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HOSANA SILMARA ELEUTERIO SILVA
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SPEECH THERAPY ASSESSMENT OF THE ORAL LANGUAGE OF CHILDREN AGED 0 TO 3 YEARS: a scoping review
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Asesor : LUCIANA FIGUEIREDO DE OLIVEIRA
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Fecha: 30-sep-2025
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Hora: 15:00
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Introduction: Oral language assessment in speech-language pathology clinics guides therapeutic
processes and prevents future difficulties. This practice is guaranteed by Resolution No. 414 of the
Federal Council of Speech-Language Pathology and Audiology, which addresses the use of assessment instruments in clinical practice. Oral language assessment in the first three years of life, a period identified as the "golden age" of child development, can help speech-language pathologists monitor linguistic development and propose strategies, understanding language as a social act, constituted by relationships with others. Objective: To map protocols and identify the aspects analyzed in the oral language assessment of children aged 0 to 3 years found in the literature. Methods: This is a scoping review study developed and structured based on the elements listed in the Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension and the Joanna Briggs Institute protocol. Searches were conducted in the following databases: Medical Literature Analysis and Retrieval System Online (Medline/PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus, Web of Science, Excerpta Medica Database (EMBASE), Scientific Electronic Library Online (Scielo), as well as works available in the gray literature Google Scholar and ProQuest Dissertations and Theses. The search strategy used was developed by combining the DECS/MeSH descriptors (health sciences descriptors): Language test, Preschool, and Speech-Language Pathology. The definition of each corresponding database was followed, and the Boolean operators "AND" and "OR" were used in the combinations. Results: A total of 1,035 articles were extracted in the initial screening. Of these, 57 publications were found in EMBASE, 93 in LILACS, 517 in Medline/PubMed, 8 in Scielo, 173 in Scopus, 3 in Web of Science, in addition to works available in the gray literature, 111 in Google Scholar, and 73 in ProQuest Dissertations and Theses. After reading the title and abstract, a total of 221 studies were preselected for full-text reading. Of these, 11 studies met the eligibility criteria and were included in the review. Discussion: Oral language assessments targeted the expressive and receptive dimensions. Structured instruments were used, most of which are subdivided into phonology, vocabulary, grammar, and pragmatics, some of which include cognitive and behavioral aspects. These instruments were used to address practice based on correcting the subjects' alterations, comparing children with specific health conditions with those with typical development.
Only two studies explicitly addressed the language concept they addressed, both based on a socio-
constructivist perspective, focusing on interaction and communicative functions. However, these analyses are often marked by a normative bias, highlighting the difficulty of establishing clinical
practices that transcend biological limits and value the subject's subjectivity. Conclusion: The mapping of studies indicates a limitation in instruments aimed at children aged 0 to 3 years. Furthermore, a predominance of a normative and comparative bias between typical and atypical groups is observed, which restricts the understanding of language in its social and dialogical dimensions, which value the individual's uniqueness.
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LAISE MOURA PEGADO SUASSUNA
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Risk and Reference Indicators for Child Development in Children Aged 0 to 6 Years with Trisomy 21: Reflections for Speech-Language Pathology Practice
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Asesor : LUCIANA FIGUEIREDO DE OLIVEIRA
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Fecha: 30-sep-2025
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Hora: 13:30
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Abstract:Introduction: Language is established through interaction with others, thus
constituting a living experience of the subject, who creates meaning in relationships. A childs
immersion in language and its implications for development are linked to both biological and
social factors. Identifying psychic risk and language alterations requires early detection,
which is proposed here as a strategy for intervention. It is assumed that children with typical
development will present a greater number of developmental reference indicators when
compared to peers diagnosed with Trisomy 21 (T21). Furthermore, the absence of such
indicators may vary according to diagnosis and socioeconomic aspects. The justification for
this study lies in its relevance to clinical practice in Speech-Language Pathology. Objective:
To investigate risk and reference indicators for the development of children with T21, aged zero to six years. Methodology: This is a primary, qualitative, longitudinal, descriptive study,
designed as a case series with participant observation in a single center. Children were divided
into two groups: the first composed of those aged 18 to 36 months, and the second of those
aged 3 to 6 years. Data collection involved two stages: initially, the application of a
sociodemographic questionnaire with families; subsequently, video recordings of
speech-language therapy sessions were carried out to analyze childcaregiver interactions
through eliciting contexts, based on the framework of Smith, Bordini, and Sperb (2009).
Results and Discussion: The analysis of records and interactions revealed the absence of
certain developmental reference indicators in children with T21, particularly in the domains of
expressive language and presence/absence alternation. At the same time, protective aspects
related to play and caregiver responsiveness were observed. These findings suggest that,
although psychic risk and language delay are present, the family environment can enhance
development when responsive support is provided. In line with the literature, the results
reinforce the importance of early use of IRDI and AP3+AI instruments as non-pathologizing
tools for clinical intervention, broadening clinical listening and fostering inclusive follow-up
strategies. Social Impact: This work contributes to expanding Speech-Language Pathology
practice with tools that enable early detection and more targeted interventions, while offering
a less pathologizing and more inclusive view of the development of children with T21. Such
an approach may benefit not only healthcare and education professionals, but also families, by
promoting more humanized and effective support.
