LIM/34 - Laboratório de Ciências da Reabilitação

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O Laboratório de Ciências da Reabilitação é ligado ao Departamento de Fisioterapia Fonoaudiologia e terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo (FMUSP).

Linhas de pesquisa: função e disfunção em fisioterapia; fonoaudiologia, linguagem; audição; intervenção social em terapia ocupacional.

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Scopus: 40


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article 1 Citação(ões) na Scopus
“Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery”
(2022) LOPES, P. T.; BENTO, R. F.; GEBRIM, E. M. Mello Santiago; BECK, R. M. de Oliveira; CARVALLO, R. Mota Memede; SANCHES, S. G. Gandolfi; LESSER, J. C. Cisneros
Objective: To evaluate the esthetic and functional results of an osteoplastic flap for mastoid cavity closure in cochlear implant surgery. Study design: Double-blind, prospective, randomized clinical trial. Setting: tertiary referral center. Intervention(s): On hundred and twenty-six patients were randomized in 2 groups for cochlear implant surgery. Cases (n: 63) underwent simple mastoidectomy using an anteriorly pedicled osteoplastic flap for mastoid closure. In controls (n: 63), a traditional periosteal flap was used. Evaluation with the POSAS questionnaire was performed 1 year after surgery to assess surgical wound esthetics. Sixteen patients from each group had postoperative CT-scans and wideband tympanometry to assess mastoid aeration and middle ear absorbance. Gender and time after surgery were correlated. Main outcome measure(s): Evaluation of the quality of the surgical wound with the application of a questionnaire validated in the medical literature and translated into Portuguese language called POSAS, considering the perception of the blinded patient and doctor regarding the surgical technique proceeded. A lower POSAS score suggests better esthetics of the surgical wound. Secondary outcomes are volumetric measurement of aeration inside mastoid cavity using 3D computer tomography exam, which aims to analyze the influence of fibrocicatricial retraction in the surgical wound into the mastoid and the interference of its aeration volume in the absorption of sound in the middle ear, using the wideband tympanometry exam. Results: The POSAS questionnaire in the Case group showed a lower level of local pain and itchiness, a skin color and thickness more similar to the surrounding skin and less irregularity and stiffness, with no influence from time after surgery and gender compared to the Control group. The median tomographic volume was 6.37 cc in the cases and 4.60 cc in controls. Wideband tympanometry showed general smaller sound absorbance in the Case group results, specially, at 1000 Hz frequency. No intraoperative or postoperative complications were observed with the osteoplastic flap. Conclusions: This technique is an effective and safe alternative to alleviate common problems of mastoid surgery for cochlear implantation. In addition to esthetic benefits, it has less interference in middle ear physiology of sound absorbance and less fibrous tissue into the mastoid cavity during the follow-up of more than 1 year.
article 0 Citação(ões) na Scopus
Risk of Dysphonia in Legal Professionals: Proposal for a Screening Protocol
(2023) GULLINO, M. B. Martini Ramalho; SIMõES-ZENARI, M.; RODRIGUES, D. de Albuquerque; SAID, G. Carvalho; NEMR, K.
Introduction. Due to the communicative requirements inherent to the profession, the legal professional benefits from speech therapy monitoring for the proper use of the voice and to avoid the occurrence of vocal disorders. The development of specific instruments will contribute with more relevant data to guide this monitoring. Objective. To verify the applicability of the General Dysphonia Risk Screening Protocol (DRSP-G) and the Specific Dysphonia Risk Screening Protocol for Legal Professionals (DRSP-LP) and to correlate the average scores of both with vocal deviation, sex, age, professional performance time, vocal signs and symp-toms, and vocal self-assessment. Methods. Fifty legal professionals participated. All participants completed the DRSP-G and DRSP-LP and recorded their voices for detection of the presence of altered vocal quality. Results. Most participants presented a high risk of dysphonia, which was higher in men. Altered vocal quality was observed in 34% of the participants. The items with the highest scores in the DRSP-G were talking a lot (76%), excessive daily coffee in-take (70%), contact with smokers (60%), and insufficient hydration and sleep (48%); in the DRSP-LP, alcohol consumption (68%) and exposure to air conditioning (64%). There was no correlation between risk scores and the degree of dysphonia, or with age or length of professional experience. The DRSP-G score correlated with vocal signs and symptoms and vocal self-perception. Conclusions. The joint application of the DRSP-G and the DRSP-LP enabled a quantitative and qualitative analysis of risk factors for dysphonia in legal professionals.
