moderada entre as medidas de comprimento e volume da orofaringe, na amostra estudada.

Food consumption and masticatory performance of normal weight, overweight and obese children aged 7 to 12 years old.

Childhood obesity is a significant public health problem. Studies show that obese children are more likely to become obese adults. In an attempt to ascertain the factors associated with childhood obesity, research has shown that this condition is associated with changes in food consumption and masticatory performance. The aim of this study was thus to evaluate food consumption and masticatory performance in normal weight, overweight and obese children aged 7 - 12 years. A cross-sectional study was carried out with 92 children aged 7 - 12 years, of both sexes, from a public school in a Brazilian municipality. The children were divided into the following groups: normal weight (n = 48), overweight (n = 26) and obese (n = 18). Anthropometric parameters, food consumption, food consistency preference, and masticatory performance were evaluated. Pearson's chi-square test was used to compare categorical variables. To compare numerical variables, the one-way ANOVA test was applied. For variables not conforming to a normal distribution, the Kruskal-Wallis test was used. The level of statistical significance was set at p ≤ 0.05. Our results show that the children with obesity consumed fewer fresh foods (median = 3, IQI = 4.00-2.00, p = 0.026), consumed more ultra-processed foods (median = 4, IQI = 4.00-2.00, p = 0.011), performed fewer mastication sequences (median = 2, IQI = 3.00-2.00, p = 0.007), and ate faster (median = 58.50, IQI = 69.00-48.00, p = 0.026) compared to children of normal weight. We conclude that children with obesity exhibit differences in food consumption and masticatory performance compared to children of normal weight.

Diagnostic procedures in infrared thermography for the human face: a scoping review protocol / Procedimentos diagnósticos em termografia infravermelha para a face humana: um protocolo de revisão de escopo

ABSTRACT Purpose: to present the scoping review protocol that will describe the diagnostic procedures used in infrared thermography to evaluate the human face. Methods: based on the Joanna Briggs Institute and PRISMA-ScR checklist, with the mnemonic: population (P) - human face, concept (C) - infrared thermography, and context (C) - diagnostic procedures in infrared thermography for the human face. The methodological structure will have six stages. The PubMed, LILACS, SciELO, BBO, Web of Science, EMBASE, Scopus, Cochrane Library, and Grey Literature Report databases will be searched, with no restriction on time or language. The review will include qualitative and quantitative studies. Two reviewers will independently select studies and extract data. Results will be analyzed using a variable approach. Conclusion: this scoping review protocol followed the methodological precepts and is apt to be carried out. It will serve as the basis for other scoping reviews. Conducting a scoping review is important and the prior publication of the scoping review protocol is essential to make the review process transparent.

RESUMO Objetivo: apresentar um protocolo de revisão de escopo para identificar os procedimentos diagnósticos utilizados na termografia infravermelha para a avaliação da face humana. Métodos: baseado no The Joanna Briggs Institute e no checklist PRISMA-ScR, com o mnemônico: população (P) - face humana, conceito (C) - termografia infravermelha e contexto (C) - procedimentos diagnósticos na termografia infravermelha para a região da face humana. A estrutura metodológica consistirá em seis etapas. As bases de dados consultadas serão o PubMed, LILACS, SciELO, BBO, Web of Science, Embase, Scopus, Cochrane Library e Grey Literature Report. A busca será realizada sem delimitação temporal ou restrição de idioma. A revisão incluirá estudos qualitativos e quantitativos. Dois revisores selecionarão os estudos independentemente e extrairão os dados. Os resultados serão analisados utilizando uma abordagem variável. Conclusão: este protocolo de revisão de escopo seguiu os preceitos metodológicos e se encontra em condições de execução, servindo também como base para outras revisões de escopo. A realização de uma revisão de escopo é importante e a prévia publicação do protocolo de revisão de escopo fundamental, pois tem a finalidade de trazer transparência ao processo a ser realizado.