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ALLAN DAYNER SILVA LOPES
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FROM SCREENING TO DIAGNOSIS OF HEARING LOSS IN CHILDREN: A
SCOPING REVIEW AND AN ANALYSIS OF THE AGE OF DETECTION IN ALAGOAS
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Asesor : HANNALICE GOTTSCHALCK CAVALCANTI
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Fecha: 30-sep-2025
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Hora: 13:00
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Hearing plays a central role in the development of oral language and communication, making the early detection of hearing loss and timely intervention critical elements to ensure communicative
trajectories compatible with developmental milestones. This dissertation comprises two
complementary and interdependent studies. The first aimed to characterize the epidemiological profile of children with hearing impairment receiving care in a state-level public health network in Brazil. The second sought to map the strategies employed for the early diagnosis of hearing loss in infants through a scoping review rigorously conducted according to the methodological recommendations of the Joanna Briggs Institute (JBI) and reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The epidemiological study, designed as an observational and cross-sectional investigation, was conducted in the Specialized Rehabilitation Centers of Maceió, Alagoas, and included 940 children seen between 2012 and 2024. The majority of participants were male (53.6%), and bilateral sensorineural hearing loss was the most prevalent type (61.7%). The most frequent risk factors included neonatal intensive care unit (NICU) admission for more than five days (21.8%), exposure to ototoxic medications (15.0%), and low birth weight (<1500 g; 8.1%). The mean age at diagnosis was three years or older, indicating significant delays in the initiation of auditory intervention and compromising critical periods for language development. The scoping review included 56 studies published between 1991 and 2024, selected from an initial 10,713 records. The publications covered diverse geographic contexts, with a predominance of hospital-based and neonatal intensive care settings. The most frequent methodological designs were prospective studies (n=23) and retrospective studies (n=15), with the majority classified as level 3.e evidence according to the JBI framework. Among the most commonly used diagnostic tools were transient evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE), auditory brainstem response (ABR) and its automated format, and, to a lesser extent, the auditory steady-state response (ASSR). The most effective protocols were those based on two-stage newborn hearing screening models, incorporating active tracking of high-risk populations and targeted interventions to reduce loss to follow-up. Taken together, the findings highlight a high prevalence of bilateral sensorineural hearing loss associated with potentially preventable factors, underscoring the need to strengthen newborn hearing screening programs and enhance systematic follow-up pathways. Furthermore, the results emphasize the importance of implementing integrated, equitable newborn hearing screening systems, anchored in care coordinationstrategies, to ensure timely access to auditory interventions and mitigate health disparities, particularly in settings marked by socioeconomic vulnerability.
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GABRIELLE STEFANY DOS SANTOS SOUZA
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ACOUSTIC MEASURES PREDICTING THE PERCEPTUAL JUDGMENT OF LAY JUDGES IN THE IDENTIFICATION OF ELICITED EMOTIONS
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Asesor : ANNA ALICE FIGUEIREDO DE ALMEIDA QUEIROZ
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Fecha: 29-sep-2025
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Hora: 13:30
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Introduction: Emotions have a direct impact on vocal production, influencing the acoustic and perceptual aspects of the voice. Thus, emotional variations can be both perceived and expressed through the voice. Acoustic analysis provides objective and quantitative measures of voice, while auditory-perceptual judgment evaluates vocal quality and quantifies deviations in the voice through the auditory expertise of the judge. Both are important assessment methods for studies on emotion detection from voice and can provide valuable data to characterize, measure, and differentiate vocal aspects across different emotions. Objective: To identify whether there are acoustic measures that differentiate valences and elicited basic emotions, and to investigate whether these measures can predict the judgment of emotions and valences, as well as to verify the accuracy rate of auditory- perceptual judgment by lay judges in identifying elicited valences and basic emotions. Methods: This is a descriptive, field-based,
quantitative study. Acoustic measures were extracted from 48 audio signals from 8 male and female
speakers without vocal deviation. The speech sample consisted of the CAPE-V sentence Olha lá o
avião azul (Look at the blue airplane), requested after the volunteer watched videos designed to elicit the six basic emotions. The audio signals were collected and segmented using Audacity, and the acoustic parameters were extracted using PRAAT. Results: Acoustic analysis identified that the Harmonic-to- Noise Ratio (HNR), the standard deviation of Cepstral Peak Prominence Smoothed (CPPS), CPPS maximum, shimmer, and intensity are capable of predicting emotion valences from voice. Furthermore, the negative valence showed statistical significance compared to the positive valence. Conclusion: The findings demonstrate that negative valence triggers physiological, acoustic, and articulatory changes in the voice, and acoustic measures such as HNR, shimmer, intensity, and CPPS are sensitive in differentiating emotional valence, especially negative valence.
