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1	Fluência de fala e alteração do feedback auditivo: comparação entre medidas objetivas e perceptuais / Speech fluency and altered auditory feedback: comparison between objective and perceptual measurements Ritto, Ana Paula 04 September 2018 (has links) INTRODUÇÃO: A gagueira do desenvolvimento é uma patologia caracterizada por rupturas involuntárias no fluxo de fala, causadas por déficits no processamento neuromotor para a fala. Estes sintomas têm como consequência uma variedade de reações fisiológicas, comportamentais, cognitivas e emocionais para a pessoa que gagueja. O objetivo geral deste trabalho foi investigar os efeitos do tratamento fonoaudiológico para gagueira baseado em dispositivos de alteração de feedback auditivo, e compará-los aos efeitos do tratamento tradicional, baseado em estratégias comportamentais. MÉTODOS: Esta tese foi desenvolvida no formato de compilação de artigos científicos. Foram compilados três artigos, dois já publicados em periódicos com indexação na base de dados Web of Science e um terceiro artigo já submetido para publicação, em processo de revisão por pares. Foi incluída ainda uma análise crítica das contribuições dos artigos compilados para a área da Fonoaudiologia. RESULTADOS: Os estudos analisados não apresentaram diferenças significativas entre os resultados das duas abordagens terapêuticas investigadas; ambos os protocolos terapêuticos alcançaram melhora pós-tratamento, medida por meio da performance da fluência de fala e da qualidade de vida auto referida. CONCLUSÕES: Os dispositivos de alteração do feedback auditivo podem ser utilizados como recurso no tratamento da gagueira em adultos / INTRODUCTION: Developmental stuttering is a pathology characterized by involuntary disruptions in speech flow and is caused by deficits in neuromotor processing involved in speech production. These symptoms result in a variety of physiological, behavioral, cognitive and emotional consequences to the person who stutters. This study aimed to investigate the effects of a therapeutic approach for stuttering treatment based on altered auditory feedback devices, and to compare them with a traditional behavioral therapeutic approach. METHODS: This thesis is a compilation of two papers published in peerreviewed scientific journals indexed in the Web of Science database, and one unpublished manuscript, submitted to a scientific journal and currently awaiting review by peers. A critical analysis of the contributions of the compiled papers to the Speech-Language Pathology field was performed. RESULTS: The results presented in the analyzed papers did not show differences between the outcomes of the two therapeutic approaches; both protocols achieved improvements, as measured by speech fluency performance and selfreported quality of life. CONCLUSIONS: Altered auditory feedback devices may be used as a resource for the treatment of adults who stutter Dispositivos eletrônicos vestíveis Feedback sensory Fonoaudiologia Gagueira Medida da produção da fala Qualidade de vida Quality of life Retroalimentação sensorial Speech language and hearing sciences Speech production measurement Stuttering Wearable electronic devices
2	Fluência de fala e alteração do feedback auditivo: comparação entre medidas objetivas e perceptuais / Speech fluency and altered auditory feedback: comparison between objective and perceptual measurements Ana Paula Ritto 04 September 2018 (has links) INTRODUÇÃO: A gagueira do desenvolvimento é uma patologia caracterizada por rupturas involuntárias no fluxo de fala, causadas por déficits no processamento neuromotor para a fala. Estes sintomas têm como consequência uma variedade de reações fisiológicas, comportamentais, cognitivas e emocionais para a pessoa que gagueja. O objetivo geral deste trabalho foi investigar os efeitos do tratamento fonoaudiológico para gagueira baseado em dispositivos de alteração de feedback auditivo, e compará-los aos efeitos do tratamento tradicional, baseado em estratégias comportamentais. MÉTODOS: Esta tese foi desenvolvida no formato de compilação de artigos científicos. Foram compilados três artigos, dois já publicados em periódicos com indexação na base de dados Web of Science e um terceiro artigo