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ABSTRACT Purpose To analyze the correlation and association between the Long Latency Auditory Evoked Potential (LLAEP) and the Frequency Following Response (FFR) in young adults with normal hearing thresholds. Methods This was a cross-sectional, quantitative, and qualitative study. The sample included 32 young adults (mean age of 22.5 years) of both sexes who met the inclusion criteria. The participants underwent basic audiological evaluation, screening of auditory skills through the Random Gap Detection Test and Dichotic Digits Test, and electrophysiological tests: Auditory Brainstem Response with click stimulus, Long Latency Auditory Evoked Potential, and Frequency Following Response with verbal stimulus. Results A statistically significant and positive brightness was observed between waves V, A and C and waves P1 and N2, evidencing the participation of auditory structures of the primary auditory cortex in the generation of FFR responses, and a negative appearance between waves C and N2, reflecting the different auditory abilities to generate the responses of each component. There was no significant association between individuals classified as normal and altered in the tests in general performed in the present study or when associated between each component. Conclusion Waves V, A, and C correlate with waves P1 and N2 of the Long Latency Auditory Evoked Potential in young adults. There was no evidence of associations between the qualitative results of the Frequency Following Response and the Long Latency Auditory Evoked Potential.

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ABSTRACT Purpose To analyze surface skin temperature with infrared thermography (IRT) in the regions of the temporal, masseter, and buccinator muscles during breastfeeding before and after LF. Methods Non-randomized clinical trial in 40 infants diagnosed with ankyloglossia. The lingual frenulum was assessed with the Neonatal Tongue Screening Test, breastfeeding was assessed with a protocol and pain scale, and the regions of interest were qualitatively and quantitatively assessed with IRT. Two independent evaluators analyzed the data. Results There were post-LF improvements in the functional-anatomical tongue assessment (p < 0.001), breastfeeding pain scale (p < 0.001), and breastfeeding assessment regarding the mother’s general aspect (p < 0.001), breast pain (p = 0.03), and suction (p < 0.001). IRT data after LF showed a qualitative increase in temperature in the regions of the temporal and masseter muscles. There was no difference in the region of the buccinator muscle. Conclusion LF impacts the surface skin temperature in the regions of mandibular levator muscles during breastfeeding.

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ABSTRACT Purpose To evaluate the psychometric properties of the naming and imitation tasks of the Digital Speech Assessment Instrument. Methods Forty-five Brazilian Portuguese (BP)-speaking children aged 4 to 9 years, with and without Phonological Disorder (PD) participated in the study. Construct validity was verified by convergent validity, criterion validity was analyzed using Student's t-test for independent samples, and inter-rater reliability was assessed. Results The naming task demonstrated satisfactory construct validity. In the imitation task, correlations ranged from moderate to nearly perfect. Both tasks discriminated well between groups, with children with PD presenting consistently lower scores. Inter-rater agreement was substantial to nearly perfect. Conclusion The results indicate that the naming and imitation tasks of the Digital Speech Assessment Instrument are valid and reliable.

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ABSTRACT Purpose To characterize the swallowing function of patients with sepsis, describe the frequency of oropharyngeal dysphagia, examine the rehabilitation duration required, and identify clinical predictors associated with the occurrence of dysphagia in a high-complexity hospital setting. Methods This cross-sectional observational study included 35 patients diagnosed with sepsis, whose clinical severity was assessed using the National Early Warning Score (NEWS). Clinical and demographic data were collected from medical records. All participants underwent an initial screening with the Yale Swallow Protocol, and those identified at risk for dysphagia were further evaluated using the Dysphagia Risk Evaluation Protocol – Screening (DREP) and the Protocol for Introduction and Transition to Oral Feeding (PITOF). Swallowing functionality was classified using the Functional Oral Intake Scale (FOIS). Results Dysphagic patients had pulmonary infection as the primary source of sepsis, higher clinical severity, a greater prevalence of comorbidities such as neurological diseases and heart conditions, lower FOIS scores, increased need for alternative feeding routes, longer hospital stays, and a higher risk of mortality. The most frequent clinical signs included prolonged oral transit time, reduced laryngeal elevation, and aspiration indicators such as throat clearing and coughing after swallowing. Conclusion Oropharyngeal dysphagia in patients with sepsis is associated with worse clinical outcomes, emphasizing the importance of early diagnosis and specialized management.

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ABSTRACT Purpose To compare the POS time in individuals diagnosed with PD in the conditions of isolated deglutition (ID) and dual-task deglutition (DD) for different consistencies and volumes. Methods A total of 576 swallows edited from fiberoptic endoscopic evaluation of swallowing (FEES) of 16 individuals, both sexes, at different PD stages based on the Hoehn & Yahr (H&Y) modified scale, aged 64 to 85 years (mean ± standard deviation: 72.4 ± 6). They underwent FEES with isolated deglutition (ID) and dual-task deglutition (DD) to analyze the POS time in swallowing. An otorhinolaryngologist performed the FEES, offering standardized consistencies at levels 0 – thin; 2 – mildly thick; and 4 – extremely thick, based on the International Dysphagia Diet Standardization Initiative (IDDSI). All food consistencies were dyed with blue artificial food coloring and offered 5 mL and 10 mL in disposable spoons. After adequate training, the quantitative temporal POS analysis for both deglutition conditions was performed using specific software. Data was analyzed through the Statistical Package for the Social Sciences (SPSS) with a significance level of 0.05 (5%). The Mann-Whitney test compared the ID and DD POS time. Results The POS time was statistically significantly different for 5 mL of consistency level 4 (ID = 912 ms and DD = 2.044 ms) (p-value = 0.007). Conclusion The results indicated that there was significant difference in the POS time between ID and DD only at 5 mL of consistency level 4 for individuals with PD at performing the cognitive-motor dual-task proposed.