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MARIA EDUARDA DE OLIVEIRA BARBOSA CAVALCANTE
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Effects Of Photobiomodulation In Vocally Healthy Individuals: An Analysis Of Different Clinical Outcomes
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Asesor : PRISCILA OLIVEIRA COSTA SILVA
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Fecha: 29-sep-2025
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Hora: 09:00
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Introduction: Photobiomodulation (PBM) has been associated with beneficial effects on
tissue regeneration, analgesia, muscle relaxation, modulation of inflammation, and muscle
performance. Although empirical reports in clinical voice practice and some in vitro findingssuggest potential benefits, the field of voice remains underexplored, with most of the
scientific rationale derived from other disciplines such as physical therapy, dentistry, and
sports medicine. Objectives: (1) To investigate possible immediate variations in the acoustic parameters of healthy individuals voices following PBM. (2) To examine whether PBM can act as an
adjuvant to vocal exercises in preventing measurable signs of vocal deterioration after
exposure to high vocal demand. Method: A prospective, randomized, triple-blind clinical trial
was conducted. Healthy participants were allocated to: the LASER Group, which received
PBM followed by a semi-occluded vocal tract exercise (SOVTE) prior to a vocal loading task;
or the PLACEBO Group, which underwent the same protocol, differing only in receiving
placebo PBM. Acoustic, perceptual-auditory, and self-reported measures were collected
before and after the intervention. Results: In the first analysis, distinct patterns emerged
across acoustic responses of high, soft, and mid vowels, as well as in diadochokinesis, when
comparing laser and placebo conditions. For the high vowel, although no significant
differences were found between groups, the experimental group (EG) exhibited broader
reductions in F0 parameters, suggesting a specific effect of PBM on maximum frequency. In
the soft vowel, the control group (CG) showed higher F0 values, whereas the EG
demonstrated additional changes in TILT, GNE 1000, and Spectral Decline. For the mid
vowel, the CG presented higher F0, while the EG showed greater CPPS values, though
without consistent within-group changes. No group differences were observed in
diadochokinesis, suggesting that PBM effects may vary by vocal task, producing parameter
specific acoustic modifications. In the second analysis, intra-group results revealed that the
EG demonstrated increases in parameters such as HNR in the high vowel, H1H2 in the
habitual vowel, and mean and median F0 during counting, suggesting subtle immediate
acoustic changes after PBM. In the CG, some changes were also observed, including
improvement in H1H2 of the high vowel, reductions in tilt of the habitual vowel, and
variations in counting measures (increased mean and maximum F0, increased CPPS, and
decreased jitter). Improvements were also noted in self-assessment indicators and a reduction
in the multiparametric AVQI. Post-intervention inter-group comparisons did not demonstrate
consistent differences indicating clear superiority of either condition, suggesting that observed
variations were distributed across both interventions. Conclusion: Across both analyses, the
experimental and placebo groups exhibited changes; however, no consistent pattern of PBM
superiority over placebo was identified. PBM appears to induce task-dependent and
parameter-specific acoustic variations, without demonstrating a uniform benefit compared to
placebo. These findings suggest that the immediate effects of PBM on healthy voices are
subtle and selective, underscoring the need for further research to clarify its clinical
significance.
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MARYLIA ALBUQUERQUE ANDRADE RAMOS
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Effects of a Vocal Training Program for Emergency Call Operators
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Asesor : MARIA FABIANA BONFIM DE LIMA SILVA
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Fecha: 24-sep-2025
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Hora: 15:00
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Introduction: Emergency call operators are exposed to intense vocal demands and working conditions that may compromise vocal health and voice-related quality of life. Intervention strategies, such as vocal training and educational guidance, can contribute to the prevention and management of voice disorders in this population. Objective: To investigate the influence of working conditions on vocal health and voice-related quality of life in emergency call operators from two different centers (João Pessoa and Fortaleza) and to evaluate the effects of different speech-language intervention strategies on these outcomes. Methods: The study consisted of two designs. The first was observational, descriptive, analytical, cross-sectional, and quantitative, including 88 operators (58 from Fortaleza non-military, 6-hour shifts; 30 from João Pessoa military, 12-hour shifts), who completed the Telemarketing Operators Vocal Profile (PVOT), the Voice Disorder Screening Index (ITDV), and the Voice-Related
Quality of Life Questionnaire (V-RQOL). The second was a clinical trial, with a quantitative-qualitative approach, involving non-military operators from CIOPS/Fortaleza, allocated to either the experimental group (in-person vocal training in three sessions, eclectic approach, approximately 5 participants) or the control group (guidance through an informational booklet/leaflet). Pre- and post-intervention assessments included the ITDV, V-RQOL, and the Vocal Health and Hygiene Questionnaire (QSHV). Results: In the first study, the most frequent vocal symptoms were throat clearing (44.3%), dry throat (43.2%), dry cough (36.4%), and throat secretions (36.4%). In both institutions, 38.6% of participants presented an indication for speech-language therapy. The proportion was higher in João Pessoa (53.3%) compared to Fortaleza (31%), with a significant difference (p=0.042). The physical dimension of the VRQOL was better in João Pessoa (mean=93.8; SD=9.14) than in Fortaleza (mean=86.5; SD=13.7), with no significant differences in the socioemotional dimension. In the second study, a total of 33 participants were included, 17 in the training group and 16 in the leaflet group, with a mean age of 36.9 years (SD=9.96), most of them female (69.7%), though the proportion of women was higher in the Leaflet group (87.5%) compared to the Training group (52.9%). Both intervention modalities the vocal training workshop and the informational leaflet were effective in reducing self-reported symptoms
and improving vocal health indicators, as measured by the ITDV (from 27.3% to 6.1%) and the QSHV (median increase from 23 to 26). However, no significant changes were observed in voice-related quality of life. Conclusion: There is a correlation between self-reported voice disorders and poorer perception of voice-related quality of life among emergency call operators. Differences in institutional contexts and work hours particularly affect the physical aspects of voice. Both intervention modalities group vocal training and informational leaflets demonstrated significant results in reducing self-reported vocal symptoms and improving vocal health indicators when comparing pre- and post-group therapy.
