Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_SP |
Texto Completo: | https://tede2.pucsp.br/handle/handle/22988 |
Resumo: | INTRODUCTION: the speech therapy approach through Orofacial Myofunctional Therapy (BMT) has been presented as one of the possibilities of alternative treatment for sleep obstructive respiratory disorders, evidenced in studies with adults and children. Although the effectiveness of this intervention has been demonstrated, the morpho functional mechanisms that trigger the results obtained are poorly elucidated. OBJECTIVE: perform morpho-functional analysis of the Upper Airway during oropharyngeal exercises seeking to verify its immediate effects on mobility, stiffening and modification of oropharyngolaryngeal spaces, as well as, to verify which exercises provide greater changes in Upper Airway and greater electrical activity in suprahyoid muscles and masseters. METHOD: from the specific literature, thirteen exercises were selected for analysis. After relevant ethical processes ( CAAE: 94754418.4.0000.5482 ), respecting inclusion and exclusion criteria, fifteen healthy adult subjects, both sexes, with a mean age of 27.5 years, underwent clinical orofacial myofunctional evaluation and individual training on how to perform each exercise. Data collection consisted of surface electromyographic assessment (EMGs) of the masseter and suprahyoid muscles and recording of Upper Airway dynamics through Nasofibrolaryngoscopy (NFL), during the performance of each exercise. For the EMGs analysis, the data were normalized, tabulated according to the average of the potentials obtained and submitted to statistical analysis: ANOVA, Mauchly's test with Greenhouse correction - Geisser, tests Least Significant Difference (LSD), Bonferroni, and Pearson for correlation of results between the pairs of muscles analyzed. As for the NFL data, the exercises were recorded in two regions: nasopharynx and oropharynx / hypopharynx resulting in a sample of 390 videos, sent to the judges: three otorhinolaryngologists, blind to the subjects and to the exercises. The analyzes were recorded in a specific instrument consisting of structural verification , movement type and classification. It was made analysis of agreement between the judges: Fleiss Kappa Agreement Coefficient, for the comparison between exercises, the Friedman Test was used. RESULTS: The subjects presented vertical and transverse mobility of the present soft palate, extension of the normal uvula, symmetry of the present uvula, normal oropharyngeal region, medium face with straight or convex profile. The 13 exercises analyzed provide a mechanism of action in the Upper Airway and electrical activity of the suprahyoid muscles and masseters. The methodology used allowed to identify which exercises have greater electromyographic responses and which provide greater mobility, stiffness and modification for the regions of soft palate, pharyngeal / hypopharyngeal wall, retrolingual region and epiglottis. CONCLUSION: The results of the present study collaborate to comprehension how the exercises used in orofacial myofunctional therapy for OSA act and contribute to choosing the best clinical approach in other areas of speech therapy |
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Bianchini, Esther Mandelbaum Gonçalveshttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K8733842H4Silva, Andresa Santos da2020-03-04T10:08:56Z2020-02-18Silva, Andresa Santos da. Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono. 2020. 175 f. Dissertação (Mestrado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020.https://tede2.pucsp.br/handle/handle/22988INTRODUCTION: the speech therapy approach through Orofacial Myofunctional Therapy (BMT) has been presented as one of the possibilities of alternative treatment for sleep obstructive respiratory disorders, evidenced in studies with adults and children. Although the effectiveness of this intervention has been demonstrated, the morpho functional mechanisms that trigger the results obtained are poorly elucidated. OBJECTIVE: perform morpho-functional analysis of the Upper Airway during oropharyngeal exercises seeking to verify its immediate effects on mobility, stiffening and modification of oropharyngolaryngeal spaces, as well as, to verify which exercises provide greater changes in Upper Airway and greater electrical activity in suprahyoid muscles and masseters. METHOD: from the specific literature, thirteen exercises were selected for analysis. After relevant ethical processes ( CAAE: 94754418.4.0000.5482 ), respecting inclusion and exclusion criteria, fifteen healthy adult subjects, both sexes, with a mean age of 27.5 years, underwent clinical orofacial myofunctional evaluation and individual training on how to perform each exercise. Data collection consisted of surface electromyographic assessment (EMGs) of the masseter and suprahyoid muscles and recording of Upper Airway dynamics through Nasofibrolaryngoscopy (NFL), during the performance of each exercise. For the EMGs analysis, the data were normalized, tabulated according to the average of the potentials obtained and submitted to statistical analysis: ANOVA, Mauchly's test with Greenhouse correction - Geisser, tests Least Significant Difference (LSD), Bonferroni, and Pearson for correlation of results between the pairs of muscles analyzed. As for the NFL data, the exercises were recorded in two regions: nasopharynx and oropharynx / hypopharynx resulting in a sample of 390 videos, sent to the judges: three otorhinolaryngologists, blind to the subjects and to the