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RESUMO Objetivo verificar a concordância entre a avaliação dos aspectos miofuncionais orofaciais em pessoas idosas em processo de fragilização e o risco para disfagia. Método estudo metodológico realizado com 100 indivíduos de um centro de referência à pessoa idosa, avaliados por meio da Avaliação Miofuncional com Escores para Idosos (AMIOFE-I) e pelo Rastreamento de Disfagia Orofaríngea em Idosos (RaDI). Também foram coletadas informações referentes às alterações de mastigação, à idade, e aos anos de estudo dos participantes. Foi realizada análise da curva ROC e a sensibilidade, a especificidade, o valor preditivo positivo e o valor preditivo negativo foram gerados a partir dessa análise. Resultados o protocolo AMIOFE-I apresentou mediana de 236,5 pontos. Em relação à deglutição, a maioria dos participantes não apresentou risco para disfagia. A comparação dos protocolos AMIOFE-I e RaDI não indicou diferenças na pontuação dos aspectos miofuncionais orofaciais quando se comparam indivíduos sem e com risco para disfagia. Também não houve associação entre o AMIOFE-I e as alterações na mastigação, idade e anos de estudo. Conclusão a avaliação dos aspectos miofuncionais orofaciais nas pessoas idosas em processo de fragilização não foi capaz de indicar a presença de risco para disfagia orofaríngea.

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ABSTRACT Purpose to verify the agreement between the evaluation of orofacial myofunctional aspects and the risk of dysphagia in older people in the frailty process. Methods methodological study with 100 individuals from a referral center for older people, assessed using the Orofacial Myofunctional Evaluation Protocol with Scores for Older People (OMES-O) and the Oropharyngeal Dysphagia Screening in Older Adults (RaDI). Information regarding participants’ chewing disorders, age, and years of education was also collected. ROC curve analysis was performed, and sensitivity, specificity, positive and negative predictive values were generated from this analysis. Results the OMES-O presented a median of 236.5 points. Most participants were not at risk of dysphagia. The comparison between OMES-O and RaDI indicated no difference in the score of orofacial myofunctional aspects between individuals at risk and not at risk of dysphagia. Moreover, OMES-O was not associated with chewing alterations, age, or years of education. Conclusion The evaluation of orofacial myofunctional aspects could not indicate the risk of oropharyngeal dysphagia in older adults in the frailty process.

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RESUMO Objetivo Verificar se há efeitos imediatos da fotobiomodulação na pressão máxima e resistência da língua. Método Trata-se de uma pesquisa experimental, duplo-cego, que investigou os efeitos imediatos da fotobiomodulação na pressão máxima e resistência da língua de sujeitos sem alterações funcionais desta estrutura. A amostra, não-probabilística, foi composta por 60 indivíduos, de ambos os sexos, com idade entre 18 e 35 anos, divididos em quatro grupos. As doses testadas foram 7, 9 e 11J por ponto, no comprimento de onda infravermelho, sendo aplicados em seis pontos na face superior da língua (sendo três pontos longitudinais, em duas fileiras) e três pontos longitudinalmente em cada lateral, totalizando 12 pontos de aplicação. O grupo placebo foi submetido aos mesmos procedimentos dos demais, porém, o equipamento não foi acionado. Os participantes foram submetidos a avaliação intraoral, parte da língua, do protocolo MBGR para incluir os indivíduos na amostra, além da avaliação da pressão máxima e resistência de língua utilizando o IOPI, pré e pós irradiação. Foram comparadas a pressão máxima e a resistência da língua antes e após a fotobiomodulação. Resultados Os grupos foram homogêneos em relação ao sexo, idade, pressão máxima e resistência da língua antes da irradiação. Não houve diferença na pressão máxima ou na resistência da língua, entre os momentos pré e pós irradiação, em nenhum dos grupos testados. Conclusão A fotobiomodulação, nas doses testadas, não provocaram efeitos imediatos na pressão ou na resistência da língua de adultos sem alterações estruturais e/ou funcionais da língua.

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ABSTRACT Purpose To verify whether there are immediate effects of photobiomodulation on maximum tongue pressure and endurance. Methods This was a double-blind experimental study that investigated the immediate effects of photobiomodulation on maximum tongue pressure and endurance in individuals without functional alterations of this structure. The non-probabilistic sample consisted of 60 individuals of both sexes, aged between 18 and 35 years, divided into four groups. The tested doses were 7, 9, and 11J per point, using infrared wavelength, applied to six points on the dorsal surface of the tongue (three longitudinal points in two rows) and three longitudinal points on each lateral side, totaling 12 application points. The placebo group underwent the same procedures as the others, but the device was not activated. Participants underwent an intraoral evaluation of the tongue using the MBGR protocol to determine eligibility, as well as maximum tongue pressure and endurance assessment using the IOPI, both before and after irradiation. The maximum tongue pressure and endurance were compared before and after photobiomodulation. Results The groups were homogeneous regarding sex, age, maximum tongue pressure, and endurance before irradiation. No differences were observed in tongue pressure or resistance between the pre and post-irradiation moments in any of the tested groups. Conclusion Photobiomodulation, at the tested doses, did not produce immediate effects on maximum tongue pressure or resistance in adults without structural and/or functional alterations of the tongue.