Ultrasound assessment of swallowing: a scoping review protocol / Avaliação ultrassonográfica da deglutição: um protocolo de revisão de escopo

ABSTRACT Purpose: to conduct a scoping review to identify procedures to obtain and analyze ultrasound images related to swallowing in adults and older adults. Methods: the strategy (participants, concept, and context) was employed to determine inclusion criteria - population (adults and older adults), concept (ultrasound assessment), and context (assessment of swallowing). The review will analyze observational, experimental and/or quasi-experimental, descriptive, analytical, and qualitative studies, and opinion texts and articles. It will exclude studies unavailable in full text, in animals, or in vitro, letters to the editor, errata, study protocols, and studies using ultrasound with purposes other than swallowing. There will be no restriction on the language. Two independent professionals will select the studies in the databases (MEDLINE, EMBASE, LILACS, Web of Science, and Scopus). The review will analyze the year of publication, study design, sample, age, and procedures to assess swallowing with ultrasound. Data will be presented in diagrams, tables, and narrative. Final Considerations: the literature has described ultrasound as an assessment instrument to analyze biomechanical swallowing movements. This scoping review will describe methods to acquire ultrasound images to assess swallowing.

RESUMO Objetivo: realizar uma revisão de escopo para identificar os procedimentos de obtenção e análise de imagens ultrassonográficas relacionadas à deglutição de adultos e idosos. Métodos: a estratégia (participantes, conceito e contexto) foi empregada para determinar os critérios de inclusão - população (adultos e idosos), conceito (avaliação ultrassonográfica) e contexto (avaliação da deglutição). Serão analisados os estudos observacionais, experimentais e/ou quase experimentais, descritivos, analíticos, qualitativos, textos e artigos de opinião; e eliminados os que não estiverem disponíveis na íntegra, estudos em animais, in vitro, cartas ao editor, errata, protocolos de estudo e os que usaram a ultrassonografia para fins que não contemplam a deglutição. Não haverá restrições a idiomas. Os estudos serão escolhidos por dois profissionais, independentemente, a partir das bases de dados (MEDLINE, EMBASE, LILACS, Web of Science e Scopus). Serão analisados o ano do estudo, delineamento, amostra, idade e os procedimentos para avaliação ultrassonográfica da deglutição. Os dados serão expostos por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos biomecânicos da deglutição. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da deglutição.

Evaluation of sucking using ultrasonography in infants: a scoping review protocol / Avaliação da sucção por meio da ultrassonografia em lactentes: um protocolo de revisão de escopo

ABSTRACT Purpose: to identify studies related to ultrasound assessment of suction in infants. Methods: this research aims to investigate how the literature describes the use of ultrasound to assess suction in infants. It used the "Participants, Concept, and Context" strategy to define inclusion criteria, as follows: population, infants 1 to 180 days old; concept, assessment of suction; and context, ultrasound assessment. The search strategy will be used in the databases of MEDLINE (via PubMed), EMBASE, Web of Science, and Scopus, and studies will be selected based on the inclusion and exclusion criteria established, independently, by two trained professionals. The article analysis protocol will consider the study year and design, the number of infants assessed, their ages, the suction assessment method, the ultrasound suction image acquisition method, and the ultrasound suction analysis method. Data will be presented in charts, narratives, and tables. Final Considerations: ultrasound has been described in the literature as an assessment instrument that enables the analysis of tongue movements during suction. This scoping review will describe ultrasound acquisition methods to assess suction.

RESUMO Objetivo: identificar estudos relacionados à avaliação ultrassonográfica da função de sucção em lactentes. Métodos: esta pesquisa procura investigar como a literatura descreve o uso da ultrassonografia na avaliação da sucção dos lactentes. A estratégia Participantes, Conceito e Contexto foi utilizada para definir os critérios de inclusão, sendo a população avaliada de lactentes de um a 180 dias de vida; com o conceito investigado de avaliação da função de sucção; e o contexto investigado de avaliação ultrassonográfica. A estratégia de busca será realizada nas bases de dados eletrônicas MEDLINE (via PubMed), EMBASE, Web of Science e Scopus e os estudos serão selecionados com base nos critérios de inclusão e exclusão estabelecidos por dois profissionais treinados, independentemente. O protocolo de análise dos artigos irá considerar ano do estudo, delineamento do estudo, número de bebês avaliados, idade, metodologia para avaliação da sucção, metodologia de aquisição de imagens ultrassonográficas da sucção e metodologia de análise ultrassonográfica da sucção. Os dados serão apresentados por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos da língua durante a sucção. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da sucção.