já submetido para publicação, em processo de revisão por pares. Foi incluída ainda uma análise crítica das contribuições dos artigos compilados para a área da Fonoaudiologia. RESULTADOS: Os estudos analisados não apresentaram diferenças significativas entre os resultados das duas abordagens terapêuticas investigadas; ambos os protocolos terapêuticos alcançaram melhora pós-tratamento, medida por meio da performance da fluência de fala e da qualidade de vida auto referida. CONCLUSÕES: Os dispositivos de alteração do feedback auditivo podem ser utilizados como recurso no tratamento da gagueira em adultos / INTRODUCTION: Developmental stuttering is a pathology characterized by involuntary disruptions in speech flow and is caused by deficits in neuromotor processing involved in speech production. These symptoms result in a variety of physiological, behavioral, cognitive and emotional consequences to the person who stutters. This study aimed to investigate the effects of a therapeutic approach for stuttering treatment based on altered auditory feedback devices, and to compare them with a traditional behavioral therapeutic approach. METHODS: This thesis is a compilation of two papers published in peerreviewed scientific journals indexed in the Web of Science database, and one unpublished manuscript, submitted to a scientific journal and currently awaiting review by peers. A critical analysis of the contributions of the compiled papers to the Speech-Language Pathology field was performed. RESULTS: The results presented in the analyzed papers did not show differences between the outcomes of the two therapeutic approaches; both protocols achieved improvements, as measured by speech fluency performance and selfreported quality of life. CONCLUSIONS: Altered auditory feedback devices may be used as a resource for the treatment of adults who stutter Dispositivos eletrônicos vestíveis Fonoaudiologia Gagueira Medida da produção da fala Qualidade de vida Retroalimentação sensorial Feedback sensory Quality of life Speech language and hearing sciences Speech production measurement Stuttering Wearable electronic devices
3	Merenje parametara proprioceptivnog osećaja nakon dislokacije patele kod adolescentkinja / Measurement of parameters of proprioception after dislocation of patella in adolescent women Milankov Vukadin 11 April 2019 (has links) <p>I&scaron;ča&scaron;enje, luksacija ili dislokacija ča&scaron;ice (patele), predstavlja povredu kolena prilikom koje dolazi do pomeranja patele iz patelofemoralnog dela zgloba kolena. Pri ovoj povredi dolazi do o&scaron;tećenja medijalnih mekotkivnih struktura kolena koje su zadužene za pravilno pomeranje ča&scaron;ice unutar patelofemoralnog zgloba. Nakon prve povrede kod velikog borja pacijenata razvije se hronična nestabilnost patelofemoralnog zgloba sa posledičnim recidivantnim luksacijama patele. Mehanizam nastanka hronične nestabilnosti nije u potpunosti razja&scaron;njen i smatra se multifaktorijalnim, a za jedan od faktora smatra se naru&scaron;avanje neurolo&scaron;ke regulacije pokreta kolena. Propriocepcija je složen neurolo&scaron;ki mehanizam koji nam omogućava mentalno mapiranje delova tela, sprečavajući prekomerne i nepravilne pokrete koji mogu dovesti do povređivanja. Za njegovu procenu u zglobu kolena najče&scaron;će se procenjuje osećaj pozicije zgloba (JPS – eng. &bdquo;Joint Position Sense“) kao jedne od komponenti propriocepcije. Nerazja&scaron;njeno je koji je najbolji način za njegovu procenu u pogledu izbora različitih uglova fleksije kolena i pozicija ispitanika, ali i kakav je uticaj povreda struktura kolena na njega. U istraživanju su učestvovale isključivo osobe ženskog pola (15-17 godina), svrstane u tri kategorije od po 30 ispitanika. Prvu, kontrolnu grupu, činile su zdrave ne sportistkinje; drugu, grupu sportistkinja, činile su ispitanice koje su se takmičarski bavile ko&scaron;arkom; treću, grupu pacijentkinja, činile su osobe sa luksacijom ča&scaron;ice kolena. Za merenje JPS kori&scaron;ten je VICON optički sistem (©Vicon Motion Systems Ltd. UK registered no. 1801446) za analizu pokreta. Za svaku grupu meren je JPS metodom pasivnog pozicioniranja-aktivne reprodukcije sa kolenom u različitim nivoima fleksije (30°, 45° i 60°), u uspravnom, ležećem i sedećem