Fraga Bruno Francisco de, Almeida Sheila Tamanini de, Santana Márcia Grassi, Cassol Mauriceia
Rehabilitation Post-Graduation Program (PPGCR), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
Department of Speech Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Int Arch Otorhinolaryngol. 2018 Jul;22(3):225-230. doi: 10.1055/s-0037-1605597. Epub 2017 Aug 28.
Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments ( = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone ( = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy ( = 0.126). This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.
吞咽困难会导致喉部和口颌结构发生变化；然而，关于发声练习的应用描述甚少。为验证由肌功能练习与发声练习组成的疗法在中风患者吞咽功能康复中是否更有效。这是一项试点研究，由两个不同的组组成：一个对照组，仅进行肌功能练习；一个实验组，进行肌功能和发声练习。用于评估经口摄入量的是功能性经口摄入量量表（FOIS）。FOIS水平显示，实验组治疗前的中位数为4，治疗后增至7，而对照组的值分别为5和6。因此，实验组治疗前后评估之间存在统计学显著差异（P = 0.039），这表明肌功能和发声练习相结合在提高经口摄入量水平方面比单独的肌功能练习更有效（P = 0.059）。另一方面，对照组也有所改善，尽管与实验组相比改善率较低；因此，两组治疗后无统计学显著差异（P = 0.126）。这项试点研究表明，在中风患者吞咽康复中使用发声练习能够使经口摄入量水平有更大提高。然而，需要进一步进行更大样本的对照盲法临床试验来证实这一证据，因为本研究指出了开展此类研究的可行性。
