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1.
Codas ; 32(5): e20190123, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053087

RESUMO

PURPOSE: To elaborate and show an innovative speech and language guidance program for smartphones, tablets, and computers, with technological support. The program aims to help parents of children at risk for language disorder in order to minimize the consequences of a developmental language disorder (DLD). METHOD: An app was developed to provide a dynamic interaction between the researcher and the families for at a distance intervention, aiming to reach the greatest number of children to promote language development in a broad, low-cost and effective way. RESULTS: The content was organized in video-lessons (theoretical orientations were carried out in the form of video-lessons, taught by the researcher), videos (documentaries and videos from YouTube), reports (reports linked to sites specializing in child development), complementary content (cultural and leisure activities to be done in family) and activities (activities to stimulate the skills worked on in each week's video lesson proposed in the application). CONCLUSION: We created a remote orientation program proposing an innovative, technological, and motivating therapeutic environment compatible with the reality of today's families.


Assuntos
Transtornos do Desenvolvimento da Linguagem , Fonoterapia , Criança , Humanos , Desenvolvimento da Linguagem , Pais , Fala
3.
Int J Pediatr Otorhinolaryngol ; 138: 110318, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871515

RESUMO

OBJECTIVE: To study whether providing Speech and Language Pathology (SLP) interventions by telepractice (TP) could effectively improve speech performance in children with cleft palate (CCP). METHODS: Forty-three CCP were treated with TP intervention in 45 min sessions, 2 times per week for a period of one month. Children ages ranged 4-12 years (X = 7.04; SD = 2.59). All children presented with velopharyngeal insufficiency (VPI) and compensatory articulation (CA) after palatal repair. TP was provided in small groups (5-6 children) following the principles of the Whole Language Model (WLM). Severity of CA was evaluated by a standardized scale at the onset and at the end of the TP period. RESULTS: At the onset of the TP intervention period, 84% of the patients demonstrated severe CA. At the end of the TP period there was a significant improvement in severity of CA (p < 0.001). CONCLUSION: The results of this study suggests that TP can be a safe and reliable tool for improving CA. Considering that the COVID-19 pandemic will radically modify the delivery of Health Care services in the long term, alternate modes of service delivery should be studied and implemented.


Assuntos
Betacoronavirus , Fissura Palatina , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Fonoterapia , Patologia da Fala e Linguagem , Criança , Pré-Escolar , Fissura Palatina/complicações , Humanos , Fonoterapia/métodos , Patologia da Fala e Linguagem/métodos , Insuficiência Velofaríngea/etiologia , Insuficiência Velofaríngea/fisiopatologia
4.
J Stroke Cerebrovasc Dis ; 29(10): 105132, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912512

RESUMO

PURPOSE: Aphasia is one of the most common complications after stroke and occurs in 21-38% of the patients during acute period. The present study aimed to investigate the response to speech and language therapy according to artery involvement and lesion location in patients with post-stroke aphasia. METHOD: The medical records of 107 patients with post-stroke aphasia (mean age, 58.8 ± 14.8 years) who were admitted to a single rehabilitation center for usual care after stroke were reviewed. Location of the ischemic lesion and involved artery was determined assessing the brain MRI of the patients. All the patients received 24 sessions speech and language therapy (3 days a week) as a part of 8-week rehabilitation program. Evaluation of the aphasia was performed with Gülhane Aphasia Test-2 (GAT-2) at baseline and at the end of the rehabilitation program. RESULTS: Baseline GAT-2 scores was significantly worse in patients with middle cerebral artery (MCA) involvement compared to patients with other artery involvements (p = 0.007). While the GAT-2 scores of patients with MCA involvement were improved significantly after speech and language therapy (p < 0.001), the changes in those with anterior cerebral artery (ACA) and posterior cerebral artery (PCA) involvements were not significant (p > 0.05). CONCLUSIONS: The present findings suggested that speech functions might be more affected in ischemic lesion of MCA and response to SLT might be better in patients with MCA involvement.