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RESUMO Objetivo Analisar a produção ambulatorial do visual reinforcement audiometry (VRA) no Sistema Único de Saúde (SUS), nas Unidades da Federação (UFs) do Brasil, entre 2004 e 2021, e sua associação com a Triagem Auditiva Neonatal (TAN) e a oferta de fonoaudiólogos, serviços de saúde auditiva e equipamentos de VRA. Método Estudo ecológico misto, que utilizou dados do Sistema de Informações Ambulatoriais do SUS, do Cadastro Nacional de Estabelecimentos de Saúde e do Instituto Brasileiro de Geografia e Estatística. A variável dependente foi a taxa da realização do procedimento “audiometria de reforço visual (via aérea/óssea)”, por 10 mil habitantes, enquanto as variáveis independentes foram as taxas de TAN, fonoaudiólogos, serviços de saúde auditiva e equipamentos de VRA. Foi realizada estatística descritiva e inferencial e análise espacial. Resultados A taxa de realização de VRA no Brasil foi de 11,8/10 mil habitantes entre 2004 e 2021. Nas UFs, as taxas de VRA variaram de 0 a 125,1/10 mil habitantes nos períodos estudados. A menor taxa deste exame foi registrada no triênio 2004-2006, ao passo que a maior foi visualizada no triênio 2007-2009. Constatou-se que não houve correlação significativa entre a taxa de realização de VRA do triênio 2016-2018 com as taxas de TAN, fonoaudiólogos, serviços de saúde auditiva e equipamentos de VRA. Conclusão A realização do VRA é restrita e discrepante entre as UFs brasileiras e não apresenta associação com as variáveis investigadas, apontando a necessidade de medidas para melhorar o acesso a este exame no SUS.

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ABSTRACT Purpose To analyze the outpatient production of the visual reinforcement audiometry (VRA) in the Unified Health System (SUS), in the Federation Units (UFs) of Brazil, between 2004 and 2021, and its association with Neonatal Hearing Screening (NHS) and offering audiologists, hearing health services and VRA equipment. Methods Ecological mixed study, which used data from the SUS Outpatient Information System, of the National Registry of Health Establishments and of the Brazilian Institute of Geography and Statistics. The dependent variable was the rate of performance of the “visual reinforcement audiometry (air/bone route)” procedure, per 10 thousand inhabitants, while the independent variables were the rates of NHS, speech therapists, hearing health services and VRA equipment. Descriptive and inferential statistics and spatial analysis were performed. Results The VRA rate in Brazil was 11.8/10 thousand inhabitants between 2004 and 2021. In the UFs, VRA rates varied from 0 to 125.1/10 thousand inhabitants in the periods studied. The lowest rate for this exam was recorded in the 2004-2006 triennium, while the highest was seen in the 2007-2009 triennium. It was found that there was no significant correlation between the VRA performance rate for the 2016-2018 three-year period with the rates of NHS, speech therapists, hearing health services and VRA equipment. Conclusion The realization of the VRA is restricted and discrepant among Brazilian states and does not show any association with the variables investigated, indicating the need for measures to improve access to this exam in the SUS.

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ABSTRACT Purpose This study aimed to evaluate the impact of preclinical simulation-based learning experience in reducing student anxiety in interacting with real patients and enhancing their self-perceived clinical competence. Methods Second-year undergraduate speech-language pathology (SLP) students undertaking a preparatory course for clinical work and placement participated. Two clinical case simulation sessions were embedded as part of this course. In each session, two professional actors role-played as caregivers of family members with communication disorders. The first simulation focused on foundational assessment skills, and students were required to obtain a case history with the simulated caregivers. The second simulation focused on intervention, and students recommended communication strategies to the simulated caregivers. Students’ self-perceived level of skills, confidence and anxiety were assessed before and after the simulation sessions. Results Students reported significant increases in their confidence level following simulation sessions. They perceived themselves as much better prepared for working with real patients in upcoming clinical placements. Conclusion Simulation-based learning experience in a controlled environment enhances preclinical SLP students’ perceived confidence levels and clinical competence.

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ABSTRACT Purpose To translate and culturally adapt the Hyperacusis Handicap Questionnaire (HHQ) to Brazilian Portuguese. Methods The cultural adaptation followed the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines and included five stages: 1) translation of the questionnaire from English to Brazilian Portuguese (BP) by two bilingual translators; 2) synthesis of the translations into a consensus version; 3) back-translation into English by two professional translators; 4) development of the pre-final version of the HHQ in Brazilian Portuguese by a committee of experts; and 5) testing of the pre-final and adjusted pre-final versions with individuals from the target population. Results No discrepancies were observed in the title, key responses, or questionnaire items throughout the translation process. In the pre-final version testing phase, more than 80% of participants understood the HHQ items in BP, demonstrating the effectiveness of the adaptation. However, four items were adjusted based on participants’ suggestions during the testing phase. Subsequently, the adjusted pre-final version was tested, with 100% of participants demonstrating comprehension of the items, confirming its appropriateness for the Brazilian population. During the linguistic equivalence assessment, none of the participants selected the "not applicable" option, further validating the relevance of the questions to the Brazilian context. Additionally, an introductory statement was added, providing detailed instructions on how to complete the questionnaire. Conclusion The cultural adaptation of the HHQ to Brazilian Portuguese was completed, resulting in the final version titled Hyperacusis Handicap Questionnaire in Brazilian Portuguese (HHQ-BP). Validation of this version is currently in progress.

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RESUMO Objetivo Comparar tempo de resposta neural entre os componentes corticais do Potencial Evocado Auditivo de Longa Latência, medindo a latência e interpicos em indivíduos com e sem zumbido. Método Estudo de caráter analítico, transversal e quantitativo. Participaram do estudo 28 indivíduos, divididos em dois grupos: Grupo Controle, composto por 12 indivíduos sem percepção do zumbido e Grupo Estudo, composto por 16 participantes com transtorno do zumbido. As avaliações foram divididas em dois dias. Inicialmente todos os pacientes foram submetidos a anamnese semi-estruturada, avaliação audiológica básica, testes comportamentais do processamento auditivo central, avaliação neuropsicológica e do zumbido. No segundo dia, foram realizados o PEAC-verbal e o PEATE-neurodiagnóstico. Foram comparadas as respostas da avaliação por meio da latência dos potenciais P1, N1, P2. A análise de comparação entre os grupos foi realizada por meio do teste T para amostras independentes. Resultados Evidenciou-se diferença estatisticamente significante dos valores de interpicos dos potenciais P1-P2 e tendências à significância entre N1-P2 entre os grupos na orelha direita e na comparação de interpicos dos potenciais P1-P2 entre grupos na orelha esquerda. Conclusão Indivíduos com transtorno do zumbido apresentaram interpicos maiores, o que sugere desorganização do funcionamento auditivo central e aumento de resposta entre as interconexões neurais no processamento acústico.

