The use of photobiomodulation in swallowing difficulties in individuals who developed the severe form of COVID-19 / O uso da fotobiomodulação na dificuldade de deglutição em indivíduos que desenvolveram a forma grave da COVID-19

ABSTRACT This study aimed to verify the use of photobiomodulation in swallowing difficulties in individuals who had a severe form of COVID-19. This case report was based on a quasi-experimental, quantitative study, with primary data collected from a non-probabilistic sample of 13 adults (aged ≥ 19 to < 60 years) of both sexes, who had the severe form of COVID-19. Swallowing was assessed with the Dysphagia Risk Assessment Protocol, and the intervention used photobiomodulation. Descriptive statistics were used. It was found that all research participants' risk for dysphagia in water and pudding swallowing tests improved from before to after the intervention. It can be concluded that photobiomodulation had positive results in speech-language-hearing practice to treat swallowing difficulties in adults who were affected by the severe form of COVID-19, intubated, tracheostomized, and needed an alternative feeding route, as the swallowing difficulties improved.

RESUMO O objetivo foi verificar o uso da fotobiomodulação na dificuldade de deglutição em indivíduos que desenvolveram a forma grave da COVID-19. Trata-se de um relato de casos, a partir de um estudo quase experimental, quantitativo, com coleta de dados primários e com amostra não probabilística, realizado com 13 indivíduos adultos (idade ≥ 19 a < 60 anos) de ambos os sexos, que tiveram a forma grave da COVID-19. Foi realizada a avaliação da deglutição pelo Protocolo de Avaliação para o Risco de Disfagia (PARD) e a intervenção com fotobiomodulação. Foi utilizada a estatística descritiva. Verificou-se que todos os participantes da pesquisa apresentaram melhora no risco para disfagia no teste de deglutição de água e de alimento pastoso do momento pré para o pós-intervenção. Pode-se concluir que a utilização da fotobiomodulação na prática fonoaudiológica para tratar a dificuldade de deglutição dos adultos que foram acometidos pela forma grave da COVID-19, intubados, traqueostomizados e necessitaram fazer uso de via alternativa de alimentação, trouxe resultados positivos, com melhora da dificuldade de deglutição.

Impact of cervical pain, neck mobility, and body mass index on teachers' postural control / Impacto da dor cervical, da mobilidade e do índice de massa corporal no controle postural de professores

ABSTRACT Purpose: to analyze the impact of neck pain, neck mobility, and body mass index on teachers' postural control. Methods: a cross-sectional study with 54 state public school teachers, 68.5% (n = 37) being females, with a mean age of 46.5 ± 9.3 years. Data were collected with the following instruments: Craniocervical Dysfunction Index (Brazilian version), force platform in bipedal and semi-tandem stance, visual analog scale, cervical mobility index, and body mass index. Data were analyzed with nonparametric statistics and multiple linear regression; the significance level was set at p<0.05, with 95% confidence intervals. Results: teachers with neck pain and severely impaired neck mobility had greater postural control changes in the semi-tandem stance. In the bipedal stance, those with mild mobility changes and neck pain had a smaller total displacement. Obese teachers had a smaller movement amplitude in the anteroposterior and mediolateral directions. Conclusion: teachers presented with neck pain and severely impaired neck mobility had a worse postural control. Obese teachers had a smaller total amplitude in both movement directions.

RESUMO Objetivo: analisar o impacto da cervicalgia, mobilidade cervical e índice de massa corporal no controle postural de professores. Métodos: estudo transversal com 54 professores da rede estadual de ensino, com média de idade de 46,5 ± 9,3 anos, dos quais: 68,5% (n = 37) eram do sexo feminino. A coleta de dados teve como base os seguintes instrumentos: Craniocervical Dysfunction Index (versão brasileira), plataforma de força na posição bipodal e semitandem, escala visual analógica, índice de mobilidade cervical e índice de massa corporal. Para análise dos dados, foi utilizada estatística não paramétrica e análise de regressão linear múltipla, com nível de significância p<0,05 e intervalo de confiança de 95%. Resultados: os professores com cervicalgia e comprometimento severo da mobilidade cervical tiveram maior alteração do controle postural na posição semitandem. Na posição bipodal, aqueles com leve alteração da mobilidade e dor cervical apresentaram menor deslocamento total, assim como professores obesos demostraram menor amplitude de movimento nas direções anteroposterior e médio-lateral. Conclusão: os professores com cervicalgia e comprometimento severo da mobilidade cervical tiveram pior controle postural. Já os obesos apresentaram menor amplitude total em ambas as direções do movimento.