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TALIANE ROCHA BALBINO
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Effect of therapeutic ultrasound associated with orofacial myofunctional therapy
in the treatment of temporomandibular joint disorders
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Asesor : SILVIA DAMASCENO BENEVIDES
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Fecha: 08-ago-2025
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Hora: 14:00
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ARTICLE 1 - Introduction: Temporomandibular disorder (TMD) is a set of conditions affecting
the temporomandibular joint (TMJ) and associated structures, leading to pain, limited movement,
and changes in chewing and speech. Non-invasive treatments are commonly used, such as low-level
laser therapy, electrostimulation, biofeedback, kinesiology taping, and therapeutic ultrasound (USt),
while surgery is reserved for more severe cases. USt, which uses high-frequency sound waves, may
help reduce pain, inflammation, and improve blood circulation. Objective: To evaluate the
effectiveness of therapeutic ultrasound (USt) combined with orofacial myofunctional therapy
(OMT) in patients with TMD. Methods: This randomized clinical trial was conducted at the
Orofacial Motricity Laboratory of UFPB and included 26 women aged 1855 years with chronic
muscular TMD. Participants were randomly assigned to two groups: G1 (OMT + USt) and G2
(OMT), both undergoing four weekly sessions. Data collection followed four steps: screening using
the American Academy of Orofacial Pain (AAOP) criteria, DC/TMD protocol application, orofacial myofunctional evaluation (AMIOFE), and therapeutic intervention. OMT consisted of
thermotherapy, stretching, muscle relaxation, mandibular mobility exercises, and functional
chewing training. USt was applied to the masseter and anterior temporal regions. Both groups
received counseling on parafunctional habits and home exercises. Outcomes included pain intensity,
pressure pain threshold (PPT), mandibular movement range, and masticatory pattern. Results: The
OMT + USt group showed significant improvements in maximum mouth opening (MMO) and
mandibular protrusion, with a large effect size, indicating meaningful functional gains. Trends
toward significance were also observed in right lateral movement and assisted mouth opening. Both
groups experienced significant pain reduction, with a slightly greater effect in the combined group.
Functional mandibular limitation decreased significantly only in the OMT group, while masticatory
function improved significantly in specific tasks only in the OMT + USt group. Although
masticatory patterns did not show statistically significant changes, a favorable clinical
reorganization toward more functional bilateral patterns was observed in the OMT + USt group.
Discussion: The combination of OMT with USt showed greater clinical impact on functional
variables, even without statistical significance in some outcomes. Gains in mandibular range of
motion, chewing patterns, and a trend toward increased PPT suggest functional reorganization and
decreased pain sensitivity. However, PPT values remained below reference thresholds, indicating
persistent central sensitization. Conclusion: While statistical significance was not achieved for all
variables, the combination of OMT and USt demonstrated promising clinical effects, particularly in
pain reduction, mandibular mobility, and masticatory function. Further studies with larger samples
and extended protocols are recommended to validate these findings. ARTICLE 2 - Introduction:
Temporomandibular disorder (TMD) is characterized by a set of conditions causing orofacial pain
not originating from dental sources. It involves the masticatory muscles, joint structures, facial
bones, and associated tissues. The etiology of TMD is multifactorial and may be associated with
neuromuscular alterations, deleterious oral habits, traumatic or degenerative lesions, and even
psycho-emotional disorders. Psychological factors such as stress, anxiety, and depression can
trigger or exacerbate TMD symptoms, influencing pain perception and duration. Objective: To
analyze psychosocial changes in TMD patients undergoing treatment with therapeutic ultrasound
(USt) combined with orofacial myofunctional therapy (OMT) and with OMT alone. Methods: This
is a descriptive, cross-sectional study approved by the Health Research Ethics Committee (Protocol
No. 6.136.949), conducted at the Orofacial Motricity Laboratory of the Federal University of
Paraíba. The sample consisted of 26 women aged 18 to 55 years, diagnosed with TMD according to
the DC/TMD (Diagnostic Criteria for Temporomandibular Disorders). Axis II of the protocol was
used to assess psychosocial aspects. The following instruments were applied: PHQ-4 (psychological
distress), PHQ-9 (depression), GAD-7 (anxiety), OBC (oral behaviors checklist), and Graded
Chronic Pain Scale. Results: Overall analysis revealed a significant association between
psychological distress and dysfunctional oral behaviors before treatment. However, this association
was no longer significant after the intervention in both groups. In the OMT group, there was a
significant correlation between oral behaviors and depressive symptoms before treatment, which
was not observed post-treatment. In the OMT + USt group, no such association was found before
treatment, but it emerged afterwardparticularly among patients with moderate depression and
high levels of altered oral behaviors. No statistically significant correlation was found between
chronic pain and psychological distress, anxiety, or depression scores at any stage of treatment. A
marginal trend toward significance was observed in depression scores when considering all patients
collectively. Discussion: The findings suggest that OMT alone may reduce the impact of psychological distress on dysfunctional oral behaviors. Although a post-treatment association
between moderate depression and oral behaviors was observed in the OMT + USt group, there was
a trend toward improvement in depression scores. This aligns with literature highlighting the
benefits of USt and OMT for mandibular function and their potential psychosocial impact.
Limitations such as the small sample size and reliance on self-report instruments may have
influenced the results. Conclusion: The results underscore the importance of multidimensional
therapeutic approaches for TMD and indicate the need for further studies with larger samples and
complementary methodologies to confirm the potential psychosocial benefits of combining OMT
and USt in TMD management.