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ABSTRACT Purpose To compare neural response times among cortical components of the Long-Latency Auditory Evoked Potential (LLAEP) by measuring latency and interpeak intervals in individuals with and without tinnitus. Method This was an analytical, cross-sectional, and quantitative study. A total of 28 participants were included, divided into two groups: the Control Group, comprising 12 individuals without tinnitus perception, and the Study Group, comprising 16 individuals diagnosed with tinnitus disorder. Assessments were conducted over two sessions. Initially, all participants underwent a semi-structured anamnesis, basic audiological evaluation, behavioral tests of central auditory processing, as well as neuropsychological and tinnitus assessments. On the second day, verbal LLAEP and neurodiagnostic ABR were performed. The responses were compared by analyzing the latency of P1, N1, and P2 potentials. A between-group comparison was conducted using an independent sample t-test. Results A statistically significant difference was observed in the interpeak intervals of P1-P2 potentials, as well as a trend toward significance in N1-P2 interpeak intervals between groups in the right ear. Additionally, a significant difference was found in P1-P2 interpeak intervals between groups in the left ear. Conclusion Individuals with tinnitus disorder exhibited longer interpeak intervals, suggesting central auditory processing dysfunction and increased neural response within auditory processing pathways.

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RESUMO Objetivo Analisar as percepções de fonoaudiólogos/as e pais ou responsáveis acerca do desempenho das habilidades pragmáticas de crianças com transtorno do espectro do autismo (TEA), entre 2 e 12 anos, em acompanhamento fonoaudiológico. Método Estudo transversal, prospectivo, observacional, analítico, conduzido em clínica particular de fonoaudiologia na Região Centro-Oeste do Brasil, incluindo dois grupos, por conveniência: Grupo 1. nove fonoaudiólogos/as que estavam atendendo 70 crianças com TEA, na faixa etária estabelecida; Grupo 2. 70 pais ou responsáveis ou cuidadores/as destas crianças. Os participantes responderam ao Protocolo de Avaliação de Habilidades Pragmáticas de Crianças com Transtorno do Espectro do Autismo (PAHPEA). Foram conduzidas análises descritivas para identificar as dificuldades pragmáticas das crianças percebidas pelos dois grupos, teste U de Mann-Whitney para comparar as percepções dos participantes dos dois grupos sobre as habilidades pragmáticas das crianças e análise correlacional Spearman rho para verificar se houve associação entre estas percepções dos participantes dos dois grupos. Resultados Houve diferença estatisticamente significativa de forma pontual em três dos cinco fatores abarcados pelo PAHPEA (responsividade, funcionalidade e inadequação), pois os integrantes do Grupo 1 interpretaram o desempenho das crianças de forma diferente daquela dos participantes do Grupo 2. Conclusão No geral, as percepções de fonoaudiólogos/as e pais ou responsáveis se aproximaram em quase todos os fatores e questões avaliados, houve convergência significativa com concordância superior à 75% nas respostas ao PAHPEA.

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ABSTRACT Purpose To analyze the perceptions of speech therapists and parents or guardians regarding the performance of pragmatic skills of children with autism spectrum disorder (ASD), between 2 and 12 years old, undergoing speech therapy. Method Cross-sectional, prospective, observational, analytical study, conducted in a speech therapy clinic in the Midwestern Region of Brazil, including two groups and convenience sampling: Group 1. nine speech therapists who were caring for 70 children with ASD, in the established age range; Group 2. 70 parents or guardians or caregivers of these children. Participants responded to the Protocol for the Assessment of Pragmatic Skills of Children with Autism Spectrum Disorders (PAHPEA). Descriptive analyses were conducted to identify the children's pragmatic difficulties perceived by the two groups, Mann-Whitney U test to compare the perceptions of participants in the two groups about the children's pragmatic skills, and Spearman rho correlational analysis to verify the occurrence of an association between these perceptions of participants in both groups. Results A statistically significant difference was found in three of the five factors covered by PAHPEA (responsiveness, functionality, and inadequacy), as the members of Group 1 interpreted the children's performance differently from that of the participants in Group 2. Conclusion Overall, the perceptions of speech therapists and parents or guardians were similar in almost all factors and questions evaluated.

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RESUMO Objetivo Descrever e validar as atividades do Programa de Intervenção do Ciclos Adaptado (PROCICLOS-A) para crianças com transtorno dos sons da fala tipo fonológico idiopático. Método Estudo prospectivo, transversal, de análise quantitativa. O PROCICLOS-A conta com 12 sessões, em que a cada seis sessões um processo fonológico é alvo da intervenção, sendo dois processos fonológicos e para cada um deles dois sons alvos são trabalhados, totalizando quatro sons alvos. Cada uma das 12 sessões conta com seis tipos de atividades: bombardeamento auditivo (no início e final da sessão); treino do ponto, modo articulatório e vozeamento do som alvo; reconhecimento auditivo do som alvo e discriminação auditiva com pares mínimos; atividades com pares mínimos para compreensão da regra; treino em palavras com o som alvo em posição inicial, medial e final; e atividades de consciência fonológica. Materiais específicos foram criados para executar cada estratégia. Participaram do estudo vinte juízes especialistas (JE), que fizeram o julgamento de todas as cinco atividades e suas 14 estratégias respectivas. Para as análises de concordância entre os juízes quanto as respostas referentes às atividades, foi aplicado um coeficiente alternativo, denominado AC1, proposto por Gwet (2014). Resultados A concordância entre os JE para as atividades foi de 0,7125, considerado um valor de concordância moderado. Conclusão As atividades do PROCICLOS-A para crianças com transtorno dos sons da fala apresentaram índice bom de concordância para todo o material produzido.