Stressful events among adolescents from public schools in a community in Brazil
article 0 Citação(ões) na Scopus
Auditory central pathways in children and adolescents with multiple sclerosis
(2023) BARBOSA, Dayane Aparecida Nascimento; SILVA, Liliane Aparecida Fagundes; SAMELLI, Alessandra Giannella; PAZ, Jose Albino da; MATAS, Carla Gentile
Background Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents.Objective to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS.Methods The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli.Results Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components.Conclusion Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.
article 0 Citação(ões) na Scopus
Dichotic Sentences Test Performance of Adults with communication complaints
(2023) FERREIRA, Geise Correa; SCHOCHAT, Eliane; FREIRE, Katya Marcondes; COSTA, Maristela Julio
Purpose: To analyze the performance of normal-hearing adults with communication complaints in the Dichotic Sentences Test. Methods: We selected from the database 15 normal-hearing participants with normal results in the Digits Dichotic Test, aged between 19 and 44 years, right-handed, who reported communicative complaints. The Dichotic Sentences Test was applied using two protocols consisting of four different combinations of lists called sequences 1 and 2, in the following order: training, divided attention step, right and left directed attention steps. Results: In the first application sequence, the average performance in the divided attention step was 84.7% for the right ear and 60.67% for the left, with statistical difference between ears. The asymmetry between ears varied from -50% to 60%. In the directed attention step, the average performance was 99.33% for the right ear and 98% for the left, with no statistical difference. In the second application sequence, there was a tendency for better results, more pronounced for the left ear, with no statistical significance, with the performance variation and asymmetry between ears remaining high. In the comparison between the sequences, in the divided attention step, it was found that, for the right ear, 40% of the individuals did not vary, 33% performed worse, and 26.7% performed better; for the left ear, 6.6% did not vary, 20% performed worse, and 73.33% performed better. There was result stability in the directed attention step. Conclusion: The normal-hearing adults with communication complaints presented a heterogeneous profile, especially in the divided attention step, with a marked difference between ears and response variability.
article 0 Citação(ões) na Scopus
Stroke in children and adolescents: Analysis of electrophysiological and behavioral assessment findings of auditory processing
(2023) STADULNI, Andreia Rodrigues Parnoff; SLEIFER, Pricila; BERTICELLI, Amanda Zanatta; RIESGO, Rudimar; ROCHA-MUNIZ, Carolina Nunes; SCHOCHAT, Eliane
Purpose: This study aimed to analyze the auditory processing behavior of children and adolescents diagnosed with stroke and compare it with that of typically developing individuals.Methods: This was an analytical cross-sectional study involving 48 participants aged between 7 and 17 years with adequate schooling for age and grade, allocated equally to two groups: Stroke (SG) and Control Groups (CG). For the SG, cases identified between 2003 and 2018 were considered. In the CG, school-aged participants with typical development were randomized. After screening for differential audiological assessment and confirmation of auditory pathway integrity at the brainstem level, binaural analyses of the auditory processing behavior were conducted using the Dichotic Digit Test (DDT), Frequency Pattern Test (FPT), and electrophysiological assessment (P300). The Shapiro-Wilk test for normality was conducted, followed by the T and Mann-Whitney tests, with a 95 % confidence level and significance offset at p < 0.05, using the SPSS software (IBM (R), v. 22.)Results: The CG performed better in terms of auditory processing. These differences were significant (p < 0.0001) for the binaural integration of DDT, FPT humming and Labeling, and P300 latency. The P300 results were similar; however, with a greater amplitude in the SG. Conclusion: This study showed that children and adolescents with stroke performed worse in electrophysiological and behavioral tests of auditory processing assessed using the auditory evoked potentials. These data reinforce the hypothesis that stroke-related lesions compromise the neural mechanisms underlying auditory processing.
article 0 Citação(ões) na Scopus
Risk of dysphonia and voice quality in performing arts students
(2023) FERRARI, Eloisa Pinheiro; SIMOES-ZENARI, Marcia; MASTER, Suely; NEMR, Katia
Purpose: To analyse the relationship between the risk of dysphonia and vocal quality in undergraduate performing arts students. Methods: Observational cross-sectional study with 38 undergraduate students in Performing Arts. We applied screening protocols for general and specific risk of dysphonia for actors and made recordings of sustained emission of the vowel /a/, spontaneous speech and reading a text, used for perceptual analysis performed by three evaluators using the GRBASI scale. After intra and inter-rater reliability tests it was obtained final classification of the general degree of vocal deviation parameter for each participant. Comparisons were made considering groups that had or did not have other profession/activity with the use of voice, and the groups were formed from the general grade. Results: Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild degree. Students who had another profession/activity with voice use scored higher in the specific protocol for actors, and in the sum of this protocol with the general screening protocol. There was no relationship between the degree of vocal alteration and the risk of dysphonia. Students who did not yet work professionally had more moderate or severe vocal alterations, and those who did work professionally had a higher frequency of mild vocal alterations. Conclusion: Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild alteration. There was no relationship between the risk of dysphonia and the degree of vocal alteration.
