Clinical Practice: Vocal nodules in dysphonic children

Common among children, vocal symptoms are a cause of concern for parents who seek elucidation of their diagnosis and treatment. Vocal nodules are the major cause of dysphonias in children and are related to vocal abuse. We conducted a literature review considering clinical, physiopathological, epidemiological, and histological aspects of vocal nodules, as well as diagnostic methods, highlighting the main studies addressing this issue. The controversial points of treatments were also discussed.

Perceptual and acoustic parameters of vocal nodules in children

Vocal nodules constitute the major cause of dysphonia during childhood. Auditory-perceptual and acoustic vocal analyses have been used to differentiate vocal nodules from normal voice in children.Purpose: To study the value of auditory-perceptual and acoustic vocal analyses in assessments of children with nodules.Design: Diagnostic test study.Patients and interventions: A comparative study was carried out including 100 children with videolaryngoscopic diagnosis of vocal nodules (nodule group-NG); and 100 children without vocal symptoms and with normal videolaryngoscopic exams (control group-CG). The age range of both groups was between 4 and 11 years. All children underwent auditory-perceptual vocal analyses (GRBASI scale); maximum phonation time and s/z ratio were calculated, and acoustic vocal analysis (MDVP software) were carried out.Results: There was no difference in the values of maximum phonation time and s/z ratio between groups. Auditory-perceptual analysis indicated greater compromising of voice parameters for NG, compared to CG: G (79 versus 24), R (53 versus 3), B (67 versus 23) and S (35 versus 1). The values of acoustic parameters jitter, PPQ shimmer, APQ, NHR and SPI were higher for NG for CG. The parameter f0 did not differ between groups.Conclusion: Compromising of auditory-perceptual (G, R, B and S) and acoustic vocal parameters (jitter, PPQ shimmer, APQ, NHR and SPI) was greater for children with nodules than for those of the control group, which makes them important methods for assessing child dysphonia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Aquecimento e Desaquecimento Vocal em Estudantes de Pedagogia

Introduction: the voice is one of the main features of interaction between teacher and student. As teachers, future teachers are also risk population for the development of dysphonia and may be subject to protective intervention. Purpose: to evaluate the effect of a vocal warm-up and cool-down procedure at Pedagogy students. Method: A quasi-experimental study, pre-posttest without a control group, with fourteen Pedagogy students at a public university, participants of a short course. The analysis was performed by a self-assessment visual analogue scale of 10 cm, considering aspects related to the body and voice. The protocol was implemented in three steps: pre-test, post warm-up and post cool-down, and it was calculated the averages of the variables of discomfort and compared the measurements before and after performing each procedure. It was used the the Wilcoxon signed-rank statiscal test, adopting a significance level of 5%. Results: there was less discomfort with statistical significance after the vocal warm-up (p=0.002) and cool-down (p=0.001), with greater magnitude in both aspects related to voice. Conclusions: The vocal warm-up and cool-down have positive effects on the perception of students and should be taught to future teachers in order to prevent vocal disorders. The vocal cool-down, poorly researched, should not be passed over vocal health practices since its purpose showed obvious improvement in the investigated group.

Seminários de Voz da PUC-SP: análise da trajetória entre os anos de 1993 a 2009

This is a reflexive analysis of the Voice Seminaries at PUC SP, realized between 1993 and 2009. The analysis points out to the involvement of the organizers, talkers and participants with the theme “occupational voice”.Each year, the suggestion of subjects occured methodically, conducted by events and by the direction of the late year seminary, or stimulated by a new proposition. During these years, it was observed the effort made towards a social modification, in this case, a government recognition of the vocal disorder as a desease related to working conditions of determined professional categories which use voice intensily.

