CoDAS最新文献

Purpose: This study sought to analyze the swallowing function of cancer patients undergoing palliative care according to the degree of functionality and nutritional status.

Methods: observational, cross-sectional study, conducted with advanced cancer patients outside the head and neck and upper gastrointestinal tract, in an outpatient palliative care setting at a Brazilian oncology center, conducted between March 2022 and August 2023. In the first stage, sociodemographic, clinical, functional, and nutritional data were collected. Subsequently, a speech therapy assessment was performed to classify swallowing disorders and feeding route associated with swallowing ability. Descriptive, univariate, and multivariate analyses were conducted using logistic regression.

Results: 39 individuals participated in the study, the majority were female, with functional performance between fair and good, moderately undernourished. Regarding the assessment of swallowing abilities, the sample mostly exhibited fully functional swallowing, followed by functional swallowing with occasional minimal cues, additional time, or avoidance of specific foods. As for the classification of swallowing, most participants had either normal swallowing or functional swallowing, with only one patient presenting mild oropharyngeal dysphagia. Multivariate analysis revealed a significant association between a decline in swallowing ability and poorer functional performance and nutritional status.

Conclusion: Poorer swallowing ability in patients with advanced cancer, excluding those with head, neck, and upper gastrointestinal tract cancers, was associated with lower global functionality and nutritional status.

Purpose: To verify the efficacy of PROCICLOS-A in children with SSD, according to the weekly frequency of sessions, and the severity's influence on the sessions' performance.

Methods: Eight children with SSD participated, both sexes, ages between 5:03 and 7:07 years, divided into two groups: C1, once a week; C2, twice a week. The efficacy of PROCICLOS-A was verified in C1 and C2 by analyzing variables from the phonology tests of the ABFW assessment across three evaluation moments. The performance in the sessions was obtained through scoring the activities.

Results: All measures significantly differed, indicating improved performance in the evaluations after the intervention. Regarding the influence of the frequency of the sessions, there was no significant difference between C1 and C2 in the three evaluation moments. Blocks of sessions analyzed the performance in the sessions: A (sessions 1, 4, 7, 10), B (sessions 2, 5, 8, 11), C (sessions 3, 6, 9, 12). The analysis revealed lower performance during the sessions of Block A, while Blocks B and C demonstrated better performance.

Conclusion: The study provided evidence for the efficacy of PROCICLOS-A, regardless of the dosage and frequency of sessions. It suggests that maintaining the cumulative intensity of the intervention is vital, indicating that the total number of intervention hours may have a greater impact than the number of sessions held per week. There was an improvement in each child's performance throughout the program, regardless of the target sound and severity at the beginning of the intervention.

Purpose: To describe speech profiles in individuals with Huntington's Disease (HD), correlate them with cognitive and clinical aspects, and compare them with healthy controls.

Methods: Symptomatic individuals with a clinical and molecular diagnosis of HD were included. Seven healthy controls, matched by age and sex, were also included. Clinical and sociodemographic data were obtained from medical records. The Unified Huntington's Disease Rating Scale was used to measure severity. Cognitive data were collected using verbal fluency, symbol digit modalities, and Stroop tests. Auditory perceptual assessments were used to evaluate speech, and acoustic analysis extracted information about the following tasks: sustained vowel /a/, utterances with different intonations, oral diadochokinesis, spontaneous speech, and the repeated diphthong /ju:/.

Results: Of the seven individuals with HD, four women with a mean age of 48.86 (±16.03), presented severe (57.15%), moderate (28.57%), and mild (14.28%) dysarthria. Speech impairment in HD case subjects was related to overall motor decline; the worse the motor symptoms, the worse the speech impairment. There was no correlation with the other clinical data or cognition. The case subjects were significantly worse than the control group, specifically regarding the subsystems of phonation (fundamental frequency, phonation time, local jitter, local shimmer), respiration (maximum phonation time) and articulation (speech rate, phonation time in spontaneous speech, number of syllables in spontaneous speech, average duration of syllables and duration of spontaneous speech).

Conclusion: In HD subjects, the most affected speech subsystems were articulation, phonation, and respiration. Poor motor speech patterns were associated with overall motor decline. Speech assessments may provide biomarkers that predict HD progression.

