Análise morfofuncional da via aérea superior durante exercícios orofaríngeos para reabilitação dos distúrbios respiratórios do sono

Detalhes bibliográficos
Autor(a) principal: Silva, Andresa Santos da
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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spelling 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
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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
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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 reponame:Biblioteca Digital de Teses e Dissertações da PUC_SP
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