Assuntos
Afasia/reabilitação , Infarto da Artéria Cerebral Anterior/terapia , Infarto da Artéria Cerebral Média/terapia , Infarto da Artéria Cerebral Posterior/terapia , Terapia da Linguagem , Fonoterapia , Fala , Reabilitação do Acidente Vascular Cerebral , Adulto , Idoso , Afasia/diagnóstico , Afasia/psicologia , Bases de Dados Factuais , Feminino , Humanos , Infarto da Artéria Cerebral Anterior/diagnóstico por imagem , Infarto da Artéria Cerebral Anterior/psicologia , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/psicologia , Infarto da Artéria Cerebral Posterior/diagnóstico por imagem , Infarto da Artéria Cerebral Posterior/psicologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do Tratamento
5.
J Rehabil Med ; 52(9): jrm00100, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32896863

RESUMO

OBJECTIVE: We present a case report that complements the conclusion of Stam et al. in their call to rehabilitation facilities to anticipate and prepare to address post intensive care syndrome in post-Covid-19 patients. METHODS: The case report presented here provides insight into treating mechanically ventilated post-Covid-19 patients. RESULTS: Early intervention with dysphagia therapy and speech therapy and ventilator-compatible speak-ing valves, provided within an interprofessional collaborative team, can mitigate the potentially negative consequences of prolonged intubation, long-term use of cuffed tracheostomy, and post intensive care syndrome resulting from Covid-19. CONCLUSION: Such a treatment approach can be used to address what is important to patients: to be able to speak with family and friends, eat what they want, and breathe spontaneously.


Assuntos
Infecções por Coronavirus/reabilitação , Transtornos de Deglutição/reabilitação , Terapia da Linguagem/métodos , Pneumonia Viral/reabilitação , Pneumologia/métodos , Fonoterapia/métodos , Betacoronavirus , Infecções por Coronavirus/virologia , Cuidados Críticos , Transtornos de Deglutição/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Equipe de Assistência ao Paciente , Pneumonia Viral/virologia , Respiração , Respiração Artificial/efeitos adversos , Fala , Síndrome , Traqueostomia/efeitos adversos , Traqueostomia/métodos
7.
J Stroke Cerebrovasc Dis ; 29(9): 105078, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807476

RESUMO

BACKGROUND AND PURPOSE: Left hemisphere stroke often results in a variety of language deficits due to varying patterns of damage to language networks. The Cookie Theft picture description task, a classic, quick bedside assessment, has been shown to quantify narrative speech reliably. In this study, we utilized diffusion tensor imaging (DTI) to assess language network white matter tract correlates of lexical-semantic and syntactic impairments longitudinally. METHODS: Twenty-eight patients with mild to severe language impairments after left hemispheric lobar and/or subcortical ischemic stroke underwent the Cookie Theft picture description test and DTI up to three different time points: within the first three months, six months and twelve months after stroke. Dorsal and ventral stream language pathways were segmented to obtain DTI integrity metrics of both hemispheres. Multivariable regression models and partial correlation analyses adjusted for age, education, and lesion load were conducted to evaluate the temporal DTI profile of the white matter microstructural integrity of the language tracts as neural correlates of narrative speech within the first year after stroke. RESULTS: Among all the major language white matter pathways, the integrity of the left arcuate (AF), inferior fronto-occipital, and inferior longitudinal fasciculi (ILF) were related to picture description performance. After FDR correction, left ILF fractional anisotropy correlated with syntactic cohesiveness (r=0.85,p=0.00087) within the first three months after stroke, whereas at one year post-stroke, the strongest correlations were found between lexical-semantic performance and left AF radial diffusivity (r = -0.71, p = 0.00065). CONCLUSION: Our study provides a temporal profile of associations between the integrity of the main language pathways and lexical semantics and syntactic impairments in left hemispheric strokes.


Assuntos
Afasia/diagnóstico por imagem , Imagem de Tensor de Difusão , Fala , Acidente Vascular Cerebral/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Afasia/fisiopatologia , Afasia/psicologia , Afasia/reabilitação , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Semântica , Índice de Gravidade de Doença , Fonoterapia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Fatores de Tempo , Resultado do Tratamento , Substância Branca/fisiopatologia
8.
Am J Phys Med Rehabil ; 99(11): 977-981, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32804713