article 0 Citação(ões) na Scopus
Learning challenges in Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs during the COVID-19 pandemic
(2023) SAMELLI, Alessandra Giannella; MATAS, Carla Gentile; NAKAGAWA, Naomi Kondo; SILVA, Talita Naiara Rossi da; JOAO, Silvia Maria Amado
Purpose: COVID-19 posed numerous challenges to educational programs that had to quickly adapt to remote online learning (ROL) to ensure the continuity of health professional training over the pandemic. We aimed to assess the students' and professors' perceptions of the teaching-learning process in the Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs at a Brazilian public university. Methods: We used an electronic self-reported questionnaire with multiple-choice questions on a Likert scale ranged 1-5; higher the score, higher the level of agreement/importance/satisfaction. Results: Most of undergraduate students and teachers had previous experience using information and communication technologies, and 85% stated their preference for in-person learning. Students expressed their appreciation for more active learning methodologies with clear objectives, accessible content, and visualization of abstract concepts. Regarding benefits and barriers, some similar perceptions were observed between students and teachers with ROL favoring time management, benefits in the teaching-learning process, satisfaction and motivation with the course content, and low attendance rates to general academic activities due to absent or poor access to technological resources. Conclusion: ROL is an alternative learning mode when the in-person classes cannot be carried out, as in the case of the COVID-19 pandemic. ROL is believed to be unfit to replace in-person learning, although it can complement the traditional classroom-based education in a hybrid model, respecting the nature of each program in the field of health that requires in-person practical training.
article 0 Citação(ões) na Scopus
Universal neonatal hearing screening before and during the COVID-19 pandemic
(2023) BESEN, Eduarda; PAIVA, Karina Mary de; GONCALVES, Laura Faustino; SAMELLI, Alessandra Gianella; MACHADO, Marcos Jose; SILVA, Anna Quialheiro Abreu da; CIGANA, Luciana Berwanger; TIEZERIN, Carolina Schmitz; HAAS, Patricia
Objective: To verify the frequency of risk factors for hearing loss in newborns and their possible associations with universal neonatal hearing screening results before and during the COVID-19 pandemic. Methods: Historical cohort study with data analysis of newborns attended in a reference hearing health service of the Unified Health System (SUS) between January 2017 and December 2021. Results: Those born in 2020 and 2021 were 91% less likely to fail the screening than those born in 2017, 2018, and 2019; therefore, they had a lower percentage of referrals for a retest. There was a decrease in congenital syphilis (1.00%), decrease in HIV (0.95%), and an increase in toxoplasmosis (0.58%) and increase in rubella cases in 2021 in relation to 2017. Syphilis had lower frequency rates during the COVID-19 pandemic (2020-2021). Conclusion: Newborns born in the pandemic year compared to those born pre-pandemic showed a reduction in the presence of two risk indicators for hearing loss and, consequently, a lower chance of failing the UNHS and a lower percentage of referral for retest.
article 3 Citação(ões) na Scopus
Reducing the gap between science and clinic: lessons from academia and professional practice - part B: traditional vocal therapy techniques and modern electrostimulation and photobiomodulation techniques applied to vocal rehabilitation
(2022) BEHLAU, Mara; ALMEIDA, Anna Alice; AMORIM, Geova; BALATA, Patricia; BASTOS, Savio; CASSOL, Mauriceia; CONSTANTINI, Ana Carolina; ECKLEY, Claudia; ENGLERT, Marina; GAMA, Ana Cristina Cortes; GIELOW, Ingrid; GUIMARAES, Bruno; LIMA, Livia Ribeiro; LOPES, Leonardo; MADAZIO, Glaucya; MORETI, Felipe; MOUFFRON, Vanessa; NEMR, Katia; OLIVEIRA, Priscila; PADOVANI, Marina; RIBEIRO, Vanessa Veis; SILVERIO, Kelly; VAIANO, Thays; YAMASAKI, Rosiane
This text is the continuation of the XVIII SBFa Congress publication. In part ""A"" we presented the analyses on clinical vocal evaluation. Part ""B"" focuses on vocal rehabilitation: 4. Traditional techniques of vocal therapy; 5. Modern techniques of electrostimulation and photobiomodulation applied to vocal rehabilitation. The numerous studies on the various programs, methods, and techniques of traditional rehabilitation techniques, and many with high quality of evidence, allow us to consider such procedures relatively well described, safe, and with known effects, accounting for the treatment of various vocal disorders. The scientific evidence with traditional techniques is recognized worldwide. New fronts of evolution, with electrostimulation or photobiomodulation used to handle voice problems, seem to be promising as coadjutant approaches. There are more studies on electrostimulation in vocal rehabilitation than with photobiomodulation; however, scientific evidence for these two modern techniques is still limited. Knowledge and caution are required for the application of either technique.