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ABSTRACT Purpose This document aims to describe and validate the activities of the Adapted Cycles Intervention Program (PROCICLOS-A) for children with speech sound disorders. Method The study employs a prospective, cross-sectional design focusing on quantitative analysis. PROCICLOS-A consists of 12 sessions, with a specific phonological process selected as the target for every six sessions. In total, two phonological processes and two target sounds are chosen for each cycle, resulting in four target sounds for the intervention. Each of the 12 sessions includes six types of activities: auditory bombardment, conducted at the beginning and end of each session, training in the production of the target sound, focusing on the articulation zone, mode, and voicing, auditory recognition of the target sound and auditory discrimination using minimal pairs, activities with minimal pairs to aid in understanding the phonological rule, training with words containing the target sound in initial, medial, and final positions, and phonological awareness activities. Specific materials were developed to implement each of these strategies. A total of twenty expert judges (EJs) participated in evaluating the activities, assessing all five activities along with their 14 respective strategies. To analyze the level of agreement among the judges, we utilized an alternate coefficient known as AC1, proposed by Gwet (2014). This analysis focused on the judges' responses related to the activities. Results The agreement among the ten EJs for the activities was measured at 0.7125, indicating a moderate level of agreement. Conclusion The activities utilized in PROCICLOS-A for children with speech disorders demonstrated a good level of agreement for all the materials produced.

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ABSTRACT Purpose To evaluate usability and clinical impact of an application for tinnitus identification and intervention. Methods This was a pre- and post-test observational study. A convenience sample included individuals with tinnitus complaints and normal hearing who were on a waiting list at a teaching clinic. Audiological assessment included conventional and high-frequency audiometry, immittance testing, tinnitus pitch matching, Tinnitus Handicap Inventory, and Visual Analog Scale. The intervention consisted of auditory training. The application was assessed for efficiency, effectiveness, and participant satisfaction using the System Usability Scale and Net Promoter Score. The Shapiro-Wilk test assessed normality. Paired t-tests and Wilcoxon tests were applied, adopting a 5% significance level. Missing data were excluded from final analysis. Results From the sample of 29 participants, 23 completed the final evaluation. 47.8% were male and 52.2% female. Mean age of 46 years. All had experienced tinnitus for over six months. 39% reported a hissing sound, 43.5% a whistling sound, and 17.5% a cicada-like sound. Usability assessment showed an average score of 77.06, with 50% of participants classified as promoters, 25% as neutral, and 25% as detractors. Pre- and post-intervention results with the Zumit app demonstrated a statistically significant reduction in Visual Analog Scale scores (W = -231.000, p < 0.001) and a decrease of 21.478 points (p < 0.001) in the overall Tinnitus Handicap Inventory score. Conclusion The Zumit app featuring frequency discrimination auditory training, may be an effective tool for tinnitus management. Limitations include the sample size and restricted generalization to individuals with normal audiometry.

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RESUMO Objetivo Analisar os efeitos da Fotobiomodulação (FBM) associada à Reabilitação Vestibular (RV) em adultos com sintomas vestibulares e zumbido, em comparação com a RV associada à FBM placebo, quanto à redução do incômodo do zumbido e à melhora da função vestibular, equilíbrio postural e acuidade visual dinâmica. Método Ensaio clínico randomizado, triplo-cego, com 20 voluntários diagnosticados com hipofunção vestibular e zumbido crônico. Os participantes foram alocados em dois grupos: grupo pesquisa (GP), submetido à RV com FBM ativa; e grupo controle (GC), submetido à RV com FBM placebo. Cada grupo realizou dez sessões, duas vezes por semana, durante cinco semanas. As avaliações pré e pós-intervenção incluíram: Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI), Escala Visual Analógica (EVA), teste de Acuidade Visual Dinâmica (AVD) e posturografia. Os dados foram analisados pelos testes t de Student e Mann-Whitney (p<0,05). Resultados Na comparação entre os grupos no momento pós- intervenção , O GP apresentou melhora significativa na EVA para zumbido (p=0,046), nos domínios funcional (p=0,003), emocional (p=0,002) e total (p=0,000) do THI. O parâmetro Análise Sensorial da Função Vestibular mostrou diferença significante nos momentos pré e pós- terapia (p=0,003) apenas no GP. A EVA Sintomas Vestibulares, os escores do DHI e o Índice de Equilíbrio Composto apresentaram melhora nos dois grupos, sem diferença estatística. Conclusão A FBM associada à RV reduziu significativamente o incômodo do zumbido e apresentou um desempenho superior na Análise Sensorial da Função Vestibular . A RV isolada não demonstrou efeito na redução do zumbido.

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ABSTRACT Purpose To analyze the effects of photobiomodulation (PBM) associated with vestibular rehabilitation (VR) in adults with vestibular symptoms and tinnitus, compared to VR combined with placebo PBM, regarding the reduction of tinnitus discomfort and improvements in vestibular function, postural balance, and dynamic visual acuity. Methods Randomized, triple-blind clinical trial with 20 volunteers diagnosed with vestibular hypofunction and chronic tinnitus. Participants were allocated into two groups: research group (RG), which received VR combined with active PBM; and control group (CG), which received VR combined with placebo PBM. Both groups underwent ten intervention sessions, twice a week, over five weeks. Pre- and post-intervention assessments included: Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS), dynamic visual acuity (DVA) test, and posturography. Data were analyzed using Student's t-test and the Mann-Whitney test (p<0.05). Results In the post-intervention comparison between groups, the RG showed significant improvement in VAS for tinnitus (p=0.046), and in the functional (p=0.003), emotional (p=0.002), and total (p=0.000) scores of the THI. The Sensory Organization Test parameter showed a significant pre- and post-treatment difference (p=0.003) only in the RG. VAS for vestibular symptoms, DHI scores, and the Composite Equilibrium Score improved in both groups, with no significant difference between them. Conclusion PBM combined with VR significantly reduced tinnitus discomfort and showed superior performance in vestibular function analysis. VR alone did not demonstrate any effect on tinnitus reduction.