RESUMO

The COVID-19 pandemic transformed health care delivery, including rapid expansion of telehealth. Telerehabilitation, defined as therapy provided by physical therapy, occupational therapy, and speech and language pathology, was rapidly adopted with goals to provide access to care and limit contagion. The purpose of this brief report was to describe the feasibility of and satisfaction with telerehabilitation. A total of 205 participants completed online surveys after a telerehabilitation visit. Most commonly, participants were women (53.7%), 35-64 yrs old, and completed physical therapy (53.7%) for established visits of 30-44 mins in duration for primary impairments in sports, lower limb injuries, and pediatric neurology. Overall, high ratings ("excellent" or "very good" responses) were observed for all patient-centered outcome metrics (range, 93.7%-99%) and value in future telehealth visit (86.8%) across telerehabilitation visits. Women participated more frequently and provided higher ratings than male participants did. Other benefits included eliminating travel time, incorporating other health care advocates, and convenience delivering care in familiar environment to pediatric patients. Technology and elements of hands-on aspects of care were observed limitations. Recognizing reduced indirect costs of care that telerehabilitation may provide along with high patient satisfaction are reasons policy makers should adopt these services into future health care delivery models.


Assuntos
Infecções por Coronavirus/prevenção & controle , Terapia Ocupacional/psicologia , Pacientes Ambulatoriais/psicologia , Pandemias/prevenção & controle , Modalidades de Fisioterapia/psicologia , Pneumonia Viral/prevenção & controle , Fonoterapia/psicologia , Telerreabilitação/métodos , Adulto , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Quarentena/psicologia
9.
S Afr J Commun Disord ; 67(1): e1-e6, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32787417

RESUMO

In the era of coronavirus disease 2019 (COVID-19), many healthcare professionals are being faced with the question of what is considered to be an essential service. This opinion paper has attempted to answer this complex question by understanding the potential relationship between dysphagia and COVID-19 and how speech-language therapists (SLTs) in South Africa should tackle this. It also aims to answer the question through the lens of a risk-benefit discussion based around practices and decision-making. Important gaps in the field relating to how SLT practices need to move forward during this challenging time have also been highlighted. Reflective questions that can assist SLTs when seeing dysphagia cases have been provided.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transtornos de Deglutição/terapia , Pessoal de Saúde/psicologia , Terapia da Linguagem/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Fonoterapia/psicologia , Patologia da Fala e Linguagem , Atitude do Pessoal de Saúde , Betacoronavirus , Humanos , Medição de Risco , África do Sul
11.
Codas ; 32(3): e20180245, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32609222

RESUMO

PURPOSE: To investigate, through a systematic review, how three assessment instruments for children's vocabulary (Test of Childhood language ABFW, Expressive Vocabulary Test - EVT, and Peabody Picture Vocabulary Test - PPVT) have been used in Brazilian research, verifying its purposes of uses and the main results of the researches. RESEARCH STRATEGY: This review was organized in three studies. Study 1 referred to the process of a priori search and Study 2 referred to the a posteriori search. We searched for three Brazilian's database (CAPES, SciELO, and PePSIC). SELECTION CRITERIA: For Study 1, we selected empirical studies containing research data with one of the three-targeted tests, using typically developing school children (7 to 10 years old). For Study 2, we enlarged the age range for pre-school and extended the search to non-typically developing children. DATA ANALYSIS: The selected articles were fully read and synthesized in a table containing the study's aims, the age range of the sample, instrument, research design, main results, and journal. RESULTS: We found out 24 articles, most of which from the speech-language therapy area. The results indicated the predominance of cross-sectional and observational studies, aiming to delineate the cognitive profile of children with some developmental disturbance, with or without control groups. None of the researches conducted a psychometric inquiry of the instruments. CONCLUSION: In Brazil, it is necessary to carry out research focusing on the psychometric inquiry of instruments for evaluating the vocabulary in pre-school and school-age children.


Assuntos
Fonoterapia , Vocabulário , Brasil , Criança , Pré-Escolar , Estudos Transversais , Humanos , Testes de Linguagem
12.
Stud Health Technol Inform ; 270: 357-361, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570406

RESUMO

This paper presents the current state of progress of a project aimed at achieving an automated information entropy-based discrimination of phoneme mispronunciations in utterances of early school-age children. The introductory part briefly describes the dyslalia symptomology and the incidence of dyslalic disorders. This section also reviews the current challenges posed by the main research objective in other similar projects sharing the same objective and summarizes the current results thereof. The Material and Method section presents the conditions, the technology and the feature-extraction technique used in the experiment. The same section also describes the computation of the information entropy values of each analyzed speech sample. The highest match rate of 93.33% was achieved in the classification of words containing the phoneme /r/ in the initial position. A synthesis of the achieved results is provided in the Results section based on which conclusions are drawn and exposed in the Discussion and Conclusions section.


