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Effects of transcutaneous electrical nerve stimulation in the voice therapy of women with dysphonia: a randomized, double-blind and placebo-controlled clinical trial


Muscle Tension Dysphonia (MTD) is a hyperfunctional alteration of phonation; it may be associated to benign injuries in the larynx, such as nodules and mucus thickness, more common in women. Recommended treatment uses techniques of cervical and laryngeal relaxation for restoring equilibrium to the intrinsic muscles of the larynx, in association with stimulation of mucosal wave of vocal folds, for lesion regression, when present. On the other hand, Transcutaneous Electrical Nerve Stimulation (TENS) it is used for control or relief of pain, improvement of vascularization in the region of the application, and muscular relaxation. TENS is considered a supporting resource in MTD. Objective: To evaluate the effect of the application of TENS in the voice treatment of the dysphonic women. Method: Subjects will be 34 dysphonic women with vocal bilateral nodules or bilateral mucous thickness. Subjects are divided in two randomized groups: Group 1 (Experimental) - 17 individuals who will receive 12 sessions of TENS (200 µs and 10 Hz) for 20 minutes and traditional therapy for 30 minutes, with two weekly sessions; Group 2 (Placebo) - 17 individuals who will be submitted to 12 sessions of TENS placebo (same conditions that Group 1, but with TENS turn off) for 20 minutes and traditional therapy for 30 minutes, with during the same time spam, number of sessions and conditions of subjects in group 1. Voice will be evaluated by means of an interview, a questionnaire for investigation of pain and voice; surface electromyography of the suprahioideos muscles, sternocleidomastoid and trapezius muscles; and an auditory-perceptual and acoustic analysis; and the larynx using laryngoscopy. All evaluation will take place before and after 10 days after the realization of procedures in both groups. Data will be analyzed and compare statistically the groups and the pre- and post-therapy data using parametric tests. (AU)

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