Patência nasal em crianças respiradoras orais / Nasal patency in mouth breathing children

RESUMO Vários estudos mostram a importância da avaliação quantitativa na patência nasal e do estado funcional das vias aéreas superiores para fornecer informações clínicas e diagnósticas em indivíduos respiradores orais, as quais são de grande interesse para a fonoaudiologia. O objetivo deste estudo foi avaliar o efeito da irrigação de solução salina nasal nas vias aéreas superiores através da aeração nasal e rinomanometria anterior ativa em crianças respiradoras orais. Estudo de série de oito casos, realizado em crianças com idades entre 7 e 10 anos, com diagnóstico clínico otorrinolaringológico de respiração oral. O estudo consistiu em três etapas: avaliação inicial; intervenção e avaliação final. Foram aplicados os questionários do Índice de Identificação dos Sinais e Sintomas da Respiração Oral e qualidade de vida específica para doenças em pacientes pediátricos com queixas sinonasais. Realizaram-se as avaliações da aeração nasal e o exame da rinomanometria anterior ativa. A intervenção foi realizada por meio da irrigação de solução salina nasal com 10 ml. Em seguida, os pacientes foram reavaliados pela avaliação da aeração nasal e rinomanometria, para comparar os resultados. Em relação à avaliação da aeração nasal e rinomanometria, das 16 medidas comparativas entre pré e pós-irrigação nasal, constataram-se mudanças significativas na aeração nasal e na resistência nasal. A irrigação nasal resultou em melhora nas medidas da aeração nasal, enquanto para o fluxo nasal da rinomanometria, as medidas permaneceram inalteradas entre pré e pós-irrigação nasal.

ABSTRACT Several studies have shown the importance of quantitative assessment in nasal patency and functional status of the upper airways to provide clinical and diagnostic information in oral breather individuals, which are of great interest to speech therapy. The aim of the study was to evaluate the effect of nasal saline solution irrigation on the upper airways through nasal aeration and active anterior rhinomanometry in oral breathing children. This was an eight case series study, carried out in children aged 7 to 10 years with an otorhinolaryngological clinical diagnosis of mouth breathing. The study consisted of three stages: (I) initial evaluation; (II) intervention; and (III) final evaluation. The questionnaires of the Index for the Identification of Oral Breathing Signs and Symptoms and disease-specific quality of life in pediatric patients with sinonasal complaints were applied, nasal aeration assessments and the anterior active rhinomanometry exam were carried out. The intervention was performed by irrigating nasal saline solution with 10ml. Afterwards, they were re-evaluated by nasal aeration evaluation and rhinomanometry to compare the results. Regarding nasal aeration and rhinomanometry evaluation, from the 16 comparative measurements between pre and post nasal irrigation, we obtained significant changes in nasal aeration and nasal resistance. Nasal irrigation resulted in improvement in nasal aeration measurements while nasal flow measurements from rhinomanometry remained unchanged considering pre and post nasal irrigation.

Métodos utilizados na análise morfométrica do trato vocal em cantores: revisão integrativa / Methods used in morphometric analysis of singers' vocal tracts: an integrative review

RESUMO Objetivo descrever os principais métodos quantitativos utilizados para análise morfométrica do trato vocal em cantores, suas aplicações e os principais segmentos estudados. Estratégia de pesquisa trata-se de uma revisão integrativa guiada pela pergunta condutora: "Quais os principais métodos quantitativos utilizados para análise morfométrica do trato vocal, suas aplicações e os principais segmentos estudados em cantores?". Foram utilizadas as bases eletrônicas PubMed, Scopus e BVS, por meio da chave de busca Vocal tract OR Oropharynx AND Morphology OR Geometry AND Evaluation OR Diagnosis AND voice, sem restrições de ano de publicação, sendo incluídos artigos em três idiomas: português, inglês e espanhol. Critérios de seleção: a seleção se deu de forma independente, por meio da leitura por pares e posterior aplicação dos critérios de exclusão e inclusão. Resultados dos 380 estudos, foram excluídos 30 duplicados. A partir da leitura dos resumos, aplicando-se os critérios de seleção, foram selecionados 18 estudos para leitura na íntegra, dos quais, 12 foram incluídos nesta revisão. A ressonância magnética foi o principal instrumento utilizado e os segmentos analisados incluíram desde o comprimento e volume do trato vocal, como segmentos isolados e suas particularidades morfológicas. Conclusão os métodos de quantificação morfológica do trato vocal integram instrumentos importantes para a avaliação instrumental do trato vocal e de seus segmentos, colaborando na atualização tecnológica em voz para melhor compreensão e intervenções fonoaudiológicas na voz cantada