Purpose: To evaluate the effectiveness of the adapted Cycles approach to telepractice and family engagement in the treatment of children with speech sound disorder (SSD).

Methods: Ten children aged 5:0 to 7:8 years with a diagnosis of SSD participated. Two multiple baseline assessments and two post-treatment assessments were conducted. Effectiveness was measured by comparing pre- and post-intervention percentage of consonants correct (PCC), percentage of consonants correct revised (PCC-R), Process Density Index (PDI), and the number of phonological processes with occurrence >25% and the intervention effect size (ES). Family perceptions of daily training were obtained via digital interview and Likert scale. Subjects were randomly distributed to G1: two weekly online sessions with the speech therapist, and G2: half the sessions conducted by the caregiver trained by the speech therapist. Both groups received 12 sessions and performed daily speech training.

Results: All participants showed increased PCC, PCC-R, and decreased PDI and number of phonological processes with occurrence >25%, with ES ranging from small to large. There was a trend towards statistical significance (ES G2 > G1). All caregivers reported high child interest in activities and ease of execution, with a positive family experience (Likert=4) training the child's speech using digital resources.

Conclusion: The effectiveness of the proposed approach ranged from medium to high. The performance of the groups was similar, with a trend towards greater effectiveness for G2, which focused on family involvement. Parental training resulted in good engagement in sessions and daily training.

Purpose: To identify and describe language assessment protocols from the perspective of ABA used in speech-language therapy.

Research strategies: The question that guided the study was: What are the ABA-based language assessment protocols currently used in speech therapy? For the electronic search of articles, the databases used were Medline/PubMed, Lilacs, Web of Science and Scopus. The search strategy used indexed and free uniterms related to PCC.

Selection criteria: Studies with a cross-sectional design were included, considering individuals undergoing language assessment as the population; ABA-based assessment protocols in speech-language therapy were included. Studies that did not focus on language assessment and with a literature review design, letters to the editor, books, abstracts from proceedings, opinion articles and technical articles were excluded.

Data analysis: The data were analyzed descriptively, analyzing the studies' levels of evidence.

Results: A total of 6,859 articles were identified in all the databases. Of these, 17 articles were selected by title, after reading the abstract. 12 were excluded because they did not meet the inclusion criteria: 4 were review articles, 6 did not fit the objective of this research and 2 were repeated between the databases. Five were then selected for full text reading and subsequent data analysis.

Conclusion: Only two language assessment protocols from the perspective of ABA used in speech therapy were found in this review: VB-MAPP and ABLLS-R. Both do not have validation studies for Brazilian Portuguese.

Changes in the lingual frenulum can impair breastfeeding, leading to poor weight gain and/or early weaning. This study aimed to investigate the influence of frenotomy on the clinical and instrumental parameters of non-nutritive sucking in newborns. It is a case series study with six full-term newborns, three males and three females, diagnosed with ankyloglossia through the Lingual Frenulum Evaluation Protocol for Infants and the Bristol Tongue Assessment Tool. Clinical assessment of non-nutritive sucking was conducted using the Non-Nutritive Sucking Assessment Protocol, and instrumental assessment was performed using an instrument that records sucking pressure. Both assessments were conducted before frenotomy and up to 48 hours after the procedure, respectively, comparing the parameters between these moments. The number of suctions, suction groups, and the mean pressure increased significantly. The evaluation scores also changed significantly after surgery, with a decrease in the lingual frenulum assessment protocol score and an increase in the Bristol Tool score. Instrumental parameters (number of suction groups, total suctions, and mean pressure) and clinical parameters (lip sealing, tongue cupping, tongue dorsum elevation and lowering, mandible elevation and lowering, sucking strength, sucking rhythm, bites, exaggerated mandible excursions, and signs of stress) improved after frenotomy.

Purpose: This study aimed to translate and cross-culturally adapt The Boston Residue and Clearance Scale (BR-BRACS) into Brazilian Portuguese and validate the image selection content for the scale.