Análise posturográfica em professores da rede estadual de ensino com diferentes níveis de atividade física habitual / Posturographic analysis of schoolteachers with different levels of habitual physical activity

RESUMO Objetivo comparar parâmetros do controle postural em professores da rede estadual de ensino com diferentes níveis de atividade física habitual. Métodos participaram 50 professores (48,1±9 anos) que foram avaliados em plataforma de força, na posição bipodal, olhos abertos, em superfícies rígida e instável. O Questionário Internacional de Atividade Física (versão curta) foi utilizado para categorizar o nível de atividade física em baixo, moderado e alto. O nível de atividade física também foi dicotomizado em grupos de mais ativos (G1) e menos ativos (G2). O estudo realizou análise de subgrupos para gênero e faixa etária e aplicou a estatística não paramétrica. Resultados os dados demonstraram que o grupo G2, as mulheres menos ativas e os indivíduos menos ativos na faixa etária de 49 a 60 anos apresentaram piores resultados na velocidade na direção anteroposterior, na condição de superfície instável e na diferença das médias entre a superfície rígida e a instável. Conclusão o grupo menos ativo, as professoras menos ativas e os participantes menos ativos na faixa etária de 49 a 60 anos apresentaram piores resultados na velocidade na direção anteroposterior.

ABSTRACT Objective to compare parameters of postural control in teachers of state education network with different levels of habitual physical activity. Methods 50 teachers (48.1 ± 9 years) participated and were evaluated on a force platform, in a bipedal position, eyes open, on surfaces rigid and unstable. The International Physical Activity Questionnaire (version abbreviated) was used to categorize the level of physical activity into low, moderate and high. The level of physical activity was also divided into groups of more active (G1) and less active (G2). The study carried out an analysis of subgroups by gender and age range and applied non-parametric statistics. Results the data showed that the G2 group, the less active women and the less active individuals in the age group of 49 to 60 years presented worse results in speed in the anteroposterior direction, in the condition of unstable surface and the difference in means between the rigid surface and the unstable. Conclusion the less active group, the less active teachers and less active participants in the 49-60 age group had worse results in velocity in the anteroposterior direction.

Estudo comparativo de zumbido e aptidão cardiorrespiratória entre pessoas pós-COVID-19 / Comparative study of tinnitus and cardiorespiratory fitness among people post COVID-19

RESUMO Objetivo Verificar a relação entre zumbido e aptidão cardiorrespiratória em pessoas após COVID-19. Métodos Estudo transversal com amostra de pessoas pós-COVID -19 que responderam à Escala Visual Analógica para zumbido e questionário padronizado contendo dados sobre internação e zumbido. Para avaliar a aptidão cardiorrespiratória, utilizou-se a avaliação clínica e o Teste de Bruce para mensurar o consumo de oxigênio diretamente (via analisador de gases, com utilização do consumo pico de oxigênio - VO2pico). Resultados Participaram 192 pessoas, com média de idade de 47,8 ± 12,6 anos. A prevalência de zumbido autorreferido foi de 27,1% (n = 52). Dos 52 pacientes com zumbido, 27 iniciaram com o sintoma durante ou após o diagnóstico de COVID-19. Houve diferença significativa para o VO2pico absoluto entre os grupos com e sem zumbido (p = 0,035), sendo que o grupo com zumbido apresentou os menores valores; o tamanho do efeito foi pequeno. Não houve correlação entre os escores da Escala Visual Analógica para o zumbido e os valores de VO2pico absoluto e relativo (p > 0,05). Conclusão Houve diferença estatisticamente significativa entre as queixas de zumbido e o VO2pico nas pessoas após a COVID -19, sendo que o grupo com zumbido apresentou o VO2pico absoluto menor do que o grupo sem zumbido. Nos pacientes com zumbido, também foi encontrado VO2pico absoluto e relativo menor para as mulheres, além do VO2pico relativo menor para os hipertensos e obesos.

ABSTRACT Purpose To verify the relation between tinnitus and cardiorespiratory fitness among people after COVID-19. Methods Cross-sectional study with a sample of people post Covid-19 who responded to the Visual-Analog Scale for tinnitus and standardized questionnaire containing data on hospitalization and tinnitus. To evaluate cardiorespiratory fitness, it used the clinical assessment and Bruce test to measure oxygen consumption directly (via gas analyzer, using peak oxygen consumption - VO2peak). Results In total, 192 participants were assessed, with a mean age of 47.8 ± 12.6 years . The prevalence of self-reported tinnitus was 27.1% (n = 52). Of these 52 patients with tinnitus, 27 people started with the symptom during or after the diagnosis of COVID-19. There was a significant difference for the absolute VO2peak and the groups with and without tinnitus (p = 0.035): the tinnitus group showed the lowest values, the effect size was small. There was no correlation between the scores of the Visual-Analog Scale for tinnitus and the absolute and relative VO2peak (p > 0.05). Conclusion There was a statistically significant difference between tinnitus complaints and the VO2peak among people post COVID-19, with the tinnitus group having a lower absolute VO2peak than the non-tinnitus group. In tinnitus patients, we also found lower absolute and relative VO2peak for women, in addition to lower relative VO2peak for hypertensive and obese patients.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire

Abstract Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Do Body Mass Index Levels Correlate with Tinnitus Among Teachers?