exercises. The analyzes were recorded in a specific instrument consisting of structural verification , movement type and classification. It was made analysis of agreement between the judges: Fleiss Kappa Agreement Coefficient, for the comparison between exercises, the Friedman Test was used. RESULTS: The subjects presented vertical and transverse mobility of the present soft palate, extension of the normal uvula, symmetry of the present uvula, normal oropharyngeal region, medium face with straight or convex profile. The 13 exercises analyzed provide a mechanism of action in the Upper Airway and electrical activity of the suprahyoid muscles and masseters. The methodology used allowed to identify which exercises have greater electromyographic responses and which provide greater mobility, stiffness and modification for the regions of soft palate, pharyngeal / hypopharyngeal wall, retrolingual region and epiglottis. CONCLUSION: The results of the present study collaborate to comprehension how the exercises used in orofacial myofunctional therapy for OSA act and contribute to choosing the best clinical approach in other areas of speech therapyINTRODUÇÃO: a abordagem fonoaudiológica por meio da Terapia Miofuncional Orofacial (TMO) vem sendo apresentada como uma das possibilidades de tratamento alternativo para os distúrbios respiratórios obstrutivos do sono, evidenciada em estudos com adultos e crianças. Embora demonstrada a eficácia dessa intervenção, os mecanismos morfofuncionais que desencadeiam os resultados obtidos são pouco elucidados. OBJETIVO: realizar análise morfo-funcional da Via Aérea Superior (VAS) durante exercícios orofaríngeos buscando verificar seus efeitos imediatos na mobilidade, enrijecimento e modificação dos espaços orofaringolaríngeos, assim como, verificar quais exercícios propiciam maiores modificações na VAS e maior atividade elétrica em musculatura supra-hióidea e masseteres. MÉTODO: A partir da literatura específica, treze exercícios foram selecionados para análise. Após processos éticos pertinentes (CAAE: 94754418.4.0000.5482), respeitando-se critérios de inclusão e exclusão, quinze sujeitos adultos saudáveis, ambos os sexos com média de idade de 27,5 anos foram submetidos à avaliação clínica miofuncional orofacial e treinamento individual quanto ao modo de execução de cada exercício. A coleta de dados constou de: avaliação eletromiográfica de superfície (EMGs) dos músculos masseteres e supra-hióideos e registro da dinâmica da VAS por meio da Nasofibrolaringoscopia (NFL), durante a realização de cada exercício. Para as análises da EMGs os dados foram normalizados, tabulados quanto à média dos potenciais obtidos e submetidos às análises estatísticas: ANOVA, teste de Mauchly's com correção de Greenhouse – Geisser, testes Least Significant Difference (LSD), Bonferroni, e Pearson para correlação dos resultados entre os pares de músculos analisados. Quanto aos dados da NFL, os exercícios foram registrados em duas regiões: nasofaringe e orofaringe/hipofaringe resultando numa amostra de 390 vídeos, enviados aos juízes: três médicos otorrinolaringologistas, cegos quanto aos sujeitos e quanto aos exercícios. As análises foram registradas em instrumento específico constando de verificação estrutural, tipo e classificação do movimento. Foi realizada análise de concordância entre os juízes: Coeficiente de Concordância Fleiss Kappa, para a comparação entre os exercícios foi utilizado o Teste de Friedman. RESULTADOS: Os sujeitos apresentaram mobilidade vertical e transversal do palato mole presente, extensão da úvula normal, simetria da úvula presente, região orofaríngea normal, face média com perfil reto ou convexo. Os 13 exercícios analisados propiciam mecanismo de ação na VAS e atividade elétrica da musculatura supra-hióidea e masseteres. A metodologia utilizada permitiu identificar quais exercícios apresentam maiores respostas eletromiográficas e quais propiciam maior mobilidade, enrijecimento e modificação para as regiões de palato mole, parede faríngea/hipofaríngea, região retrolingual e epiglote. CONCLUSÃO: Os resultados do presente estudo colaboram para compreensão de como os exercícios utilizados na terapêutica miofuncional orofacial para AOS atuam e contribuem para escolha da melhor abordagem clínica de outras áreas da fonoaudiologiaConselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/51600/Andresa%20Santos%20da%20Silva.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em FonoaudiologiaPUC-SPBrasilFaculdade de Ciências Humanas e da SaúdeTerapia Miofuncional OrofacialNasofibrolaringoscopiaEletromiografia de superfícieMyofunctional Orofacial TherapyNasofibrolaryngoscopySurface electromyographyCNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIAAnálise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sonoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTAndresa Santos da Silva.pdf.txtAndresa Santos da Silva.pdf.txtExtracted texttext/plain300269https://repositorio.pucsp.br/xmlui/bitstream/handle/22988/4/Andresa%20Santos%20da%20Silva.pdf.txtdfc3d7abab559b84532d5fd17e52c5e9MD54LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
title |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
spellingShingle |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono Silva, Andresa Santos da Terapia Miofuncional Orofacial Nasofibrolaringoscopia Eletromiografia de superfície Myofunctional Orofacial Therapy Nasofibrolaryngoscopy Surface electromyography CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
title_short |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