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VALDÍZIA DOMINGOS DA SILVA
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PATIENT PARTICIPATION AND ACTIVATION IN HEALTH CARE
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Fecha: 31-mar-2025
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Hora: 14:00
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Introduction: Patient participation in health care refers to their inclusion in the process of caring for their health, in order to make autonomous choices, engage with others, learn about their needs and treatment processes. The engagement of individuals in this sphere has a bidirectional dependence on the responsibility of professionals and patients. In this respect, investigating the levels of patient participation and their needs is crucial for quality healthcare. Objective: To translate, adapt and validate The Patient Action Inventory for Self-Care (TPAI-SC) questionnaire into Brazilian Portuguese, as well as to map and describe the evidence related to assessing the engagement of patients or their families in healthcare. Methodology: The dissertation consists of two separate articles. Article 1 is a methodological study, for the translation, adaptation and validation of the TPAI-SC protocol into Brazilian Portuguese following guidelines established for this type of study, and with a team of judges and testing and application of the translated protocol. This work was accepted by the human research ethics committee of the university where it was collected. Article 2, on the other hand, is a scoping review that follows the PRISMA and Joana Briggs guidelines for its methodological and writing structure. Searches were carried out in the Pubmed, Scielo, Web of Science, PsycInfo, Scopus, Lilacs and Google Scholar databases and portals, using the related descriptors patient participation, patient activation, patient engagement, health-care, self-care, assessment and meansure. They were then selected according to the eligibility criteria for this study. Results: The TPAI-SC protocol was translated and adapted into Brazilian Portuguese, and pilot validation was carried out for the selected
population stratum, with positive results being found in terms of patients' observation of their own engagement capacities, conceptions about service problems and hypotheses for seeking possible solutions, compatible with what the protocol is intended for. In article 2, possibilities were found for protocols that assess patient engagement, both for general health and for specific diseases/populations, not all of which are available in the Portuguese language spoken in Brazil. In addition, many studies focused on the validation and psychometric analysis of some protocols with a focus on specific populations, with the aim of making them more precise and specific for the desired measurements. Final considerations: In both articles, the findings corroborated discussions about the importance of patient engagement in health care, associated with the need to investigate these needs, so that health professionals can broaden and properly conduct the engagement process.
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ISABELLE JOICY DE ARAÚJO FERREIRA
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INFRARED THERMOGRAPHY IN THE DIAGNOSIS AND INTERVENTION OF TEMPOROMANDIBULAR DYSFUNCTION
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Fecha: 28-mar-2025
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Hora: 14:00
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Abstract: Article 1- Objective: To evaluate the accuracy of infrared thermography in the diagnosis of temporomandibular muscle dysfunction. Method: This is a study of diagnostic accuracy. The research was approved by the Research Ethics Committee under number 6,136,949 and was carried out at the Orofacial Motricity Laboratory of the Speech Therapy Department of the Federal University of Paraíba (UFPB). The sample comprised 70 female participants, aged between 18 and 55 years old, who met the eligibility criteria. The participants were divided into two groups: with TMD (TMDG) and control (CG) of women without TMD. The variables studied included the regions of interest, which were the anterior temporal and masseter muscles, bilaterally. The sample size calculation for the comparison between women with and without TMD was performed using the R software version 4.3.3, the significance level was 5% and the test power was 80%. Results: The results describe that in the MD, 41 participants presented altered temperature, both in G1 and G2 in relation to the cutoff point of the study by Rodrigues Bigaton, which is considered normal above 32.5 °C, and below this value we consider as altered. Thus, it is possible to observe that 46.3% of the participants who did not present TMD (G2) presented altered temperature. With this, it is understood that the specificity (0.557) is effective for the right masseter, however the sensitivity (0.537) was considered ineffective. In the analysis of the results of the ME, it was reported that 39 participants presented altered temperature, in relation to the cutoff point adopted for this side of the muscle, which was 32.6 °C. With these findings, of the 39 participants who presented altered temperature, 59% of the participants were from G2. With these results, it was observed that the sensitivity (0.410) was low according to the findings of this study, and the specificity (0.387) was good. As shown in the results, DT and TE did not present good specificity and sensitivity with thermography in TMD. Conclusion: It was concluded that infrared thermography presented good results in patients diagnosed with TMD (specificity), and can be used as a complementary exam in screenings. Article 2 Objective: To verify whether there is a correlation between PPT and temperature in patients with TMD. Method: This is a descriptive study, approved by the Health Ethics Committee, under number 6,136,949. The sample consisted of 35 women, aged between 18 and 55 years, who met the eligibility criteria. After randomization, the participants were equally distributed into two groups: Group 1 (G1) women with TMD while Group 2 (G2) was formed by women without the diagnosis of TMD. Results: Pearson's correlation test was performed, which showed an inversely proportional, weak and non-significant correlation, indicating that the two variables have an inverse relationship, in which one variable should increase and the other decrease, but this did not occur due to the small relationship between them. Conclusion: After the statistical analysis, it was observed that there was no correlation, since the relationship between the temperature and LDP variables was negative for participants with TMD.