Abstract Introduction Working conditions can contribute to the development of lifestylerelated diseases among teachers, including obesity and tinnitus. Describing tinnitus in relation to characteristics and comorbidities can help the treatment and prognosis of teachers affected by this symptom. Objective To verify a possible association between tinnitus complaint and body mass index (BMI) in teachers. Methods Cross-sectional study with a sample of teachers who responded to the Visual Analog Scale (VAS) and to the Tinnitus Handicap Inventory (THI). The BMI (kg/m2) was calculated based on self-reported body weight (in kilograms) divided by height (in meters squared). Nonparametric statistics were applied adopting a significance level < 0.05 Results A total of 83 teachers were assessed, with a mean age 48 ± 9.7 years old; 63.9% (n= 53) were females; 44.6% were eutrophic (n = 37), and 16.9% (n = 14) were obese. Of the total, 19.3% (n = 16) reported tinnitus. No differences were found between the groups and BMI (p > 0.05), although there was a significant difference between the Tinnitus and No Tinnitus groups for age (p < 0.001). The chi-squared test showed an association between age group and tinnitus (p < 0.028); those with tinnitus were in the 49 to 65 years old age group. In addition, there was a moderate correlation between tinnitus parameters (VAS; THI-Functional; THI-Total) and BMI. Conclusion There was a moderate correlation between tinnitus parameters and BMI indicating that, as the BMI increased, so did the impact of tinnitus in the lives of the teachers. Body mass index should be considered a factor in tinnitus assessment and rehabilitation process.

Anosmia and ageusia in people after COVID-19: an analysis between the type and length of hospital stay / Anosmia e ageusia em pessoas após a COVID-19: análise entre tipo e tempo de hospitalização

ABSTRACT Purpose: to analyze the type and length of hospital stay in people who reported anosmia and ageusia after COVID-19. Methods: a cross-sectional study with patients who were referred by the hospital after medical discharge. They answered a standardized in-person questionnaire on age, sex, anthropometry, need for hospitalization, anosmia, and ageusia. Nonparametric statistics were calculated to analyze the data. The Mann-Whitney and Kruskal-Wallis tests were used to compare the groups. Significance was set at p<0.05. Results: the responses of 201 participants with a mean age of 44.7 ± 12.7 years were analyzed, 52.2% (n = 105) were males, 67.7% had been hospitalized (n = 136), 60.2% (n = 121) reported ageusia, and 55.7% (n = 112) reported anosmia. There was a difference in days spent in the Intensive Care Unit (ICU) for the Ageusia group (p = 0.004), which had a shorter length of stay. As for those who reported anosmia, there was a difference and shorter length of stay for both the ward (p = 0.001) and ICU (p = 0.004). Categorical data showed that anosmia was associated with hospitalization (yes or no) (p = 0.018; phi = -0.167). Among those who were not hospitalized, 67% (n = 44) reported anosmia. Conclusion: those who reported anosmia and ageusia had shorter hospital stays, when necessary.

RESUMO Objetivo: analisar o tipo e tempo de hospitalização em pessoas que relataram anosmia e ageusia após a COVID-19. Métodos: estudo transversal com pacientes que foram encaminhados pelo hospital após a alta médica. Um questionário padronizado foi aplicado presencialmente contendo dados referentes a idade, sexo, antropometria, necessidade de internação, anosmia e ageusia. Estatística não-paramétrica foi utilizada para analisar os dados. Os testes de Mann Whitney e Kruskal-Wallis foram utilizados para comparação dos grupos. Considerou-se significante um p<0,05. Resultados: foram analisadas as respostas de 201 participantes com média de idade de 44,7 ± 12,7 anos, 52,2% (n = 105) eram do sexo masculino, 67,7% foram internados (n = 136), 60,2% (n = 121) relataram ageusia e 55,7% (n = 112) informaram anosmia. Houve diferença em relação aos dias de permanência em Unidade de terapia intensiva (UTI) para o grupo Ageusia (p = 0,004), sendo que estes apresentaram menor tempo de internação. Quanto aos que relataram anosmia, houve diferença e menor tempo de internação para ambos, enfermaria (p = 0,001) e UTI (p = 0,004). Os dados categóricos demonstraram associação entre anosmia e internação (sim e não) (p = 0,018; phi = -0,167), sendo que, entre os que não foram internados, 67% (n = 44) relataram anosmia. Conclusão: aqueles que relataram anosmia e ageusia apresentaram menor tempo de internação, quando necessário.