Vocal complaint in physical education teachers and its association with the cardiovascular system

Background: We examined the vocal complaints and evaluated the correlation between the vocal handicap index (VHI) and heart rate variability (HRV) in physical education teachers. We evaluated 46 teachers. Method: The subjects were investigated regarding voice complaint and the VHI was applied. HRV was recorded at seated rest for ten minutes and it was analyzed in the time, frequency domains, geometric indices and fractal exponents. The three domains of the VHI were correlated with the indices of HRV. Results: The physical education teachers presented a VHI score much below the standard of the physiological normality. There was correlation of the organic domain of the VHI with the NN50 and pNN50 and correlation of the functional domain and organic domain of the VHI with the HF index of HRV. Conclusion: The physical education teachers evaluated reported vocal complaints that affected their function and it is suggested to be related with the cardiac autonomic regulation.

Teatralidade em frequência e intensidade: análise da matriz vocal do espetáculo Passos, do grupo Obragem de Teatro e Cia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Determinação da crítica razão esforço-pausa em Uchi-Komi no judô, com a utilização de deltas de variação de lactato sanguíneo e da escala subjetiva de esforço de Borg

In the competitive judo, the form as a trainer organizes the process of his/her athlete's training is a very important task for a good acting and a better use of the technical procedures. There is great importance in determining the exercise intensity for the judocas training due to the interest for the high income in several competitions, and few studies returned for this research area, involving those athletes' different physiologic conditions. Therefore, it is necessary to improve protocols of physical evaluation for this modality, increasing his/her applicability. The present study aimed at to verify the validity of a protocol of specific aerobic test of the judo (technique ipon-seoi-nague), no exhausting, adapted of the method of CHASSAIN (1986), using deltas of variations of the lactacidemia and of the Scale of Perception of Effort of Borg, in athletes well. The test adapted to the judo constituted of four exercise series with two efforts similar (double) of 180 seconds with one interval of 90 seconds among them. The series of exercises were accomplished in consecutive days. The intensities of the double tests were of 85%, 95%, 105% and 115% of the minimum lactato for each participant. This work used the technique ipon-seoi-nague, obeying the reasons effort-pause individualized for each athlete, that you/they correspond to the intensities of exercises proposed by the protocol of CHASSAIN (1986). In that way, the athletes applied a blow (maximum speed) and they rested some seconds, depending on the regime effort-pause of the session. At the end of each collection collection of blood (25NL) of each participant's earlobe was accomplished, seeking to measure the concentration of sanguine lactato. The collections were accomplished at the end of the first and of the second efforts, in each one of the series. For the analysis of the Perception of the athletes' Effort, the Scale of Perception... (Complete abstract click electronic access below)

Efeito da especificidade do treinamento (de fundistas e culturistas) sobre os indicadores bioquímicos do estresse obtidos em teste de esforço máximo em esteira e com pesos

Dezesseis atletas treinados em musculação (grupo AN = 7) ou em corridas de longa distância (AE = 9) foram submetidos a exercícios de máxima intensidade específicos e inespecíficos a sua modalidade de treinamento. A influência da especificidade do treinamento sobre as alterações promovidas por sessões agudas de exercício exaustivo nos parâmetros hemodinâmicos, de dano muscular e de estresse oxidativo foi analisada, e foram comparados os padrões de resposta aos exercícios entre os dois grupos. Os testes máximos consistiram de teste exaustivo em esteira, utilizando protocolo de rampa, e teste com pesos utilizando cargas iniciais de 80% de 1RM, progressivamente reduzidas, até a exaustão, em dois exercícios que abrangeram grupos musculares distintos. Foram realizadas coletas de sangue antes e imediatamente após os exercícios para a determinação de indicadores de hemoconcentração, de lesão muscular, de processo inflamatório e determinação de parâmetros hemogasimétricos. A glicemia se elevou significativamente após os testes somente para o grupo AE. Foram verificados aumentos significativos na acidose devidos a elevação das concentrações de lactato, H+ combinados a redução do HCO3-. Foram observadas variações significativas nas concentrações dos íons sódio e potássio. Também houveram aumentos significativos nas concentrações de CPK e DHL. Além disso, houveram elevações das concentrações plasmáticas e dos leucócitos. Dentro dos parâmetros analisados, as respostas observadas não foram uniformes em comparação aos dois grupos, e houve variação também interna aos grupos, quando comparados os exercícios específicos aos inespecíficos. Os resultados apontam que embora seja esperada uma resposta metabólica característica após o esforço físico exaustivo, a especificidade do treinamento é determinante sobre os processos adaptativos... (Resumo completo, clicar acesso eletrônico abaixo)