Resumo em Português:

RESUMO Objetivo Investigar os efeitos do tabaco, a influência do tempo de fumo e da quantidade de cigarros/dia no campo dinâmico da voz de homens fumantes. Método Estudo observacional transversal e comparativo. Participaram 62 homens entre 18 e 59 anos: 31 no grupo fumantes (GF) e 31 no grupo de não fumantes (GNF). O campo dinâmico da voz dos participantes foi obtido pela fonetografia que registra medidas de frequência (mínima, máxima e extensão vocal) e de intensidade (mínima, máxima e extensão dinâmica máxima). As medidas da fonetografia dos participantes dos GF foram comparadas com as do GNF pelo Teste t Student e correlacionadas com o tempo de fumo e com número de cigarros por dia pelo Teste de correlação de Pearson, nível de significância 5%. Resultados O GF apresentou valores menores (p<0,05) em relação ao GNF na frequência máxima, extensão vocal e extensão dinâmica máxima e valor maior na intensidade mínima. O tempo maior de fumo reduziu as frequências mínima e máxima, a extensão vocal e a intensidade máxima. A quantidade maior de cigarros/dia diminuiu a frequência mínima. Conclusão O campo dinâmico dos homens fumantes, comparados a homens não fumantes, apresentou redução dos valores de frequência máxima, extensão vocal e extensão dinâmica máxima e aumento da intensidade mínima. Quanto maior o tempo de uso do tabaco, menores as frequências mínima e máxima, a extensão vocal e a intensidade máxima. Quanto maior a quantidade de cigarros/dia, menor o valor da frequência mínima. A fonetografia é um recurso eficaz nas avaliações da voz.

Resumo em Inglês:

ABSTRACT Purpose To investigate the effects of tobacco use, smoking duration, and number of cigarettes/day on the vocal dynamic field of male smokers. Methods A cross-sectional, comparative observational study was conducted with 62 men aged 18 to 59 years: 31 smokers (SG) and 31 non-smokers (NSG). Vocal dynamic field measurements were obtained using phonetography, which assesses frequency (minimum, maximum, and vocal range) and intensity (minimum, maximum, and maximum dynamic range). Comparisons between groups were made using the Student’s t-test, and correlations with smoking duration and number of cigarettes/day were analyzed using Pearson’s correlation test (5% significance level). Results Compared to the NSG, the SG showed significantly lower values (p < 0.05) for maximum frequency, vocal range, and maximum dynamic range, and higher values for minimum intensity. Increased smoking duration was associated with reductions in minimum and maximum frequencies, vocal range, and maximum intensity. Additionally, a higher number of cigarettes/day was correlated with lower minimum frequency. Conclusion The dynamic field of male smokers, compared to non-smokers, showed a reduction in the values of maximum frequency, vocal range and maximum dynamic range and an increase in minimum intensity. The longer the time of tobacco use, the lower the minimum and maximum frequencies, vocal range and maximum intensity. The greater the number of cigarettes/day, the lower the value of minimum frequency. Phonetography is an effective resource in voice assessments.

Resumo em Português:

RESUMO Objetivo Analisar os efeitos vocais do treinamento muscular inspiratório por 28 dias em mulheres sem queixas vocais. Método Participaram do estudo 22 mulheres sem queixas vocais, que realizaram treinamento inspiratório com Exercitador e Incentivador Respiratório Respiron® Classic. O treinamento consistiu em 2 séries por dia, de 30 repetições, durante 28 dias consecutivos. Amostras vocais foram coletadas pré e pós treinamento e comparadas quanto a: julgamento perceptivo-auditivo (JPA), análise acústica, medidas aerodinâmicas, diadococinesia e autoavaliação vocal. Os dados foram analisados estatisticamente por meio de testes dependentes. Resultados Não foram encontradas diferenças no JPA da vogal sustentada /a/ e da contagem de números. Foram encontradas diferenças na análise acústica, com diminuição da mediana de Shimmer % e aumento de HNR. Houve aumento das médias dos tempos máximos de fonação da vogal /i/, das fricativas /s/ e /z/ e da contagem de números. Houve, ainda, aumento das médias do número de repetição de sílabas na diadococinesia das sílabas /ka/ e /pataka/ e da vogal /a/. Aumento das médias do protocolo de autoavaliação QVV físico e QVV total, e diminuição do IDV-10; ESV limitação, ESV físico e ESV total. Conclusão Pode-se inferir que o treinamento inspiratório promoveu maior eficiência fonatória e aumento do controle aerodinâmico, propiciando uma melhora na qualidade vocal. Assim sendo, incentiva-se o treinamento muscular inspiratório para sujeitos sem queixas vocais que desejem obter aumento de sua eficiência fonatória.