Sleep lifestyle correlate of dizziness among teachers

Abstract Introduction Some studies have shown associations between sleep quality and dizziness. However, this association has not been investigated in teachers. Objective To verify a possible association between dizziness complaint and sleep quality in teachers. Methods Cross-sectional study developed with 96 school teachers (mean age of 47.8 ± 9.8 years). To assess dizziness, an audiological assessment was performed, which was the same one used in routine audiological care (Miller protocol). The dizziness handicap inventory (DHI) was applied to those individuals who reported dizziness. To evaluated sleep quality, the Pittsburgh sleep quality index was used. Results The prevalence of dizziness was 22.9% (n = 22). Of these, 77.3% (n = 17) were women, 63.6% (n = 14) demonstrated poor sleep quality, and 54.5% (n = 12) were young adults (27-48 years). In the comparison between the dizziness and the control groups, no statistically significant differences were found (p> 0.05). The analysis adjusted for the confounding variables showed a difference for men in the sleep efficiency variable (p = 0.043); young adults showed a statistically significant difference in the total score (p = 0.021) and total sleep time (p = 0.029). There was a moderate correlation between DHI and total time in bed (p = 0.036, r = 0.497) and DHI and sleep efficiency (p = 0.014; r = -0.582). Conclusion Dizziness influences the quality of sleep in teachers, especially that of the youngest and male patients. There was a moderate correlation between total time in bed, sleep efficiency, and DHI, demonstrating that sleep quality should be considered an important factor in the assessment and rehabilitation process of dizziness.

Is remote and distance teaching during the COVID-19 pandemic related to the university professors' weight gain, body mass index changes, hearing complaints, and self-perception of voice?

ABSTRACT Purpose: to verify the impact of weight and BMI (Body Mass Index) changes on auditory and vocal symptoms in university professors, during the COVID-19 pandemic. Methods: the symptoms were assessed with a semi-structured questionnaire developed on Google Forms, to which the consent form was appended. It comprised 27 questions related to symptoms, changes, and health, during the pandemic - specifically, vocal and auditory symptoms, anthropometric factors, vocal parameters, physical activity, neck pain, and comorbidities. The Mann-Whitney and Chi-square test were used to identify differences or associations between variables (95% CI; P < 0.05). Results: altogether, 74 professors who comprise the faculty of the undergraduate program at the institution where the research was conducted were assessed. Significant differences were found between those with auditory symptoms (G1: worsened hearing; G2: unchanged hearing) regarding BMI, in which G1 had higher values; and sleep, in which G1 slept fewer hours. The chi-square test showed an association between the groups and BMI classification - those with worsened hearing (G1) were more overweight and their sleeping hours were more affected. There was also an association between the groups and voice change, headphone use (mainly in-ear) during classes, dizziness or vertigo episodes, tinnitus episodes and headache. Conclusion:this study revealed an association between worsened hearing, sleep, and BMI in university professors due to remote and distance teaching during the COVID-19 pandemic.

Dysphonia, arterial hypertension, diabetes mellitus, thyroid diseases, and noise complaints as probable factors associated with hearing loss among teachers / Disfonia, hipertensão arterial, diabetes mellitus, doenças da tireoide e queixas de ruído como prováveis fatores associados a perda auditiva em professores

ABSTRACT Objective: to verify a possible association between hearing loss and dysphonia, arterial hypertension, diabetes mellitus, thyroid diseases, and noise complaints. Methods: a cross-sectional study involving 60 teachers, mean age 47.05 years. Pure-tone threshold audiometry was used to assess hearing, the voice questionnaire and voice acoustic evaluation were used for voice perception and quality, and the standardized questionnaire verified noise complaint and comorbidities. The statistical analysis was conducted with Mann-Whitney and Fisher's exact tests and multivariate linear regression. Results: there was a significant association between hearing loss and diabetes mellitus, hypertension, and thyroid disease (both p <0.0001), but there was no association between noise complaints and hearing loss in this population. The regression showed that dysphonia (p = 0.0311) and diabetes mellitus (p = 0.0302) are independent risk factors for hearing loss. A correlation was found between hearing loss and voice characteristics: roughness, breathiness, tension, and resonance. Conclusion: this study showed that hypertension and thyroid diseases are factors associated with hearing loss. In addition, dysphonia and diabetes mellitus are independent factors associated with hearing loss in teachers. These results show the need for policies aimed at promoting teachers' health.

RESUMO Objetivo: verificar possível associação da perda auditiva com disfonia, hipertensão arterial (HA), diabetes mellitus (DM), doenças da tireoide e queixas de ruído. Métodos: estudo transversal envolvendo 60 professores, média de idade de 47,05 anos. Foi avaliada a audição por meio da Audiometria tonal limiar, a percepção e qualidade vocal com o questionário vocal e a avaliação vocal acústica, enquanto a queixa de ruído e as comorbidades envolvidas foram investigadas com o questionário padronizado. A análise estatística utilizou os testes Ex-act de Mann Whitney, Fisher e regressão linear multivariada. Resultados: houve associação significante entre perda auditiva e DM, HA e doenças da tireoide (ambas p <0,0001), mas não foi encontrada associação entre queixa de ruído e perda auditiva nesta população. A regressão mostrou que as variáveis disfonia (p = 0,0311) e DM (p = 0,0302) são fatores de risco independentes para perda auditiva. Houve correlação entre perda auditiva e as características vocais rugosidade, soprosidade, tensão e ressonância. Conclusão: este estudo demostrou que HA e doenças da tireoide são fatores associados a perda auditiva, além disso a disfonia e DM se constituem em fatores associados independentes para a perda auditiva em professores. Estes resultados mostram a necessidade de políticas direcionadas a promoção da saúde do professor.