Assuntos
Algoritmos , Distúrbios da Fala , Criança , Entropia , Humanos , Fala , Fonoterapia
13.
Codas ; 32(3): e20200144, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32578694

RESUMO

We present an experience report on the implementation of real-time telehealth in speech-language and hearing therapy for patients who were previously seen on an outpatient basis in a primary health care service. The Speech-Language Therapy (SLT) team was monitoring twenty-five users when the first cases of COVID-19 were notified in southern Brazil. Of these, it was judged that twelve patients required at least a monitoring call every two weeks. Teleconsultations were available in this first stage, on an emergency basis, during the implementation of the project in this format. The idea was to guarantee, due to the suspension of the SLT sessions, the maintenance of the care service for patients who could suffer worsening of their cases or even comorbidities. The appointments were carried out by video calls by SLT students, therapists of the extension project, and supervised by a speech-language therapist, synchronously. All conversations and orientations during the teleconsultation were conducted as calmly as possible and, in the case of infant patients, permeated by some playful activities. Telehealth has shown to be an efficient resource for the care of patients with SLT demands, enabling remote care with the same quality as face-to-face care. Besides, it has relevant potential, once there is a significant number of patients, who need SLT assessment and live in regions where there is a shortage of qualified professionals.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Desenvolvimento de Programas , Fonoterapia/organização & administração , Telemedicina/organização & administração , Adulto , Idoso , Brasil , Criança , Humanos , Terapia da Linguagem/organização & administração , Terapia da Linguagem/psicologia , Fonoterapia/psicologia , Telemedicina/instrumentação , Telerreabilitação/instrumentação , Telerreabilitação/organização & administração
15.
Artigo em Russo | MEDLINE | ID: mdl-32490631

RESUMO

Anxiety and speech disorders frequently co-exist, provoking and intensifying each other's manifestations, which is important to consider when choosing optimal therapeutic strategy. Linguistic anxiety is a separate anxiety disorder in which the speech itself, the fear of making a mistake may act as principal fear and start up the negative affect. Linguistic anxiety may develop due to disturbance of functional interactions between various systems in any healthy individual, but the risk of it developing increases significantly by the presence of initial speech defect such as post-stroke aphasia. Comorbidity of speech disorders and affective specter disorders is also noted in patients with neurodegenerative diseases. Strategies aimed at stopping anxiety may be effective for decreasing speech disorders severity.


Assuntos
Ansiedade , Afasia , Transtornos de Ansiedade , Humanos , Fala , Distúrbios da Fala , Fonoterapia
18.
20.
Am J Otolaryngol ; 41(4): 102455, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475619

RESUMO

BACKGROUND: There are no reliable outcome predictors for functional dysphonia (FD) patients. OBJECTIVES: To investigate if any clinical or phoniatric characteristics could identify FD patients at risk of negative outcome after speech therapy. METHODS: We retrospectively reviewed the results of 78 FD patients treated with the proprioceptive elastic method. Before and one-month after therapy, patients underwent endoscopy, acoustic analysis with Multi-Dimensional Voice Program, and Voice Handicap Index-10 questionnaire (VHI-10). Negative outcome was the persistence of VHI-10 ≥ 13. RESULTS: 26 FD patients had negative outcome (i.e. VHI-10 ≥ 13) after speech therapy. At univariate analysis, clinical variables (i.e. sex, age, comorbidities, dysphonia duration, and professional voice use) were not associated with the outcome. Elevated Jitter% (Jitt; p = 0.03), Shimmer% (Shim; statistical trend, p = 0.06), and Noise to Harmonics Ratio (statistical trend, p = 0.06) were found in patients with poor results. At multivariate analysis, higher Jitt was an independent negative prognostic factor (p = 0.02), while a statically trend was identified for Shim (p = 0.06). A panel of Jitt >1.5 and Shim >5.1 showed an acceptable discriminatory power (AUC [ROC] = 0.76) according to Hosmer and Lemeshow scale. CONCLUSION: A panel of two acoustic analysis parameters could help in identifying FD patients at risk of speech therapy failure. Further studies in these patients are needed to evaluate the most efficient treatment protocol.


Assuntos
Disfonia/diagnóstico , Disfonia/reabilitação , Fonação , Acústica da Fala , Medida da Produção da Fala/métodos , Fonoterapia/métodos , Falha de Tratamento , Qualidade da Voz , Voz , Adulto , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco
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