položaju, nakon čega su rezultati bili poređeni između grupa. Na&scaron;i rezultati su pokazali da odabir pozicije ispitanika i ugla merenja ne utiče na JPS u zdravim populacijama, kontrolnoj grupi i grupi sportiskinja, niti postoji statistički značajna razlika odgovarajućih pozicija i uglova između ovih grupa. Za grupu pacijentkinja dobili smo da postoji deficit propriocepcije, i da je sedeći stav najosetljivijim za procenu deficita osećaja pozicija zgloba kolena. U odnosu na odgovarajuće uglove kontrolne grupe i grupe sportistkinja, kod pacijentkinja postoji statistički značajno veća gre&scaron;ka traženih uglova u sedećem stavu, zbog čega je ovaj stav karakterističan za ovu grupu. Takođe smo uočili da je najveća razlika pri uglu od 45°, čineći ga kritičnim uglom za grupu pacijentkinja. Ono &scaron;to je ključni zaključak je da nakon povrede kolena po tipu luksacije ča&scaron;ice postoji neurolo&scaron;ki deficit kontrole pokreta kolena, koji potencijalno može dovesti do daljeg povređivanja. 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4	Eficácia do equipamento de biofeedback vibrotátil Vertiguard® na reabilitação do equilibrio corporal / Efficacy of biofeedback equipment vibrotactile Vertiguard® on vestibular rehabilitation Brugnera, Cibele 27 August 2014 (has links) O presente estudo avaliou a eficácia do equipamento de biofeedback Vertiguard®), que utiliza a informação vibrotátil como substituto sensorial (SS) de apoio ao sistema vestibular. Foram selecionados 13 pacientes com comprometimento severo do equilíbrio corporal e não obtiveram resultado satisfatório à terapia de reabilitação vestibular convencional. Os sujeitos foram randomizados entre dois grupos controle (GC), que utilizou o estímulo vibratório e estudo (GE), que treinou com o equipamento desligado. Os indivíduos foram treinados com o equipamento durante dez dias e foram orientados a corrigir o alinhamento corporal sempre que recebessem um estímulo vibrotátil de um cinto com quatro vibradores dispostos em ângulo de 90°entre eles, que informava o desvio corporal para aquele lado e o risco de queda. Para avaliação pré e pós tratamento foi utilizada o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de auto percepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). O GE apresentou melhora estatisticamente significante em C5 (p=0,007) e C6 (p= 0,012) após treinamento. Na escala ABC houve diferença significante entre o início e o final do tratamento apenas no GE (p=0,04). No questionário DHI ocorreu diferença significante no aspecto físico nos GC e GE, e no aspecto funcional (p=0,0427) apenas no grupo GE. Os resultados observados demonstram que o estímulo de substituição sensorial vibratório oferecido pelo sistema Vertiguard®, propicia a melhor integração das redes neurais envolvidas na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal / This study evaluated the effectiveness of biofeedback equipment Vertiguard® that uses vibrotactile information as sensory substitution (SS) of the vestibular system. We selected thirteen patients with severe impairment of balance who did not obtain enough improvement from conventional vestibular rehabilitation. A randomization list was used to distribute the patients in Control Group (CG), who received the vibrotactile stimulus and Study Group (SG), who trained without any stimulus. During ten days of training, the patients in both groups used the equipment attached to the waist. They were instructed to correct body alignment when vibrotactile stimulus received from one of the four vibrators arranged at an angle of 90° signaling the risk of f alling. The results of the treatment were evaluated by the protocol sensory organization test (SOT) of the computerized dynamic posturography (CDP), ABC scale (Activities-specific Balance Confidence) and DHI (Dizziness Handicap Inventory). After treatment the SG showed a statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.012). In the ABC scale there was significant difference between the beginning and end of treatment only in the SG (p = 0.04). The Dizziness Handicap Inventory questionnaire (DHI) showed in the after training a significant difference in functional in both CG and SG, and in physical aspects (p = 0.0427) only in SG. The present findings show that sensory substitution using the vibrotactile stimulus of Vertiguard (R) system promotes the improvement of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance Biofeedback psychology Doenças vestibulares/fisiopatologia Doenças vestibulares/reabilitação Equilíbrio postural Feedback sensory Neurofeedback Neurorretroalimentação Postural balance Retroalimentação sensorial Vertigem/reabilitação Vertigo/rehabilitation Vestibular diseases/physiopathology Vestibular diseases/rehabilitation