Posturographic Analysis in the Elderly with and without sensorineural Hearing Loss

Abstract Introduction Sensorineural hearing loss (SNHL) is a serious public health problem. Some evidence suggests a significant relationship between SNHL and balance disorders. The inability to maintain balance associated with SNHL while standing further increases the risk of falls among older people. Objective To investigate the association between SNHL on the postural balance in elderly individuals of both genders. Methods The sample consisted of 247 (166 women) physically independent elderly individuals, (mean age = 68.4 ± 6.0). The instruments used were the anamnesis and the pure tone audiometry for hearing loss, and for balance a force platform based in measures of center of pressure area and of sway velocity in the anteroposterior and mediolateral directions. Results Presence of hearing loss (HL) was observed in 68% of the participants. We observed a significant association between SNHL and characteristics of balance between the groups with and without HL for center of pressure (COP) area (p = 0.010), anteroposterior velocity (p = 0.001) and mediolateral velocity (p = 0.020). There was a significant difference between the gender groups for center of pressure area (p = 0.004), anteroposterior velocity (p = 0.001) and mediolateral velocity (p = 0.001) with better performance in the female group. Amongst men, there was a difference between the ones with HL and those without it, for COP area (p = 0.049). Conclusion In the present study, elderly individuals with SNHL exhibited more instability on the postural balance, and elderly men presented worse results in the test.

Hypovitaminosis D, Low Bone Mineral Density, and Diabetes Mellitus as Probable Risk Factors for Benign Paroxysmal Positional Vertigo in the Elderly

Abstract Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM). Objective To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM. Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire. Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender (p= 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin D found (p= 0.001) and for age (p= 0.001). In the elderly group with DM and BPPV, a difference was found for the standard deviation of the femur (p= 0.022) with posthoc Dunn, identifying the difference between diabetics with and without BPPV (p= 0.047). Conclusion Although no association was found (25 (OH) D levels) with BPPV in the general population of this study, it was observed that there was an association with bone mineral density in the elderly group with DM and BPPV, and, in the group with BPPV, there was an association between the amount of vitamin D and age.

Comparative study of sensation and repercussion of tinnitus on the quality of life and craniocervical posture in teachers / Estudo comparativo da sensação e repercussão do zumbido na qualidade de vida e postura craniocervical em professores

ABSTRACT Purpose: to verify whether there is a correlation between tinnitus sensation and repercussion on the quality of life and craniocervical posture in teachers, participating in the Pró-Mestre project. Methods: a cross-sectional study with a sample of 90 teachers, mean age of 47.70 years, who responded to the Craniocervical Dysfunction Index (CDI), to verify the craniocervical posture, the analog visual scale (AVS), and the Portuguese adaptation of the Tinnitus Handicap Inventory (THI), to investigate tinnitus and its impact on the quality of life. Appropriate statistical tests were applied, by adopting a significance level lower than 0.05. Results: out of the 90 teachers, 18 (20%) had tinnitus. There was a statistically significant difference between the sensation of tinnitus, according to the AVS and the craniocervical posture (CDI) in teachers (p <0.001). There was also an association between tinnitus complaint and right-rotation range of motion, with age and right lateral tilt being independent factors, regarding teachers' tinnitus sensation. In the correlation of the THI (total and domains), there was an association with cervical mobility, only in the left inclination. Conclusion: since a statistically significant difference was found between the subjective sensation of tinnitus and the craniocervical posture with a correlation between tinnitus sensation and repercussion on the quality of life and craniocervical posture in teachers, these aspects should be considered in the assessment of teachers presented with tinnitus, as well as further studies with a population of teachers, healthy adults, in order to increase the knowledge on the subject.