Methods: The project was approved by the Institution's Ethics Committee under number 67715717.6.0000.5406. The process involved translating the scale into the target language, synthesizing the translations, and back-translating it into the original language. A literature review was conducted to define the concept of pharyngeal residue and ensure the content validity of the images representing the scale. Then, 50 fiberoptic endoscopic evaluations of swallowing were analyzed and submitted to three judges for visual-perceptual evaluation. Agreement among the judges was analyzed using Fleiss' Kappa test with a 95% confidence interval.

Results: Discrepancies in lexical and syntactic contexts were identified during translation and resolved through a consensus among translators and authors. The back-translated versions were equivalent to the original. The images proposed for the scale showed near-perfect agreement among the judges.

Conclusion: The translation, cross-cultural adaptation, and selection of images for visual-perceptual evaluation of pharyngeal residue in the BR-BRACS were completed with evidence of content validity.

Purpose: The study aims to develop a proposed methodology for workforce planning in Speech-Language Pathology within the Unified Health System (SUS), considering the specific needs of the population and the guidelines from the Ministry of Health.

Methods: An extensive literature review on workforce planning for healthcare professionals was conducted, with a particular focus on Speech-Language Pathology. Based on the collected data, preliminary criteria for staffing parameters were defined, including demand, supply, and current public policies. A flowchart and a preliminary equation for workforce planning were formulated.

Results: Variables essential for workforce planning were identified. Demand was determined by the population with specific needs and the types of services required. Supply was evaluated based on the average working hours of professionals and their productivity. The proposed calculation for workforce planning was based on the demand and supply of professionals and considering five variables: i) population served, ii) population with speech-language pathology-related health needs, iii) distribution of the nature of procedures, iv) average frequency of speech-language pathology follow-ups, and v) average duration of a session. The calculation of supply considers three variables: i) speech-language pathologists, ii) average working hours, iii) dedication to direct patient care.

Conclusion: The discussions on workforce planning is essential to ensure an adequate supply of services to meet the population's needs, improving the organization of care lines and the effectiveness of the services provided.

Purpose: This study aimed to validate the STEP, an application developed for the analysis of various auditory and vestibular electrophysiological signals. The STEP was designed to enhance the accuracy and efficiency of latency and amplitude analysis, as well as other waveform morphological features such as calculation of area, slope, and Fast Fourier Transform (FFT).

Methods: The methodology was structured into two phases: one involving simulated waveforms and the other based on experimental data. In the first phase, waveforms were generated using mathematical functions, and their features were marked and analyzed both by trained examiners and by the STEP application. In the second phase, the STEP was tested using real electrophysiological recordings, with latency and amplitude values compared across STEP and two established gold-standard systems.

Results: The results demonstrated high accuracy of STEP in both manual and automatic peak and trough markings, as well as in subsequent calculations. No statistically significant differences were found among the evaluated systems, nor between the examiners.

Conclusion: The STEP proved to be a reliable tool for identifying latencies and amplitudes of electrophysiological waveforms and for performing additional analyses, including P1N1 area calculation, slope estimation, and FFT analysis.

Purpose: This scoping review aimed to map and synthesize evidence on technological advancements using Artificial Intelligence in the diagnosis and management of dysphagia. We followed the PRISMA guidelines and those of the Joanna Briggs Institute, focusing on research about technological innovations in dysphagia.

Research strategies: The protocol was registered on the Open Science Framework platform. The databases consulted included EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS), Livivo, PubMed/Medline, Scopus, Cochrane Library, Web of Science, and grey literature.

Selection criteria: The acronym 'PCC' was used to consider the eligibility of studies for this review.

Data analysis: After removing duplicates, 56 articles were initially selected. A subsequent update resulted in 205 articles, of which 61 were included after applying the selection criteria.

Results: Videofluoroscopy of swallowing was used as the reference examination in most studies. Regarding the underlying diseases present in the patients who participated in the studies, there was a predominance of various neurological conditions. The algorithms used varied across the categories of Machine Learning, Deep Learning, and Computer Vision, with a predominance in the use of Deep Learning.

Conclusion: Technological advancements in artificial intelligence for the diagnosis and management of dysphagia have been mapped, highlighting the predominance and applicability of Deep Learning in examinations such as videofluoroscopy. The findings suggest significant potential to improve diagnostic accuracy and clinical management effectiveness, particularly in neurological patients. Identified research gaps require further investigations to solidify the clinical applicability and impact of these technologies.