ABSTRACT Purpose To describe the main quantitative methods used for morphometric analysis of the vocal tract in singers, their applications and the main segments studied. Research strategy This is an integrative review guided by the guiding question "What are the main quantitative methods used for morphometric analysis of the vocal tract, their applications and the main segments studied in singers?". The electronic databases PubMed, Scopus and VHL were used through the search key (Vocal tract OR Oropharynx) AND (Morphology OR Geometry) AND (Evaluation OR Diagnosis) AND (voice), without restriction of years of publication, including articles in three languages: Portuguese, English and Spanish. Selection criteria The selection took place independently through reading by pairs and subsequent application of exclusion and inclusion criteria. Results Of the 380 studies, 30 duplicates were excluded. After reading the abstracts, applying the selection criteria, 18 studies were selected for full reading, of which 12 were included in this review. Magnetic resonance imaging was the main instrument used and the analyzed segments ranged from the length and volume of the vocal tract to isolated segments and their morphological particularities. Conclusion Vocal tract morphological quantification methods are important for the instrumental evaluation of the vocal tract and its segments, a technological update leading to better understanding of singers' voice and therapeutical intervention.

Desempenho do diagrama de desvio fonatório no monitoramento da qualidade vocal pré e pós exercício vocal em indivíduos com Doença de Parkinson / Performance of the phonatory deviation diagram in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease

RESUMO Objetivo Verificar o desempenho do diagrama de desvio fonatório e de suas medidas no monitoramento da qualidade da voz, pré e pós exercício vocal, em indivíduos com Doença de Parkinson. Método Estudo retrospectivo e documental. Utilizou-se uma amostra de 30 sujeitos, sendo 50% do sexo masculino, com média de idade de 62,13 ± 9,05 anos. Foram analisados os resultados do diagrama de desvio fonatório, nos momentos pré e pós exercício vocal com a técnica de empuxo associada aos sons plosivos, considerando-se a área, densidade, forma e localização do diagrama nos quadrantes. Para fins de comparação, os parâmetros acústicos de jitter, shimmer, glottal to noise excitation ratio e resultados da análise perceptivo-auditiva, realizada em pesquisa anterior, também foram considerados, nos momentos pré e pós-técnica. Resultados A despeito de não ocorrer diferença na distribuição das amostras no diagrama, após realização da técnica vocal, foi identificada, na análise qualitativa visual, mudança no deslocamento do diagrama em direção à área de normalidade e houve associação entre o grau geral do desvio vocal da análise perceptivoauditiva e a área do diagrama. Houve melhora nos valores de shimmer, após a técnica vocal. Conclusão O deslocamento do diagrama de desvio fonatório em direção à área de normalidade corroborou os resultados em relação ao grau geral de disfonia avaliado pela análise perceptivoauditiva e os resultados de shimmer, após a técnica vocal empregada. Desse modo, o diagrama de desvio fonatório apresentou bom desempenho no monitoramento da qualidade vocal de indivíduos com Parkinson.

ABSTRACT Purpose To assess the performance of the phonatory deviation diagram and its measurements in monitoring voice quality before and after voice exercise in individuals with Parkinson's Disease. Methods Retrospective and documentary study. A sample of 30 subjects was used, 50% male, with a mean age of 62.13 ± 9.05 years. The results of the phonatory deviation diagram were analyzed, in the moments before and after vocal exercise with the pushing technique associated with plosive sounds, considering the area, density, shape and location of the diagram in the quadrants. For comparison purposes, the acoustic parameters of jitter, shimmer, glottal to noise excitation ratio and results of the auditory-perceptual analysis, carried out in previous research, were also considered, in the pre- and post-technical moments. Results Despite the fact that there was no difference in the distribution of samples in the diagram, after performing the vocal technique, a change in the displacement of the diagram towards the area of normality was identified in the visual qualitative analysis, and there was an association between the general degree of vocal deviation in the analysis auditory perception and the area of the diagram. There was an improvement in the shimmer values after the vocal technique. Conclusion The displacement of the phonatory deviation diagram towards the area of normality corroborated the results in relation to the general degree of dysphonia, evaluated by the auditory-perceptual analysis and the shimmer results, after the vocal technique. Thus, the diagram shows good performance in monitoring voice quality of individuals with Parkinson's.

Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles / Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos

ABSTRACT Purpose To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding. Methods Observational study developed between October 2017 and June 2018 with a sample of 20 newborns and infants who attended a dental clinic and were diagnosed with ankyloglossia. Another 20 were excluded for meeting some of the following exclusion criteria: babies more than 6 months old, who were not on exclusive or mixed breastfeeding, who had other clinical impairments that interfered with breastfeeding, who had other foods introduced into their diet, who had neurological changes and/or craniofacial deformities, and/or who did not finish all the stages of the study. Breastfeeding was assessed with the UNICEF Breastfeeding Assessment and Observation Protocol, while the muscle electrical activity was assessed with the Electrical Activity Assessment Protocol for the Masseter and Suprahyoid Muscles in Newborns During Breastfeeding. The same speech-language-hearing therapist conducted the two assessments both before the conventional frenotomy and 7 days after it. Results The signs suggestive of breastfeeding difficulties changed 7 days after the surgery, with a p-value ≤ 0.002 for general observation of the mother, position of the infant, latch, and sucking. The maximum voluntary contraction of the masseter was the only integral parameter with a difference, as the electrical activity had decreased. Conclusion Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.

RESUMO Objetivo Analisar os efeitos da frenotomia lingual na amamentação de recém-nascidos, com base na atividade elétrica dos músculos masseter e supra-hióideos e avaliação da mamada. Método Estudo observacional, desenvolvido entre outubro de 2017 e junho de 2018. Amostra de 20 recém-nascidos e lactentes de uma clínica odontológica, diagnosticados com anquiloglossia; 20 foram excluídos por se encaixarem em algum dos critérios de exclusão: ter mais de seis meses de vida, não fazer aleitamento materno exclusivo ou misto, apresentar outro comprometimento clínico que interfira na amamentação, ter iniciado a ingestão de outros alimentos, alterações neurológicas e/ou deformidades craniofaciais e não ter finalizado todas as etapas do estudo. A avaliação da amamentação seguiu o Protocolo de Observação e Avaliação da Mamada da UNICEF, e a avaliação da atividade elétrica muscular o Protocolo de Avaliação da Atividade Elétrica dos Músculos Masseter e Supra-hióideos em Recém-Nascidos Durante a Alimentação, ambas realizadas pela mesma fonoaudióloga antes da frenotomia convencional e sete dias após. Resultados Os sinais sugestivos de dificuldade na amamentação mudaram sete dias após a cirurgia, com valor de p≤0,002 para a observação geral da mãe, posição do bebê, pega e sucção. Houve diferença apenas no parâmetro integral da Contração Voluntária Máxima do masseter, com diminuição da atividade elétrica. Conclusão Sete dias após a frenotomia observou-se aumento de comportamentos favoráveis ​​à amamentação em todas as categorias de avaliação da mamada e diminuição da atividade elétrica do masseter.

Geometria orofaríngea e parâmetros acústicos vocais de indivíduos hígidos e com doença de Parkinson / Oropharyngeal geometry and acoustic parameters of voice in healthy and Parkinson's disease subjects