RESUMO Objetivo: verificar se existe correlação entre a sensação e repercussão do zumbido na qualidade de vida e postura craniocervical em professores. Métodos: estudo transversal com uma amostra de 90 professores participantes do projeto Pró-Mestre, com média de idade de 47,70 anos, que responderam ao Índice de disfunção Crânio cervical e a escala visual-analógica (EVA) e a adaptação para a língua portuguesa do Tinnitus Handicap Inventory (THI) para verificar o zumbido e sua repercussão na qualidade de vida. Foram aplicados os testes estatísticos pertinentes, adotando o nivel de significancia menor que 0,05. Resultados: dos 90 professores 18 (20%) apresentavam zumbido. Houve diferença estatisticamente significante entre a sensação do zumbido pela escala EVA e a postura craniocervical em professores (p <0,001). Também foi encontrada associação entre a queixa de zumbido e a amplitude de movimento com rotação para a direita, sendo que a idade e a inclinação lateral para a direita são fatores independentes no que se refere a sensação de zumbido em professores. Na correlação do THI (total e domínios) apenas a inclinação à esquerda apresentou associação com a mobilidade cervical. Conclusão: os resultados da pesquisa demonstraram correlação entre a sensação e repercussão do zumbido na qualidade de vida e postura craniocervical em professores, apontando que estes aspectos devem ser considerados na avaliação de professores com zumbido, além de que, são necessários mais estudos com população de professores, adultos saudáveis, com intuito de ampliar o conhecimento sobre o assunto.

Possible Association between the Lack of Regular Physical Activity with Tinnitus and Headache: Cross-sectional Study

Introduction: Physical inactivity is an important risk factor for many aging-related symptoms. Studies suggest that physical activity may help to relieve tinnitus and headache. Objective: To investigate the presence of tinnitus and headache in elderly individuals by associating it with the lack of regular physical activity. Methods: A cross-sectional study including elderly individuals who live independently. The practice of physical activity and the complaints of headache and of tinnitus were checked by means of a questionnaire with objective questions. The statistical analysis was performed using the chi-squared test and relative risk, and a multiple logistic regression model was used to determine how well each factor predicted headache while controlling for each of the other factors. Results: Based on a sample of 494 subjects, it was found that 213 (43.11%) complained of tinnitus. Among the complainants, 97 (45.53%) practiced physical activity regularly. We have confirmed associations between headache with lack of physical activity among elderly individuals with tinnitus (p = 0.0440). It was also observed that certain factors, such as male gender and tinnitus, are independent factors for the complaint of headache. Conclusion: We have found that headache could be a symptom related to the lack of regular physical activity among elderly individuals with tinnitus. (AU)

Tinnitus and its relationship with anxiety and depression in the elderly: a systematic review / O zumbido e sua relação com ansiedade e depressão em idosos: uma revisão sistemática

ABSTRACT Objective: to verify, in the literature, a probable association of tinnitus with anxiety and depression in the elderly. Methods: a systematic review (through a search in the indexed databases - Lilacs, Scielo, Pubmed, Science Direct, The Cochrane Library) of studies published between 2013 and 2018, in Portuguese and in English, involving adults and/or elderly (18 years and older). The descriptors used were: "tinnitus", "depression", "anxiety", "adult", "elderly", interspersed by the Boolean operator AND. Results: 11 studies were selected, from which, 5 compared adults to elderly and only 2 evaluated such relationship in the elderly alone. Studies suggest that, as age increases, tinnitus severity and psychological symptoms also increase, affecting both men and women. Conclusion: few studies compared the relationship between the variables among the elderly. A probable association between the variables for both genders has been found, suggesting that the advancing age contributes to the increase of tinnitus severity and its psychological symptoms, affecting the quality of life of these individuals. Further studies are suggested to confirm the association between tinnitus, anxiety and depression in the elderly. Multi-professional work is important for the evaluation and treatment of these people.

RESUMO Objetivo: verificar na literatura uma provável associação do zumbido com ansiedade e depressão em idosos. Métodos: revisão sistemática, com busca nas bases de dados indexadas (Lilacs, Scielo, Pubmed, Science Direct, The Cochrane Library), de estudos publicados entre 2013 e 2018, em português e inglês, que incluíssem adultos e/ou idosos com idade igual ou maior que 18 anos. Os descritores utilizados foram: "zumbido", "tinnitus", "depressão", "depression", "ansiedade", "anxiety", "adulto", "adult", "idosos", "elderly", intercalados pelo operador booleano AND. Resultados: foram selecionados 11 estudos e dentre estes, 5 compararam adultos e idosos, enquanto apenas 2 avaliaram esta relação somente em idosos. Os estudos sugerem que à medida que a idade aumenta, a severidade do zumbido e os sintomas psicológicos aumentam também, afetando homens e mulheres. Conclusão: poucos estudos compararam a relação entre as variáveis nos idosos. Foi constatada uma provável associação entre as variáveis, para ambos os sexos, e que o avançar da idade contribui para o aumento da severidade do zumbido e de seus sintomas psicológicos, acometendo a qualidade de vida desses indivíduos. Sugerem-se mais estudos para confirmar a associação entre zumbido, ansiedade e depressão na população idosa, sendo importante a atuação multiprofissional na avaliação e tratamento destas pessoas.

