Electrical stimulation as an adjunct in vocal therapy in elderly

Abstract

Electrical stimulation is seen as a way to get effective and rapid results in vocal therapy. Neuromuscular electrical stimulation has been applied as an adjuvant in vocal rehabilitation; however, specifically for dysphonia secondary to vocal fold bowing, studies are scarce and require research with greater methodological rigor. A controlled clinical study, for understanding the role of electrical stimulation associated with the traditional voice therapy, applied to the elderly population, will bring great benefit to the area. Objective: To analyze the immediate and medium-term use of electrical stimulation associated with vocal therapy in dysphonia rehabilitation in the elderly. Considering the benefits of electrostimulation associated with vocal therapy seek to confirm the following hypothesis: H1: parameters to be analyzed glottal configuration, self-assessment, voice quality and maximum phonation time would be different when comparing the Pre moments intervention (Pre) and Post immediate intervention (Pl), Pre and one month after completion of the intervention (P1M) but not between Pl and P1M.Type of study: controlled clinical trial. Method: A pilot project will be carried out to estimate the size of the sample. Subjects will be senile individuals that presented vocal complaints and ENT examination that indicates the presence of vocal cords bowing during breathing and / or spindle chink during phonation. Participants will be arranged randomly in an experimental group (EG) and a control group (CG). All of them will undergo a therapeutic proposal, adapted from LaGorio, composed of 12 sessions divided in four weekly sessions of one hour each. GE will be part of the therapeutic proposal associated with neuromuscular electrical stimulation (NMES) and the GC will undergo the same proposal without the application of NMES. It will be used two pairs of electrodes on all participants in each session of the therapeutic proposal. The electrodes will be placed vertically on the middle of the thyroid cartilage above the cricoid membrane and another pair of electrodes in submadibular region, below the posterior horn of the hyoid bone. It will be used the VitalStim equipment for electro stimulation. To verify the effectiveness of the therapeutic approach applied with the use of NMES as adjuvant, larynx exams will be applied the Voice Quality of Life protocol - QVV, followed by perceptual evaluation from three speech pathologist judges in accordance with the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol and evaluation of acoustic parameters and maximum phonation time through the Multi Dimensional Voice Program Software - MDVP. All evaluations shall be carried out in pre intervention period (Pre), post intervention - Instant (PI) and after one month of intervention (P1M). The data obtained in the different evaluations will be placed in EXCELL tables in order to facilitate the analysis of results through described and inferential statistical analysis. For the analysis of perceptual evaluation data will be held intra-judge agreement between responses of judges. Next, comparison analysis tests will be applied the results of evaluations between the Pre moments, PI and P1M. (AU)