Resumo em Inglês:

ABSTRACT Purpose To analyze the vocal effects of inspiratory muscle training for 28 days in women without vocal complaints. Methods The study included 22 women with no vocal complaints who underwent inspiratory training with the Respiron® Classic Breathing Trainer and Stimulator. The training consisted of 2 sets per day of 30 repetitions for 28 consecutive days. Vocal samples were collected pre and post training and compared regarding auditory-perceptual evaluation (APE), acoustic analysis, aerodynamic and diadochokinesis measurements, and vocal self-assessment. The data was statistically analyzed using dependent tests. Results No differences were found in the APE of the sustained vowel /a/ and number counting. Differences were found in the acoustic analysis, with a decrease in the median Shimmer % and an increase in HNR. There was an increase in the average maximum phonation times of the vowel /i/, of the fricatives /s/ and /z/, and counting numbers. There was also an increase in the average number of syllable repetitions in the diadochokinesis of the syllables /ka/ and /pataka/ and the vowel /a/. Increase in the means of the physical V-RQOL self-assessment protocol and total V-RQOL, and decrease in VHI-10; VoiSS limitation, VoiSS physical, and total VoiSS. Conclusion It can thus be inferred that the inspiratory training resulted in enhanced phonatory efficiency and augmented aerodynamic control, thereby conferring an improvement in vocal quality. It is therefore recommended that subjects who do not present vocal complaints and who wish to enhance their phonatory efficiency engage in inspiratory muscle training.

Resumo em Inglês:

ABSTRACT The aim of this study was to examine the effects of tDCS during intensive word-finding therapy on subacute aphasia after stroke. A single-case study with an 86-year-old man with four years of formal education, diagnosed with an ischemic stroke in the left hemisphere, resulting in non-fluent aphasia of the mixed type, accompanied by acquired apraxia of speech. For this purpose, the Montreal-Toulouse Language Assessment Battery - Brief Version was administered at five different time points: (A1) one week before the start of treatment; (A2) after the first session; (A3) after five sessions; (A4) after ten sessions and; (A5) after 30 days without intervention. The Naming and Visual Recognition Test was also administered at points A1, A4 and A5. After the intervention, improvements were noted in word naming and verbal word comprehension. There was a reduction in linguistic errors such as paraphasias. These results support the combination of tDCS and behavioral training.

Resumo em Inglês:

ABSTRACT Purpose This study aimed to map studies that investigated the influence of speech rate on the reproduction of audiovisual resources in university students' learning using a Scope review. Research strategies The PCC strategy was used where P- University students, C- Increased or decreased speech rate, C- Learning. The searches were conducted using the SciELO, Lilacs, PubMed, Scopus, Web of Science, and Google Scholar databases. Selection criteria Scientific articles published in the databases above with a target audience of university students were included; works that compared average speech rate with increased or decreased speed and had learning-related skills as the study response. Data analysis The Joanna Briggs Institute checklists were used for methodological quality assessment. Results We found that four articles observed an improvement in learning performance when the audiovisual resource was presented at a speed of up to 2x, three did not observe a difference and two studies observed a worsening in the skills involved in learning.The results indicate a low risk of bias in most studies included. Conclusion A study indicated improved learning in audiovisuals at a speed slower than 1x. It was observed that reproduction speed rates of audiovisual resources impact university students' learning process. Rates greater than 2x limit the learning process. Rates within the normal range (between 1x and 1.75x) are more favorable for capturing the content.

Resumo em Português:

RESUMO Objetivo mapear ações sobre voz na infância desenvolvidas em escolas públicas brasileiras e analisá-las segundo componentes do Programa Saúde na Escola (PSE). Estratégia de pesquisa trata-se de uma revisão de escopo, estruturada segundo as diretrizes metodológicas do Instituto Joanna Briggs (JBI) e que teve como pergunta norteadora: Quais ações sobre voz na infância são desenvolvidas em escolas públicas do Brasil e quais componentes do PSE estão contemplados nessas ações? Foi realizada busca eletrônica nas bases de dados MEDLINE, LILACS, Scopus, Web of Science, Embase e Cochrane, busca manual na literatura cinzenta, lista de citações e consulta aos especialistas. As estratégias de busca foram compostas por termos livres e indexados relacionados ao tema e adaptados para cada fonte de evidências. Critérios de seleção foram selecionados estudos envolvendo escolares até 12 anos de idade, ações sobre voz desenvolvidas por fonoaudiólogos, em escolas da rede pública de ensino e publicados após 2007. Foram extraídos dados da publicação, da amostra e ações sobre voz infantil segundo os componentes do PSE. Análise dos dados a análise de dados foi descritiva. Resultados foram encontrados 4.087 estudos e 27 foram selecionados. As ações envolveram os escolares, com maior frequência, seguidos pelos pais e professores; 26 estudos incluíram ações de avaliação das condições de saúde dos escolares e um, ações de promoção da saúde e prevenção de agravos em um curso online para pais e escolares. O procedimento de avaliação mais frequente foi o julgamento perceptivo-auditivo. Conclusão estudos na área de voz na infância em escolas são escassos e priorizam avaliação das condições de saúde vocal.

Resumo em Inglês:

ABSTRACT Purpose To map childhood voice interventions developed in Brazilian public schools and analyze them according to components of the School Health Program (SHP). Research strategies This was a scoping review, structured according to the methodological guidelines of the Joanna Briggs Institute (JBI). The research question was, “What childhood voice interventions are developed in Brazilian public schools, and which SHP components are included in these interventions?”. An electronic search was conducted in the MEDLINE, LILACS, Scopus, Web of Science, Embase, and Cochrane databases, along with a manual search of gray literature, citation lists, and expert consultations. The search strategies consisted of free and indexed terms related to the topic and adapted for each source of evidence. Selection criteria The review included studies involving schoolchildren up to 12 years old with voice interventions developed by speech-language-hearing pathologists in public schools, published after 2007. It extracted data regarding the publication, the sample, and childhood voice interventions according to the SHP components. Data analysis Data analysis was descriptive. Results 4,087 studies were found, and 27 were selected. The most common interventions involved students, followed by parents and teachers. Twenty-six studies included assessments of students' health conditions, and one included health promotion and disease prevention actions in an online course for parents and students. The most common assessment procedure was auditory-perceptual evaluation. Conclusion Studies on childhood voice in schools are scarce and prioritize assessment of vocal health conditions.