Probable Association of Hearing Loss, Hypertension and Diabetes Mellitus in the Elderly

Abstract Introduction The aging process causes changes in body structure in a continuous manner, and contributes to clinical disorders. Life expectancy is increasing, especially in developing countries. Objective To assess the prevalence of hearing loss and its possible association with hypertension and diabetes mellitus (DM) in the elderly. Methods A cross-sectional study with 519 elderly individuals aged over 60 years who underwent an audiological evaluation (pure tone audiometry), and answered a comorbidity questionnaire that included questions about age, gender, tinnitus and medical history, with data concerning DM. The dependent variable was the presence of hearing loss. The independent variables were age, gender, DM and hypertension. The variables were presented in absolute numbers and proportions, and enabled us to estimate the prevalence. The statistical analysis was performed through multiple logistic regression with 95% confidence intervals and values of p< 0.05 for the hearing loss and its associated factors. Results A total of 519 subjects of both genders with a median age of 69 years were evaluated, and the individuals who did not attend the audiometric test were excluded from the study, so the final sample was composed of 498 subjects. Sensorineural hearing loss was more prevalent (66.26%) of most frequently with bilateral hearing loss of 91.56% and 26.50% with mild degree. The statistical analysis showed that the variable DM was associated with the high frequency of hearing loss in the elderly, and according to the multiple logistic regression, the risk factors are independent of the hearing loss only for age and exposure to occupational noise. Conclusions There was a statistically significant difference between hearing loss at high frequencies and the risk factors, that is, age and DM.

Translation to Brazilian Portuguese and Cultural Adaptation of the Craniocervical Dysfunction Index

Abstract Introduction Functional disorders of the craniocervical region affect 77.78% of Brazilian teachers. Among the most common instruments used to assess craniocervical disorders in a detailed and objective way, none had been translated to Brazilian Portuguese and adapted to Brazilian culture. Objectives To translate to Brazilian Portuguese and to culturally adapt the Craniocervical Dysfunction Index (CDI). Method The first phase of the study consisted of the translation, synthesis, backtranslation, and review of the contents by a committee of experts, who developed a trial version and sent all the steps to the original author. The trial version was applied to 50 teachers of an institution. The reliability and internal consistency were evaluated by Cronbach α. For the validation, the Brazilian Portuguese version of the CDI was correlated with the Visual Analogue Scale (VAS) domains for cervicalgia and evaluated by Spearman ρ. Result Some expressions were adapted to the Brazilian culture. Among the participants who did not report neck pain in the VAS, 84.21% suffered from craniocervical dysfunction acording to the CDI. Among the participants who reported neck pain in the VAS, 100% suffered from craniocervical dysfunction according to the CDI. The CDI showed good internal consistency and satisfactory reliability measured by Cronbrach α (α = 0.717). There was a strong correlation between the CDI and the VAS score (ρ = 0.735). Conclusion No difficulties were encountered in the translation and back-translation of the CDI, and no problems were observed regarding the trial version developed; therefore, the Brazilian Portuguese version of the CDI is a valid and reliable instrument to evaluate the functional alteration of the craniocervical region.

Vestibular dysfunction and postural balance in cochlear implant users: a narrative literature review / Disfunção vestibular e equilíbrio postural em usuários de implante coclear: revisão narrativa da literatura

ABSTRACT Cochlear implants directly stimulate nerve fibers and ganglion cells of the auditory nerve, which transform sound energy into low levels of electrical current, stimulating the remaining fibers of the auditory nerve in patients with severe to profound hearing loss, in order to provide the significant range of auditory sensation and speech comprehension. Due to the close relationship between cochlea and vestibular receptors, some patients may present vestibular and postural balance changes concomitantly after surgery. This study aimed to perform a narrative review of the main studies that relate vestibular symptoms in patients implanted in the last six years. The research was performed through the databases: SciELO, LILACS and PubMed, using associated descriptors for "cochlear implant", "vestibular dysfunction", "vertigo" and "balance", totalizing 21 studies that fitted the inclusion criteria. The results were described in a chronological order of publication, showing the main conclusions. Of the total studies analyzed, 18 related vestibular function to cochlear implant and only 3 studies did not find such a relationship. The literature characterize the effects of the cochlear implant on the vestibular system, however, the results are contradictory.

RESUMO O implante coclear estimula, diretamente, as fibras nervosas e as células ganglionares do nervo auditivo, que transformam a energia sonora em baixos níveis de corrente elétrica, estimulando as fibras remanescentes do nervo auditivo em pacientes com perda auditiva de grau severo a profundo, a fim de proporcionar o alcance significativo da sensação auditiva e compreensão da fala. Devido à estreita relação entre cóclea e os receptores vestibulares, alguns pacientes podem apresentar alterações vestibulares e do equilíbrio postural, concomitantemente, após a cirurgia. Este trabalho teve como objetivo realizar uma revisão narrativa dos principais estudos, que relacionam sintomas vestibulares, em pacientes implantados, nos últimos seis anos. A pesquisa foi realizada por meio dos bancos de dados: Scielo, LILACS e PubMed, utilizando descritores associados para "implante coclear", "disfunção vestibular", "vertigem" e "equilíbrio", totalizando vinte e um estudos, que se enquadraram nos critérios de inclusão. Os resultados foram descritos em ordem cronológica de publicação, mostrando as principais conclusões. Do total de estudos analisados, dezoito relacionaram função vestibular e implante coclear e apenas três estudos não encontraram tal relação. Estudos caracterizam os efeitos do implante coclear no sistema vestibular, no entanto, os resultados são contraditórios.