Determinação da crítica razão esforço pausa (e:pcrit) em uchi-komi no judô, utilizando deltas de variação de freqüência cardíaca e escala de percepção de esforço de Borg

O presente estudo objetivou verificar a validade de um protocolo de teste aeróbio específico do judô (técnica ipon-seoi-nague), não exaustivo, adaptado do método de CHASSAIN (1986), utilizando deltas de variações da escala de percepção de Borg e da freqüência cardíaca em atletas bem treinados. O teste adaptado ao judô constituiu de quatro séries de exercício com dois esforços iguais (duplos) de 180 segundos com um intervalo de 90 segundos entre eles. As séries de exercícios foram realizadas em dias consecutivos. As intensidades dos testes duplos foram de 85%, 95%,105% e 115% do lactato mínimo para cada participante. Este trabalho utilizou a técnica ipon-seoi-nague, sendo que as razões esforço-pausa foram específicas para cada atleta, e correspondem às intensidades de exercício propostas pelo protocolo de Chassain (1986). A escala de percepção de esforço de Borg foi mostrada ao final do primeiro e do segundo esforços, em cada uma das séries, para que o atleta determinasse o nível de cansaço. Para análise da freqüência cardíaca foi utilizado um freqüencímetro, Polar Vantage NV, obtendo freqüência cardíaca concomitantemente a escala de Borg, ao final de bloco de esforço. Dessa maneira, foram obtidos dois deltas de variações entre o primeiro e o segundo esforços, para escala de percepção de Borg (ΔBORG) e FC (ΔFC). Uma vez que foram utilizadas quatro intensidades, foi possível determinar quatro ΔBORG e quatro ΔFC. Assim, a partir de duas regressões lineares (uma para o Borg e outra para a FC), foi possível determinar as razões esforço:pausas críticas do exercício na técnica específica do Judô, a partir da determinação das intensidades nas quais a variação de Borg e da FC foi igual a zero (ΔBORG=0 e ΔFC=0). Para validar esses procedimentos adaptados de Chassain (1986) ao Judô, foi realizado o teste de Lactato Mínimo Adaptado, conforme sugerido por Azevedo (2002).

Validação de uma escala colorida de esforço percebido para adultas jovens e idosas em caminhada na esteira

The perceived exertion has been used for the intensity control and exercise prescription. Among the various scales that estimate the perceived exertion, the Borg’s RPE scale is one of the best known. However, for populations with low levels of schooling or with visual difficulties such as the elderly, the application of these scales becomes more difficult. In previous studies, a color scale of perceived exertion was developed to aim for assistance in application of the scale and interpretation of perceived exertion. This scale showed high correlation with the Borg’s scale and proved to be valid to estimate the perceived exertion. Thereby, the aim of this study was to assess the validity of the color scale of perceived exertion to measure the perceived exertion in adult women of different ages. Participated in the study 12 young adult women with age of 21,7 ± 1,5 years old, and 10 elderly women with age of 60,3 ± 3,5 years old. The participants were submitted to an incremental exercise of treadmill walking with stages of 2 minutes duration. The inicial load was 5,5 km/h and inclination of 6% for young women and 2% for elderly women, both with 2% increments at each stage completed, without changing the speed. Heart rate and oxygen comsuption responses were determined at the 30 finals seconds of each stage. At the 60 finals seconds of each stage participants indicated the perceived exertion for the overall body, for the legs and for the chest, primarily in the color scale and following in the tradicional Borg’s scale. The analysis of variance for repeated measures was used to assess the effect of different loads on the perceived exertion and physiological responses. The correlations betwen physiological variables, color scale and Borg’s scale were analyzed in group and individually. In all analysis the significance...(Complete abstract click electronic access below)