title_full |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
title_fullStr |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
title_full_unstemmed |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
title_sort |
Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono |
author |
Silva, Andresa Santos da |
author_facet |
Silva, Andresa Santos da |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Bianchini, Esther Mandelbaum Gonçalves |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K8733842H4 |
dc.contributor.author.fl_str_mv |
Silva, Andresa Santos da |
contributor_str_mv |
Bianchini, Esther Mandelbaum Gonçalves |
dc.subject.por.fl_str_mv |
Terapia Miofuncional Orofacial Nasofibrolaringoscopia Eletromiografia de superfície |
topic |
Terapia Miofuncional Orofacial Nasofibrolaringoscopia Eletromiografia de superfície Myofunctional Orofacial Therapy Nasofibrolaryngoscopy Surface electromyography CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
dc.subject.eng.fl_str_mv |
Myofunctional Orofacial Therapy Nasofibrolaryngoscopy Surface electromyography |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
description |
INTRODUCTION: the speech therapy approach through Orofacial Myofunctional Therapy (BMT) has been presented as one of the possibilities of alternative treatment for sleep obstructive respiratory disorders, evidenced in studies with adults and children. Although the effectiveness of this intervention has been demonstrated, the morpho functional mechanisms that trigger the results obtained are poorly elucidated. OBJECTIVE: perform morpho-functional analysis of the Upper Airway during oropharyngeal exercises seeking to verify its immediate effects on mobility, stiffening and modification of oropharyngolaryngeal spaces, as well as, to verify which exercises provide greater changes in Upper Airway and greater electrical activity in suprahyoid muscles and masseters. METHOD: from the specific literature, thirteen exercises were selected for analysis. After relevant ethical processes ( CAAE: 94754418.4.0000.5482 ), respecting inclusion and exclusion criteria, fifteen healthy adult subjects, both sexes, with a mean age of 27.5 years, underwent clinical orofacial myofunctional evaluation and individual training on how to perform each exercise. Data collection consisted of surface electromyographic assessment (EMGs) of the masseter and suprahyoid muscles and recording of Upper Airway dynamics through Nasofibrolaryngoscopy (NFL), during the performance of each exercise. For the EMGs analysis, the data were normalized, tabulated according to the average of the potentials obtained and submitted to statistical analysis: ANOVA, Mauchly's test with Greenhouse correction - Geisser, tests Least Significant Difference (LSD), Bonferroni, and Pearson for correlation of results between the pairs of muscles analyzed. As for the NFL data, the exercises were recorded in two regions: nasopharynx and oropharynx / hypopharynx resulting in a sample of 390 videos, sent to the judges: three otorhinolaryngologists, blind to the subjects and to the exercises. The analyzes were recorded in a specific instrument consisting of structural verification , movement type and classification. It was made analysis of agreement between the judges: Fleiss Kappa Agreement Coefficient, for the comparison between exercises, the Friedman Test was used. RESULTS: The subjects presented vertical and transverse mobility of the present soft palate, extension of the normal uvula, symmetry of the present uvula, normal oropharyngeal region, medium face with straight or convex profile. The 13 exercises analyzed provide a mechanism of action in the Upper Airway and electrical activity of the suprahyoid muscles and masseters. The methodology used allowed to identify which exercises have greater electromyographic responses and which provide greater mobility, stiffness and modification for the regions of soft palate, pharyngeal / hypopharyngeal wall, retrolingual region and epiglottis. CONCLUSION: The results of the present study collaborate to comprehension how the exercises used in orofacial myofunctional therapy for OSA act and contribute to choosing the best clinical approach in other areas of speech therapy |
publishDate |
2020 |
dc.date.accessioned.fl_str_mv |
2020-03-04T10:08:56Z |
dc.date.issued.fl_str_mv |
2020-02-18 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Silva, Andresa Santos da. Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono. 2020. 175 f. Dissertação (Mestrado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020. |
dc.identifier.uri.fl_str_mv |
https://tede2.pucsp.br/handle/handle/22988 |
identifier_str_mv |
Silva, Andresa Santos da. Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono. 2020. 175 f. Dissertação (Mestrado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020. |
url |
https://tede2.pucsp.br/handle/handle/22988 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Pontifícia Universidade Católica de São Paulo |
dc.publisher.program.fl_str_mv |
Programa de Estudos Pós-Graduados em Fonoaudiologia |
dc.publisher.initials.fl_str_mv |
PUC-SP |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Faculdade de Ciências Humanas e da Saúde |
publisher.none.fl_str_mv |
Pontifícia Universidade Católica de São Paulo |
dc.source.none.fl_str_mv |
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MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da PUC_SP - Pontifícia Universidade Católica de São Paulo (PUC-SP) |
repository.mail.fl_str_mv |
bngkatende@pucsp.br||rapassi@pucsp.br |
_version_ |
1809277820335030272 |