5	Eficácia do equipamento de biofeedback vibrotátil Vertiguard® na reabilitação do equilibrio corporal / Efficacy of biofeedback equipment vibrotactile Vertiguard® on vestibular rehabilitation Cibele Brugnera 27 August 2014 (has links) O presente estudo avaliou a eficácia do equipamento de biofeedback Vertiguard®), que utiliza a informação vibrotátil como substituto sensorial (SS) de apoio ao sistema vestibular. Foram selecionados 13 pacientes com comprometimento severo do equilíbrio corporal e não obtiveram resultado satisfatório à terapia de reabilitação vestibular convencional. Os sujeitos foram randomizados entre dois grupos controle (GC), que utilizou o estímulo vibratório e estudo (GE), que treinou com o equipamento desligado. Os indivíduos foram treinados com o equipamento durante dez dias e foram orientados a corrigir o alinhamento corporal sempre que recebessem um estímulo vibrotátil de um cinto com quatro vibradores dispostos em ângulo de 90°entre eles, que informava o desvio corporal para aquele lado e o risco de queda. Para avaliação pré e pós tratamento foi utilizada o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de auto percepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). O GE apresentou melhora estatisticamente significante em C5 (p=0,007) e C6 (p= 0,012) após treinamento. Na escala ABC houve diferença significante entre o início e o final do tratamento apenas no GE (p=0,04). No questionário DHI ocorreu diferença significante no aspecto físico nos GC e GE, e no aspecto funcional (p=0,0427) apenas no grupo GE. Os resultados observados demonstram que o estímulo de substituição sensorial vibratório oferecido pelo sistema Vertiguard®, propicia a melhor integração das redes neurais envolvidas na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal / This study evaluated the effectiveness of biofeedback equipment Vertiguard® that uses vibrotactile information as sensory substitution (SS) of the vestibular system. We selected thirteen patients with severe impairment of balance who did not obtain enough improvement from conventional vestibular rehabilitation. A randomization list was used to distribute the patients in Control Group (CG), who received the vibrotactile stimulus and Study Group (SG), who trained without any stimulus. During ten days of training, the patients in both groups used the equipment attached to the waist. They were instructed to correct body alignment when vibrotactile stimulus received from one of the four vibrators arranged at an angle of 90° signaling the risk of f alling. The results of the treatment were evaluated by the protocol sensory organization test (SOT) of the computerized dynamic posturography (CDP), ABC scale (Activities-specific Balance Confidence) and DHI (Dizziness Handicap Inventory). After treatment the SG showed a statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.012). In the ABC scale there was significant difference between the beginning and end of treatment only in the SG (p = 0.04). The Dizziness Handicap Inventory questionnaire (DHI) showed in the after training a significant difference in functional in both CG and SG, and in physical aspects (p = 0.0427) only in SG. The present findings show that sensory substitution using the vibrotactile stimulus of Vertiguard (R) system promotes the improvement of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance Doenças vestibulares/fisiopatologia Doenças vestibulares/reabilitação Equilíbrio postural Neurorretroalimentação Retroalimentação sensorial Vertigem/reabilitação Biofeedback psychology Feedback sensory Neurofeedback Postural balance Vertigo/rehabilitation Vestibular diseases/physiopathology Vestibular diseases/rehabilitation

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