Efeito da manipulação do feedback da percepção subjetiva de esforço esperada na percepção subjetiva de esforço e no desempenho de adultos de diferentes faixas etárias

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise do esforço amostral para ecologia comportamental: onças pardas como exemplo

Pós-graduação em Biociências - FCLAS

Presença de fatores de risco dependentes ou não de esforço físico em praticantes de corrida de rua

In order to reduce the sedentarism and to improve population's health condition, many physical activity incentive programs have been stimulated. As a result, many people have adhered to street racing, but their health condition is almost always ignored. The aim of this study was to evaluate street racers' health condition, identifying the presence of cardiovascular risk factors as well as problems associated to street racing. The study case was composed by 111 racers from the town of Bauru (94 men and 17 women) aged in average 39±13 years old, who were evaluated in 4 street race competitions. The subjects answered to an anamnesis with questions about their socioeconomic status, medicine use, cardiovascular risk, physical exercise practices, and issues related to racing and injury. Weight (kg) and height (m) were measured to calculate the body mass index (BMI, kg/m²) as well as systolic and diastolic blood pressure (BP), heart rate (HR), abdominal circumference (AC), and flexibility. It could be observed that the majority of racers were Caucasian, married and belonged to social classes over C. The prevalent age was between 18 and 35 years old (42%). Among the participants, 38.7% have already undergone some kind of surgery and 13% declared having some health problem. The questionnaire pointed out that 36% had low and moderate cardiovascular risk. It could be noticed from the AC that 10% of men and 18% of women had high cardiac risk. Among the tested, 43.2% (24.3% altered and 18.9% borderline) showed high BP on the day of the test, but only 2.7% had self-declared hypertensive. In relation to injury, 36% had already had lesions of some kind, 27.5% of which had occurred in the last 8 months. 66.6% had derived from training or racing competitions and the knee was the mostly affected body part. Only 43% had professional orientation by a physical education teacher during their training and the main reasons for them to begin racing practice were...

O nível de esforço físico durante o treinamento coletivo no Futsal na categoria Sub 13

Futsal is one of the most popular sports in Brazil, played on five continents, in hundreds of countries, but is still a poorly studied sports science. Among the types of training used in the preparation of soccer players, the collective training is one of the most used because it is a simulation game. The application of the training load is often made in large quantities (volume) with exercise duration and intensity greater than what the athlete can handle. Thus, this study aimed to evaluate the intensity of physical exertion of futsal players of basic category during collective training. We evaluated twenty (N=20) soccer players from two teams with different levels of training. There were ten players on a team federated (FED) and ten players on a team for a project extension (EXT). Samples were collected at the respective locations of training. An evaluation of anthropometric and during collective training heart rate was measured and at the end of each training time blood samples were collected for analysis of blood lactate concentration and perceived exertion of the players. There was significant difference between the two teams only in fat percentage (FED=13,4 e EXT=21,2). The average heart rate during training was 174 ± 12.2 bpm, which corresponds to 84% HRmax. There was significant difference between heart rate and the percentage of HRmax in the two parts of training in both teams. The Federated team players remained most of the time in more intense intensity zone (above 85% HRmax), while the EXT players were most of the time zone of moderate intensity (65-85% HRmax). The rating of perceived exertion (FED=3,5 e EXT=3,2) and blood lactate concentration (FED=2.4 mmol/L and EXT=2.9 mmol/L) showed no significant difference between the two teams and between the two times. During training there was a significant correlation (p= 0.71) between heart rate and lactate concentration. The collective training showed an intensity that is supposed to be...