RESUMO Objetivo verificar se existem diferenças nas medidas acústicas e da geometria orofaríngea entre indivíduos hígidos e pessoas com Doença de Parkinson, segundo a idade e sexo e investigar se há correlações entre as medidas geométricas orofaríngeas nessa população. Método participaram 40 indivíduos, sendo 20 com diagnóstico de Doença de Parkinson e 20 indivíduos hígidos, pareados por faixa etária, sexo e índice de massa corporal. As variáveis acústicas estudadas foram frequência fundamental, jitter, shimmer, glottal-to-noise excitation ratio, ruído e média da intensidade. As variáveis geométricas da orofaringe foram aferidas por faringometria acústica. Resultados as variáveis geométricas foram menores no grupo com Doença de Parkinson e os idosos com Doença de Parkinson apresentaram menor área da junção orofaríngea que os idosos hígidos. Com relação aos parâmetros acústicos vocais, o valor da frequência fundamental foi menor no sexo masculino, no grupo com Doença de Parkinson e os valores de jitter foram maiores no grupo não idoso dos sujeitos com Doença de Parkinson. Houve correlação positiva moderada entre o comprimento e volume da cavidade oral, comprimento da cavidade faríngea e o comprimento do trato vocal e do volume da cavidade faríngea e o volume do trato vocal. Conclusão indivíduos com Doença de Parkinson apresentaram menores valores de área glótica e área da junção orofaríngea, comparativamente aos hígidos. Quando distribuídos por faixa etária e sexo, a frequência fundamental foi menor no grupo com doença de Parkinson, na população masculina. Houve correlação positiva moderada entre as medidas de comprimento e volume da orofaringe, na amostra estudada.

ABSTRACT Purpose to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population. Methods 40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry. Results geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values ​​were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume. Conclusion individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.

Evaluating the use of wearables in the masseter and temporal muscles: a scoping review protocol / Avaliação do uso de tecnologias vestíveis nos músculos masseter e temporal: um protocolo de revisão de escopo

ABSTRACT Purpose: to develop a scoping review protocol that seeks to identify which procedures and for what purpose wearables available in the literature are being used on the masseter and temporal muscles. Methods: the approach recommended by The Joanna Briggs Institute and the PRISMA-P guidelines, will follow. Databases to be searched include PubMed, Cochrane Library, LILACS, Scopus, Web of Science, Embase and grey literature. In the first step, two reviewers will independently evaluate the articles by titles and abstracts, then, a full review of the selected articles will be performed according to the inclusion and exclusion criteria. Any uncertainties or differences of opinion will be discussed for consensus. Articles published without date or language restrictions will be included. All components will be presented in tables and flow charts. In addition, a narrative summary of each component will be included for further details. Final Considerations: this protocol will present the general state of the literature on the use of wearables in masseter and temporal masticatory muscles.

RESUMO Objetivo: desenvolver um protocolo de revisão de escopo que busque identificar quais procedimentos e com que finalidade as tecnologias vestíveis disponíveis na literatura estão sendo usadas nos músculos masseter e temporal. Métodos: seguirá a abordagem recomendada pelo The Joanna Briggs Institute e as diretrizes PRISMA-P. As bases de dados a serem pesquisadas incluem PubMed, Cochrane Library, LILACS, Scopus, Web of Science, Embase e literatura cinzenta. Em uma primeira etapa, dois revisores, de forma independente, avaliarão os artigos pelos títulos e resumos, em seguida, será realizada a revisão na íntegra dos artigos selecionados de acordo com os critérios de inclusão e exclusão. Quaisquer incertezas ou diferenças de opinião serão discutidas para consenso. Serão incluídos artigos publicados sem restrição de data e idioma. Todos os componentes serão apresentados em tabelas e fluxogramas. Além disso, um resumo narrativo de cada componente será incluído para mais detalhes. Considerações finais: este protocolo irá apresentar o estado geral da literatura acerca do uso das tecnologias vestíveis na musculatura mastigatória de masseter e temporal.

Voice Therapy for Older Adults During the COVID-19 Pandemic in Brazil.

OBJECTIVE: To characterize the clinical practice of Brazilian speech-language-hearing therapists regarding voice therapy for older adults during the COVID-19 pandemic. METHODS: Cross-sectional survey conducted remotely. Data were collected through a form shared online with approximately 1.500 speech-language-hearing therapists. The form included voice therapy practice with older adults during the COVID-19 pandemic. It was responded by 155 voice experts. RESULTS: Most respondents were females with over 21 years' experience in vocal health care, working with both in-person therapy and teletherapy. Obtaining acoustic parameters and using therapy strategies for breathing and body training were the most reported changes in remote therapy during the pandemic. The main difficulties involved wearing masks in in-person therapy and assessing the voice in teletherapy. Patient adherence and goals reached were deemed positive by most participants. Associations were found between place and format of service; between patient adherence and goals reached; and between difficulties in teletherapy and use of complementary therapeutic resources. CONCLUSION: The COVID-19 pandemic led Brazilian speech-language-hearing therapists to change their clinical practice with older adults in both remote and in-person therapy. The main changes involved wearing masks in in-person therapy and assessing the voice in teletherapy. Remote therapy proved to be a safe and effective possibility.

