O efeito do treinamento auditivo na autopercepcão da qualidade vocal de profissionais da voz
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Data
2014
Autores
Mesquita, Loriane Gratão de [UNIFESP]
Orientadores
Pereira, Liliane Desgualdo [UNIFESP]
Tipo
Dissertação de mestrado
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Objetivo: Verificar o efeito do processo de fonoterapia vocal convencional isolada e combinada com treinamento auditivo no aprimoramento da autopercepcao vocal em profissionais da voz com diagnostico de disfonia funcional e organofuncional. Metodo: Foram selecionados 12 jovens adultos profissionais da voz falada, dos sexos masculino e feminino, na faixa etaria de 18 a 45 anos com diagnostico otorrinolaringologico de disfonia funcional e organofuncional. Esses jovens foram sorteados e reunidos em tres grupos: quatro individuos que participaram da abordagem de intervencao vocal, denominado grupo intervencao vocal, (GI); quatro individuos que participaram da intervencao vocal combinada com um treinamento auditivo, denominado grupo intervencao combinada (GC). Quatro individuos foram selecionados para o grupo denominado sem intervencao (GS). Para a avaliacao e reavaliacao vocal de todos os individuos foram utilizados o Questionario de Qualidade de Vida em Voz (QVV), Escala Analogica Visual (EAV), escala numerica para avaliacao perceptivo-auditiva da qualidade vocal abreviado GRBASI-G; Protocolo de Avaliacao Vocal e o de gravacao da voz. Para a avaliacao e reavaliacao do Processamento Auditivo Central foram utilizados: Teste Dicotico de Digitos- TDD, Teste de Padrao de Frequencia- TPF, Teste Random Gap Detection u RGDT. Os dados foram analisados estatisticamente com testes nao parametricos e nivel de significancia de 0,10 por conta do tamanho da amostra. Resultados: Verificamos que a intervencao combinada propiciou melhora significante (p=0,068) no que diz respeito a ordenacao (TPF-N) e a resolucao temporal (RGDT). Apos a intervencao, os individuos que receberam a intervencao isolada e combinada com o treinamento auditivo relataram melhora significativa (p=0,068) da autopercepcao de vocal. Houve discordancia entre as escalas GRBASI-G e EAV no julgamento da melhora da qualidade vocal dos avaliadores e do julgamento da melhora vocal dado pelos individuos. Na avaliacao perceptivo-auditiva da qualidade vocal no momento pos-intervencao, os individuos do grupo GI e GC melhoraram a qualidade vocal, assim como na analise realizada para a melhor voz. Ocorreu melhora do tempo maximo de fonacao pos-intervencao vocal isolada e combinada mostrando melhora na coordenacao pneumofonoarticulatoria e provavelmente da coaptacao glotica independente da inclusao do treinamento auditivo na abordagem da terapia. Conclusao: A intervencao vocal combinada com treinamento auditivo teve impacto positivo na autopercepcao da qualidade vocal de individuos profissionais da voz que apresentavam disfonia funcional ou organofuncional e mostrou-se efetiva no aprimoramento da habilidade auditiva de resolucao temporal
Objective: Investigate the effect of the process of conventional voice speech therapy and combined with auditory training for the improvement of vocal self in professional voice diagnosed with functional and organofunctional dysphonia. Method: The study was approved by the Ethics and Research of the Federal University of São Paulo, CEP-UNIFESP 38422. We selected 12 young adult professionals spoken voice, male and female, aged 18-45 years, with diagnosis of functional and organofunctional dysphonia. These young people were drawn and assembled in three groups: four individuals who participated in the intervention approach Vocal, vocal group called intervention (GI), four individuals who participated in the intervention vocals combined with auditory training, group called combined intervention (GC). Four subjects who were on a waiting list participated in two evaluations with a time interval of 12 weeks, group called without intervention (GS). For the evaluation and reevaluation of vocal individuals were used: Questionnaire Quality of Life and Voice (QVV), Visual Analogue Scale (EVA), numerical scale of perceptual evaluation (GRBASI), Assessment Protocol Vocal, Voice Recording. For the assessment and reassessment of Central Auditory Processing were used: dichotic listening test-TDD, Test Pattern Frequency-TPF, Random Gap Detection Test - RGDT. Results: We found that the combined intervention showed significantly improved (p = 0.068) with temporal ordering (TPF-N) and temporal resolution (RGDT). After the intervention, individuals who received only vocal intervention and combined intervention reported significant improvement (p = 0.068) self-perceived voice. There was disagreement between the scales, GRBASI-G and VAS, judging the improvement in vocal quality of evaluators and the judgment of vocal improvement given by individuals. In perceptual evaluation of voice quality in the post-intervention time, individuals in the GI and CG groups improved voice quality, as well as analysis for best voice. There was an improvement of maximum phonation time after conventional and combined vocal intervention showing improvement in coordination between breathing, speaking and articulate and probably the glottal closure regardless of the inclusion of auditory training in therapy approach. Conclusion: The intervention vocals combined with auditory training had a positive impact on the perception of vocal quality of professional voice individuals who had functional or organofunctional dysphonia and proved to be effective in improving the ability of auditory temporal resolution.
Objective: Investigate the effect of the process of conventional voice speech therapy and combined with auditory training for the improvement of vocal self in professional voice diagnosed with functional and organofunctional dysphonia. Method: The study was approved by the Ethics and Research of the Federal University of São Paulo, CEP-UNIFESP 38422. We selected 12 young adult professionals spoken voice, male and female, aged 18-45 years, with diagnosis of functional and organofunctional dysphonia. These young people were drawn and assembled in three groups: four individuals who participated in the intervention approach Vocal, vocal group called intervention (GI), four individuals who participated in the intervention vocals combined with auditory training, group called combined intervention (GC). Four subjects who were on a waiting list participated in two evaluations with a time interval of 12 weeks, group called without intervention (GS). For the evaluation and reevaluation of vocal individuals were used: Questionnaire Quality of Life and Voice (QVV), Visual Analogue Scale (EVA), numerical scale of perceptual evaluation (GRBASI), Assessment Protocol Vocal, Voice Recording. For the assessment and reassessment of Central Auditory Processing were used: dichotic listening test-TDD, Test Pattern Frequency-TPF, Random Gap Detection Test - RGDT. Results: We found that the combined intervention showed significantly improved (p = 0.068) with temporal ordering (TPF-N) and temporal resolution (RGDT). After the intervention, individuals who received only vocal intervention and combined intervention reported significant improvement (p = 0.068) self-perceived voice. There was disagreement between the scales, GRBASI-G and VAS, judging the improvement in vocal quality of evaluators and the judgment of vocal improvement given by individuals. In perceptual evaluation of voice quality in the post-intervention time, individuals in the GI and CG groups improved voice quality, as well as analysis for best voice. There was an improvement of maximum phonation time after conventional and combined vocal intervention showing improvement in coordination between breathing, speaking and articulate and probably the glottal closure regardless of the inclusion of auditory training in therapy approach. Conclusion: The intervention vocals combined with auditory training had a positive impact on the perception of vocal quality of professional voice individuals who had functional or organofunctional dysphonia and proved to be effective in improving the ability of auditory temporal resolution.
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MESQUITA, Loriane Gratão de. O efeito do treinamento auditivo na autopercepcão da qualidade vocal de profissionais da voz. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.