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THAÍSE SARA COSTA DIAS
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PEDIATRIC FEEDING DISORDERS IN CHILDREN WITH AUTISM SPECTRUM DISORDER: OROFACIAL MYOFUNCTIONAL CONDITIONS
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Fecha: 28-mar-2025
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Hora: 10:00
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Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by
social communication deficits and restrictive and repetitive behavioral patterns. Due to such
ritualistic patterns and tendencies, in addition to sensory sensitivities inherent to autistic traits, this population often manifests selective eating characteristics, especially in childhood. Regarding eating skills, the stomatognathic system (SS) plays a fundamental role, since it is formed by a set of structures that perform oral functions, which include breathing, chewing, swallowing and speaking. Children with ASD, due to their atypical development, may present oral motor difficulties related to chewing and swallowing, problems in the gastrointestinal tract (GIT) and sensory dysfunction that in turn can directly or indirectly influence eating. Thus, it is important to have a detailed survey of the characteristics of the ES, in addition to identifying which structures and functions are in fact deficient in the population with autism who have eating difficulties. The objectives of the articles are (1) to characterize the stomatognathic profile of children on the autism spectrum at different levels of support and (2) to investigate whether there is a relationship between the stomatognathic profile, the characteristics of pediatric eating disorders, and the different levels of support. To this
end, following a descriptive, cross-sectional, observational study methodology with a quantitative approach, through the MMBGR, EBAI, and CARS protocols, we sought to find answers to the
proposed objectives. The sample consisted of 30 participants, 22 (73.33%) males and 8 (26.67%)
females, with a mean age of 3.63 years. In conclusion, in article 1, the orofacial myofunctional
characteristics of children with autism, for the most part, do not differ from the profile expected for children in general. Regarding the support levels, level 2 stood out as the most homogeneous profile in relation to the characteristics studied, followed by level 1. Level 3 of support, although it did not demonstrate characteristics significantly different from what was expected, was the level of support that presented the most variations. In article 2, it can be said that there were relationships between the level of support and some orofacial myofunctional characteristics in the population investigated. The oral health aspects of the teeth of children with support level 3 were shown to be regular, the lip tone of children with support level 2 was hypotonic, the lip posture and food retention when chewing, in children with autism at level 1, were shown to be partially altered, in addition to there
being food leakage at the same level of support.
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JESSYCA PORTO SANTANA
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Nasal Obstruction and Laryngopharyngeal Reflux: Relationships with Perceptual-Auditory, Acoustic, Laryngeal, Aerodynamic, and Self-Assessment Voice Parameters.
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Asesor : LEONARDO WANDERLEY LOPES
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Fecha: 26-mar-2025
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Hora: 16:00
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Introduction: Vocal disorders can be caused by a variety of factors, including conditions such as nasal obstruction (NO) and laryngopharyngeal reflux (LPR). NO, which can be triggered by ana-tomical or inflammatory factors, affects vocal resonance due to the difficulty of air passing through the nasal cavities. This leads to compensatory effort in the larynx, which can result in muscle tension, vocal fatigue, and even functional dysphonia. Furthermore, changes in acoustic parameters, such as instability in fundamental frequency, jitter, and shimmer, are common in individuals with NO. LPR, in turn, occurs when gastric content ascends to the larynx and pharynx, causing inflammation of the vocal folds. This continuous exposure to acid can lead to edema, thickening of the mucosa, and impair vocal fold vibration, resulting in hoarseness, loss of vocal quality, and difficulties in voice projection. Reflux also affects acoustic parameters, altering vocal frequency, jitter and shimmer stability, and the harmonic-to-noise ratio (HNR), contributing to a rougher and more unstable voice. Objective: The aim of this study is to analyze the relationships between nasal obstruction (NO) and laryngopharyngeal reflux (LPR) with laryngeal characteristics, perceptual-auditory parameters, acoustic, aerodynamic, and self-assessment vocal parameters. Method: This is a cross-sectional and descriptive study, approved by the Research Ethics Committee, investigating the relationship between nasal obstruction (NO) and laryngopharyngeal reflux (LPR) with vocal parameters. The sample consisted of 88 participants (41 male and 47 female), with a mean age of 32.46 years, divided into groups: with NO and without NO; with LPR and without LPR. The participants were selected based on eligibility criteria and were recruited using the Snow Ball sampling technique. In the data collection phase, participants completed questionnaires about nasal and vocal symptoms, including the Vocal Symptoms Scale (VSS), Nasal Obstruction Symptom Scale (NOSE), and Vocal Tract Discomfort Scale (VTDS). Flexible nasofibroscopy and videolaryngostroboscopy were also performed to check for anatomical or inflammatory changes in the upper airways and larynx. Vocal samples were collected in two parts on the same day. In the first part, the samples were analyzed for perceptual-auditory judgment and acoustic measurements using the Fonoview and Praat software. In the second part, aerodynamic measures (such as subglottic pressure, mean airflow rate, and glottal resistance) were collected using Aeroview software and a Rothenberg airflow mask. Results: Regarding the statistical analysis between the groups with NO and without NO, there was a significant difference in the NOSE Scale values (0.025) and PAH Psub Average (0.04). When comparing the NOSE score of the groups with and without NO with the other analyzed parameters (presence of vocal deviation, dysphonia, laryngeal disorder, VSS classification, presence of free edge lesion, and laryngeal compression), no statistical difference was found between the two groups. However, there was a weak positive correlation between the NOSE score and the VSS, VTDS-F, and VTDS-I scores. Regarding LPR, there was a trend for an association between LPR and dysphonia (p=0.054), but it did not reach statistical significance. An association was found between LPR and smoking (p=0.004). Comparing individuals with LPR and those without LPR signs concerning voice and laryngeal function variables, the group with LPR showed a significant association with changes in the VSS score, glottal closure time, and subglottic pressure. Conclusion: Understanding the laryngeal differences, perceptual-auditory measures, aerodynamic measures, and vocal discomfort in patients with NO and/or LPR may provide clinically relevant information for medical and speech therapy management. These findings can aid in the diagnosis and treatment of NO and LPR in populations at risk for voice disorders, as well as in the early stages of treatment for dysphonic patients.