Thermography in complementary assessments of head and neck muscles: A scoping review.

INTRODUCTION: Infrared thermography has the potential to help assess human head and neck muscles, as thermal variation measurements due to muscle imbalance can contribute to the evaluation and therapeutic follow-up of various clinical conditions in the field of health. OBJECTIVE: This study investigated, with a scoping review, the use of infrared thermography in complementary assessments of human head and neck muscles to determine the extent of research on the topic, what methodologies are used in thermal assessment and thermographic analysis, what regions are assessed, and what results are expected in thermography. METHODS: LILACS, MEDLINE, SciELO, and Web of Science were the databases searched to identify articles published on the topic, with no restriction of language or time of publication. Descriptive, analytical, and experimental observational studies on the assessment of the human head and neck muscle surface temperature with infrared thermography were included. Case studies, case series, methodological accuracy, literature review, animal studies, studies that assessed patients with head and neck cancer, and studies that did not assess head and neck muscle temperature with thermography were excluded. The articles were analysed with a protocol developed by the authors, with data on author, year, country, type of study, sample characterisation, muscles assessed, outcomes investigated, thermal assessment methodology, thermographic analysis methodology and thermography measurements. RESULTS: This review identified and analysed 27 articles. The studies assessed thermal distribution in normal individuals and those with pathologies related to hyper- and hypofunctional head and neck muscle conditions for diagnosis or therapeutic follow-up. The masseter, temporal, digastric, anterior cervical region, orbicularis oris, frontalis, buccinator, suprahyoid, trapezius, sternocleidomastoid and levator scapulae muscles were assessed. Quantitative analyses with area selection tool predominated, considering absolute temperatures and temperature differences. The studies investigated temperature and its relationship with myogenic pain, quantitative assessment of muscle parameters and blood flow velocity. The mean temperature ranged from 32.97°C (±2.21) to 34.90°C, and hyper-radiant and/or asymmetric regions were observed in hyperfunctional conditions and normal subjects after muscle activation. CONCLUSION: Thermography is used in complementary assessments of head and neck muscles, identifying hyper-radiant regions and thermal asymmetry related to muscle tension and activation state. Papers are limited to specific clinical conditions and few muscle groups, besides having great methodological variability.

Relationship Between Oropharyngeal Geometry and Acoustic Parameters in Singers: A Preliminary Study.

OBJECTIVE: To verify possible correlations between formant and cepstral parameters and oropharyngeal geometry in singers, stratified by sex. METHOD: Voice records and oropharyngeal measures of 31 singers - 13 females and 18 males, mean age of 28 (±5.0) years - were retrieved from a database and analyzed. The oropharyngeal geometry measures were collected with acoustic pharyngometry, and the voice records consisted of sustained vowel /Ԑ/ phonation, which were exported to Praat software and edited to obtain the formant and cepstral parameters, stratified by sex. The Pearson linear correlation test was applied to relate voice parameters to oropharyngeal geometry, at the 5% significance level; the linear regression test was used to justify the variable related to the second formant. RESULTS: Differences between the sexes were identified only in the oral cavity length (greater in males) and pharyngeal cavity length (greater in females). There was a linear correlation between the third formant and the cepstrum in the female group. In the male group, there was a linear correlation between the cepstrum and the third and fourth formants. A positive linear correlation with up to 95% confidence was also identified between the pharyngeal cavity volume and the second formant in the female group, making it possible to estimate a regression model for the second formant (R2 = 0.70). CONCLUSION: There are correlations between the oropharyngeal geometry and formant and cepstral parameters in relation to sex. The pharyngeal cavity volume showed the greatest correlation between females and the second formant.