Associação entre disfunção temporomandibular e zumbido em idosos / Association between temporomandibular disorders and tinnitus in the elderly

RESUMO Objetivo Verificar a associação entre zumbido e disfunção temporomandibular em idosos. Métodos Estudo transversal realizado com a inclusão de idosos com vida independente. A disfunção temporomandibular foi avaliada por exame odontológico e o zumbido foi verificado pela história médica. A análise estatística foi realizada utilizando o teste Qui-quadrado, o risco relativo e a regressão logística. Resultados O zumbido foi observado em 82,9% dos indivíduos com disfunção temporomandibular e, através desta análise, observou-se que a disfunção temporomandibular é um fator de risco para o zumbido. Conclusão Houve associação entre zumbido e disfunção temporomandibular na população idosa. Ressalta-se a importância de identificar fatores de risco para o zumbido, que podem ser modificados por meio de intervenções específicas, uma vez que esta prática é essencial na prevenção de episódios futuros, bem como na gestão do processo de tratamento de pacientes idosos, em geral.

ABSTRACT Purpose To verify the association between tinnitus and temporomandibular dysfunction in the elderly. Methods A cross sectional study was conducted with the inclusion of elderly individuals with independent living. Temporomandibular dysfunction was assessed by odontological evaluation and tinnitus was verified by medical history. Statistical analysis was performed using the chi-square test, relative risk and logistic regression. Results Tinnitus was observed in 82.9% of individuals with temporomandibular dysfunction and through this analysis is shown that temporomandibular dysfunction as a risk factor for tinnitus. Conclusion The results showed that there was association between tinnitus and temporomandibular dysfunction in the elderly population and emphasizes the importance of identifying risk factors for tinnitus that can be modified through specific interventions, since it is essential in the prevention of future episodes, as well as managing the process of treatment of elderly patients in general.

Effectiveness of acupuncture therapy as treatment for tinnitus: a randomized controlled trial / Efetividade da terapia por acupuntura como tratamento para o zumbido: ensaio clínico aleatorizado

ABSTRACT INTRODUCTION: Tinnitus is a subjective sensation of hearing a sound in the absence of an external stimulus, which significantly worsens the quality of life in 15-25% of affected individuals. OBJECTIVE: To assess the effectiveness of acupuncture therapy for tinnitus. METHODS: Randomized clinical trial (REBEC: 2T9T7Q) with 50 participants with tinnitus, divided into two groups: 25 participants in the acupuncture group and 25 participants in the control group. The acupuncture group received acupuncture treatment and the control group received no treatment. After a period of 5 weeks, they were called to perform the final evaluation and the control group received acupuncture treatment for ethical reasons. RESULTS: A statistically significant result was found for the primary outcome, reducing the intensity of tinnitus, with p = 0.0001 and the secondary endpoint, showing improvement in quality of life, with p = 0.0001. CONCLUSION: Chinese scalp acupuncture associated with bilateral electroacupuncture demonstrated, in the short term, a statistically significant improvement by reducing the level of tinnitus intensity, as well as improving the quality of life of individuals with tinnitus.

Resumo Introdução: O zumbido é a sensação subjetiva de ouvir um som na ausência de um estímulo externo e piora significativamente a qualidade de vida de 15%-25% das pessoas afetadas. Objetivo: Verificar a efetividade da terapia por acupuntura em indivíduos com zumbido. Método: Ensaio clínico aleatorizado com 50 participantes com zumbido, divididos em dois grupos: 25 participantes no Grupo da Acupuntura (GA) e 25 participantes do Grupo de Controle (GC). O GA recebeu tratamento com a craniopuntura chinês e o GC não recebeu nenhum tratamento. Após o período de 5 semanas, eles foram chamados para realizar a avaliação final e o GC recebeu tratamento de acupuntura por questões éticas de pesquisa. Resultados: Foi encontrado resultado estatisticamente significativo para o desfecho primário, reduzindo a intensidade do zumbido, com p = 0,0001 e o desfecho secundário, apresentando melhora na qualidade de vida, com p = 0,0001. Conclusão: A craniopuntura chinesa associada à eletroacupuntura bilateral nos mostrou no curto prazo, uma melhora estatisticamente significativa, reduzindo o nível de intensidade do zumbido, bem como melhorando a qualidade de vida dos indivíduos com zumbido.