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BRUNA ALVES RODRIGUES
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Photobiomodulation combined with orofacial myofunctional therapy in
temporomandibular disorders: Specific clinical trial
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Fecha: 26-mar-2025
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Hora: 14:00
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Introduction: Temporomandibular dysfunction (TMD) is a set of changes that affect the masticatory muscles, the temporomandibular joint (TMJ) and adjacent structures. Its treatment requires a multidisciplinary approach, in which Orofacial Myofunctional Therapy (OMT) stands out as a therapeutic option. The association of BMT with photobiomodulation (FBM) has been studied for its possible effects on pain control, inflammatory modulation and improvement of mandibular performance. Objective: To evaluate the effectiveness of FBM associated with BMT in the treatment of chronic TMD.Methodology: Randomized clinical study, approved by the Health Ethics Committee (no 6,136,949), involving 26 women between 18 and 55 years old, selected according to eligibility criteria. Data collection occurred in four stages, including screening by the American Academy of Orofacial Pain, application of the Diagnostic Criteria for Temporomandibular Disorders
(DC/TMD) protocol and the Orofacial Myofunctional Assessment (AMIOFE). Participants were
randomly distributed into two groups: Group 1 (G1 FBM + BMT) and Group 2 (G2 BMT alone).
G1 received four weekly sessions of BMT associated with FBM in the masseter (superior, middle and inferior) and temporal (anterior, middle and posterior) muscles, while G2 underwent only BMT for the same period. The clinical outcomes evaluated were oral opening width, pressure pain threshold (LDP), pain intensity by visual analogue scale (VAS) and masticatory function, in addition to analyzing levels of anxiety, depression, stress and dysfunctional oral behaviors.Results: Both groups showed improvement in the range of mandibular movements, chewing pattern, pain threshold and intensity. However, no statistically significant differences were observed between groups or over time. Furthermore, there were no relevant variations in relation to jaw limitation, anxiety, depression, stress and oral symptoms. It was observed that the control group showed greater reductions in the levels of mandibular limitation, stress and depression compared to the group undergoing photobiomodulation. The relationship between certain oral habits and psychological symptoms was also observed, such as sleeping in a position that puts pressure on
the jaw and stress; teeth grinding when awake and depression; teeth grinding when awake and anxiety; clenching teeth when awake and depression; tense the muscles without touching the teeth and depression; chewing food on only one side and stress; and chewing food on only one side and anxiety.It is concluded that the approaches adopted contributed to reducing pain and improving jaw and masticatory function. However, the relationship between FBM and BMT did not show statistical superiority in relation to isolated BMT. Although BMT does not focus on the direct treatment of anxiety, depression and stress, its relationship with TMD suggests that reducing harmful habits may result in secondary benefits in reducing these symptoms.
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MONICA CLAUDINO MEDEIROS HONORATO
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Use of mindfulness in the treatment of tinnitus: consensus based on the opinion of
Brazilian experts
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Fecha: 25-mar-2025
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Hora: 14:00
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Tinnitus is a symptom that can be associated with various clinical conditions and is often
considered difficult to manage. Among the available therapies, mindfulness has shown benefits such as reduced severity of the symptom, psychological suffering, and disability, as well as decreased distress caused by tinnitus. However, there is variability in the protocols regarding the number of sessions and the follow-up of these patients. The aim of this work is to develop a consensus among expert otolaryngologists, speech therapists, and physiotherapists regarding the recommendations and use of mindfulness applied to the treatment of tinnitus. This study will be observational, descriptive, quantitative, and cross-sectional. The research was conducted remotely and online through a websurvey hosted on the Google Forms digital platform. The sampling was convenience-based and included 23 specialists with recognized knowledge on the subject under study. We used the Delphi method, which consists of an artifice for structuring the communication of a group of experts on a complex subject by means of questionnaire interactions, divided into two stages, accompanied by feedback, keeping the participants' answers anonymous, in the search for a common result through statistical calculations. The first stage consisted of objective and subjective questions and we analysed them. The second stage consisted of 10 participants answering 34 questions derived from the themes and items that emerged from the answers in the first stage. The experts had to analyse each item and demonstrate their level of agreement on a five-point Likert scale. The content validity coefficient (CVC) was used to investigate the degree of agreement between the judges and select the final consensus items. Based on the results found, there was consensus on 25 of the 34 items (CVC ≥ 0.70). The experts consider that mindfulness is a therapeutic resource indicated for tinnitus, but not as the sole therapy for tinnitus (monotherapy). With regard to the frequency of application of this technique, there was consensus that it should be carried out once a week, with daily practice at home. There was also agreement that therapy can be followed up after 8 weeks using scales such as THI (Tinnitus Handicap Inventory) and VAS (Visual Analogue Scale). The only topic on which there was no consensus was the minimum number of sessions for remission. This study has the potential to improve the criteria for recommending and using mindfulness applied to the treatment of tinnitus. The findings may be useful for the development of future research and clinical recommendations in the area.