Resumo em Português:

RESUMO Objetivo Descrever o processamento do som no sistema auditivo a partir dos potenciais evocados auditivos. Estratégia de pesquisa Foi realizada uma revisão da literatura sobre o processamento auditivo sob a perspectiva da avaliação eletrofisiológica auditiva, considerando estudos clássicos e atuais da área. Critérios de seleção Foram incluídos estudos que abordaram os potenciais evocados auditivos e sua relação com os processos de codificação, decodificação, discriminação, percepção e congruência semântica do som. Análise dos dados Os dados foram analisados de forma descritiva e crítica, integrando informações sobre diferentes potenciais evocados auditivos e seus respectivos papéis no processamento auditivo. Resultados O sistema auditivo organiza e codifica características acústicas, como frequência, intensidade e modulações temporais, transformando-as em representações neurais interpretadas pelo córtex. Os potenciais evocados auditivos fornecem informações sobre os processos de codificação, decodificação, discriminação, percepção e congruência semântica. O Frequency Following Response avalia a precisão da codificação neural dos sons, especialmente da fala; os potenciais evocados auditivos corticais refletem processos avançados de codificação, decodificação e discriminação; e o N400 está associado à congruência semântica, elucidando o processamento auditivo cognitivo. Conclusão Os potenciais evocados auditivos são ferramentas importantes para a avaliação do processamento auditivo, contribuindo para o diagnóstico de transtornos e para o monitoramento do desempenho auditivo em diferentes populações.

Resumo em Inglês:

ABSTRACT Purpose To describe sound processing in the auditory system based on auditory evoked potentials. Research strategies A literature review was conducted on auditory processing from the perspective of electrophysiological auditory assessment, considering both classical and current studies in the field. Selection criteria Studies addressing auditory evoked potentials and their relationship with sound encoding, decoding, discrimination, perception, and semantic congruence processes were included. Data analysis Data were analyzed in a descriptive and critical manner, integrating information on different auditory evoked potentials and their respective roles in auditory processing. Results The auditory system organizes and encodes acoustic features, such as frequency, intensity, and temporal modulations, transforming them into neural representations interpreted by the cortex. Auditory evoked potentials provide information on encoding, decoding, discrimination, perception, and semantic congruence processes. The frequency-following response evaluates the accuracy of neural encoding of sounds, especially speech; cortical auditory evoked potentials reflect advanced processes of encoding, decoding, and discrimination; and the N400 is associated with semantic congruence, elucidating cognitive auditory processing. Conclusion Auditory evoked potentials are important tools for evaluating auditory processing, contributing to the diagnosis of disorders and to the monitoring of auditory performance across different populations.

Resumo em Português:

RESUMO Objetivo Esta metanálise tem o objetivo de avaliar a evidência existente dos efeitos da tDCS nas alterações de fala e de voz de pacientes com DP. Estratégias de Pesquisa PubMed, LILACS, EMBASE, Cochrane Central Register of Controlled Trials, Science Direct, Web of Science, Scopus e de literatura cinzenta Google Scholar e Open Grey. A busca incluiu os descritores: “Parkinson Disease, Transcranial Direct Current Stimulation, Voice, Speech” combinados com AND e OR. Critérios de Seleção Pacientes com a Doença de Parkinson, ambos os sexos. Uso da Estimulação Transcraniana por Corrente Contínua (tDCS) para tratar os parâmetros de voz e fala nos pacientes acometidos pela Doença de Parkinson. Análise de dados Um total de 1.345 artigos, 14 artigos incluídos na revisão sistemática e 6 artigos na metanálise. O risco de viés e o nível de evidência foram avaliados pelo software REVIEW MANAGER 5.4.1. e GRADE. Resultados Os resultados mostraram um tamanho de efeito geral da tDCS de Z= 0.89 (P=0.37). Estudos com área alvo no córtex pré-frontal (PFC) apresentaram maior tamanho de efeito 1.38(P=0.17), portanto com maior impacto para desfecho de fala e voz com uso de tDCS para DP. Três estudos apresentaram baixo risco de viés e três estudos apresentaram risco pouco claro. Conclusão Apesar do baixo número de estudos, os achados desta metanálise sugerem a potencial aplicabilidade da tDCS como ferramenta adjuvante no tratamento das alterações de voz e fala em pacientes com DP.

Resumo em Inglês:

ABSTRACT Purpose This meta-analysis aims to evaluate the existing evidence on the effects of tDCS on speech and voice alterations in patients with PD. Search strategies PubMed, LILACS, EMBASE, Cochrane Central Register of Controlled Trials, Science Direct, Web of Science, Scopus, and gray literature searches: Google Scholar and Open Grey. The search included the descriptors: "Parkinson Disease, Transcranial Direct Current Stimulation, Voice, Speech" combined with AND and OR. Selection criteria Patients with Parkinson's Disease, both sexes. Use of Transcranial Direct Current Stimulation (tDCS) to treat voice and speech parameters in patients with Parkinson's Disease. Data analysis A total of 1,345 articles were included, 14 articles in the systematic review and 6 articles in the meta-analysis. The risk of bias and level of evidence were assessed using REVIEW MANAGER 5.4.1 and GRADE software. Results The results showed an overall effect size of tDCS of Z=0.89 (P=0.37). Studies targeting the prefrontal cortex (PFC) showed a larger effect size of 1.38 (P=0.17), thus demonstrating a greater impact on speech and voice outcomes with the use of tDCS for PD. Three studies presented a low risk of bias, and three studies presented an unclear risk. Conclusion Despite the small number of studies, the findings of this meta-analysis suggest the potential applicability of tDCS as an adjunctive tool in the treatment of voice and speech disorders in patients with PD.