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THAÍS FERNANDES SEBASTIÃO
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Immediate effects of a vocal warming-up program versus continuous singing on the
voice of popular singers
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Fecha: 24-mar-2025
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Hora: 14:00
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Objective: To see if there are differences in the immediate effects on aerodynamic, acoustic
and self-assessment measures between popular singers who participated in a 20-minute continuous singing activity and those who underwent a structured vocal warm-up program of the same duration. Method: Thirty singers took part in the study, 22 women (73.3%) and eight men (26.7%), with a mean age of 26.10±6.21 years. All the participants answered self-assessment protocols (Dysphonia Screening Instrument - DSI-Br; Vocal Symptoms Scale - ESV; and Index of Vocal Disadvantage in Modern Concert - IDCM) and underwent laryngeal videostroboscopy at the initial assessment. All the singers underwent two interventions (continuous singing for 20 minutes and vocal warm-up for 20 minutes), with a minimum interval of 24 hours between them. They had their voices recorded and answered the
Evaluation of the Ability to Sing Easily (EASE) immediately pre- and post-intervention. From the vocal samples, Praat software was used to extract the acoustic measurements (standard deviation of the fundamental frequency, jitter, shimmer, harmonic -to-noise ratio - HNR, amplitude difference between the first two harmonics of the voice spectrum - H1H2, glottal-to-noise excitation - GNE, and smoothed cepstral peak prominence - CPPS) and Aeroview software to obtain aerodynamic measurements (subglottal pressure - Psub, mean airflow rate - MFR and glottal resistance (Psub/MFR). Results: After continuous singing, there was an increase in the values of the aerodynamic measure MFR (p = 0.018) and GNE (p = 0.033), with a reduction in the values of glottal resistance (p = 0.037). In turn, the structured
vocal warm-up resulted in lower EASE-Br scores (p < 0.001) and an increase in the HNR acoustic measure (p = 0.022). MANOVA indicated a significant effect of task type on EASE-Br, with subsequent analyses revealing that vocal warm-up was more effective in reducing EASE-Br scores compared to continuous singing, with effect size considered large. Conclusion: There are differences in the immediate effects between continuous singing and vocal warm-up. After continuous singing, there was an increase in MFR and GNE, with a reduction in glottal resistance, with no differences in vocal self-perception. In contrast, structured vocal warm-up significantly improved self-assessment and vocal quality, reducing the EASE-Br score and increasing the values of the HNR measure.
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MARIANA PEREIRA ROQUE
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Effects of vocal overload on healthy voices: a study on laryngostroboscopic signs and clinical symptoms of vocal fatigue
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Fecha: 27-feb-2025
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Hora: 14:00
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Introduction: Vocal fatigue is a phenomenon that limits the speaker's ability to speak and
can manifest itself in different ways. There is no consensus on the parameters that can characterize vocal fatigue, and it is therefore difficult to define because many factors, such as self-reported symptoms, clinical signs observed in the voice and/or laryngeal physiology, and instrumental measures, can be criteria for its determination. Currently, vocal fatigue is seen as a complex construct that associates the clinician's perception with the patient's perception. Studies that seek to evaluate laryngeal signs of vocal fatigue indicate that exposure to prolonged vocal demand can result in laryngeal changes and self-assessment of fatigue by the patient. Identifying these signs can help in the clinical diagnosis of vocal fatigue and in preventing the development of possible structural changes in the larynx. Objective: To investigate the effects of vocal overload on healthy voices, characterize videolaryngostroboscopic signs of vocal fatigue, and analyze their association with symptoms of vocal fatigue. Method: This is a cross-sectional, descriptive, explanatory and quantitative study developed in two stages: in the first stage, snowball sampling was used to select
the panel of experts and the Delphi technique was used as a method to obtain consensus on
videolaryngostroboscopic parameters indicative of vocal fatigue. A sequence of rounds of meetings and administration of online forms were conducted to select parameters that led to a consensus on recommendations for otorhinolaryngological evaluation of vocal fatigue. In the second stage, adult individuals, without voice complaints and without structural and functional alterations of the larynx, were submitted to a vocal overload activity, characterized by reading texts at high vocal intensity, lasting ninety minutes. The videolaryngostroboscopic examination was performed before and after the vocal overload activity. Vocal self-assessment questionnaires were also applied to analyze the perception of fatigue, effort and quality of vocal production by the participant in relation to their own voice. The examinations were evaluated by experienced otorhinolaryngologists in a blind and consensual manner, based on the parameters of an initially constructed protocol. Results: The
results revealed a consensus of over 80.0% for a set of items composed of tasks and parameters relevant to the otorhinolaryngological evaluation of vocal fatigue, through the
videlaryngostroboscopic examination. These items comprised a structured protocol to be
recommended to otorhinolaryngologists in the evaluation of patients with suspected vocal fatigue or
exposed to high vocal demands. In the second stage of the study, related to the experiment
performed with high vocal load activity, the blind judgment of the expert judges indicated a
difference in the samples evaluated before and after overload, with the pre-overload activity
examination being better in 66,7% of the cases. Regarding the parameters evaluated, there was
statistical significance only for the evaluation of the glottic closure pattern and the increase in the proportion of some glottic gaps after vocal load activity. In the self-assessment of symptoms of fatigue, effort and worsening in the quality of vocal production, worsening was observed in all self assessment instruments: Visual Analogue Scale of Vocal Fatigue (VAFV), Borg CR10 Scale and Self-Perception of Vocal Production Quality Scale (SAQPV) with vocal overload activity, but this worsening is not associated with worsening of the parameters of the visual examination of the larynx. Conclusion: The consensus reached in the study stages, in relation to the parameters and evaluation methodology, provides an important basis for future clinical application in the diagnosis and management of vocal fatigue. The worsening of the videolaryngostroboscopy examination after vocal overload activity is not directly related to the worsening of symptoms on the part of the patient. However, the patient's perception proved to be very important for the monitoring and clinical diagnosis of vocal fatigue to prevent the development of more serious changes in the larynx,as well as highlighting the complexity of vocal fatigue, which involves both objective and subjective signs.
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