Autoavaliação e avaliação vocal de professoras após terapia miofascial

• Ano de defesa: 2026
• Autor(a) principal: Gonçalves, Daniela da Silva
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Santa Maria; Brasil; UFSM; Programa de Pós-Graduação em Distúrbios da Comunicação Humana; Centro de Ciências da Saúde
• Palavras-chave em Português: Acústica; Docentes; Qualidade da voz; Terapia de liberação miofascial; Acoustic; Faculty; Myofascial release therapy; Voice quality; CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA
• Link de acesso: http://repositorio.ufsm.br/handle/1/38735

Introduction: Teachers present a higher risk of developing voice disorders due to daily occupational factors that lead them to make maladaptive vocal adjustments. These include maintaining an elevated sound pressure level during speech, using inefficient posture and breathing patterns, and tensioning the cervical musculature. The vocal symptoms most frequently reported by teachers range from hoarseness, vocal fatigue, throat clearing, and effort and/or pain while speaking, in addition to musculoskeletal complaints, with pain in the neck, shoulders, trunk, and legs. Myofascial release using pompage and breathing reeducation, applied to female teachers with musculoskeletal and vocal complaints and normal larynges, has shown improvements in voice, posture, and pain. Objective: To characterize and compare the results of auditory-perceptual, acoustic, and self-assessment vocal measures of female teachers with vocal complaints, musculoskeletal complaints, and normal larynges, following myofascial release therapy using pompage and breathing reeducation, and to compare these results with a control group. Methods: A randomized controlled clinical trial, approved by the Research Ethics Committee for Human Subjects. The sample, consisting of 56 female teachers with normal larynges and vocal and musculoskeletal complaints, was divided into a study group and a control group. The study group underwent myofascial release therapy using pompage and breathing reeducation. Pre- and post-intervention assessments were performed using vocal self-assessment protocols (Voice Handicap Index, Vocal Symptoms Scale, and Vocal Tract Discomfort Scale) and recording of the sustained vowel /a/. Acoustic analysis of the vowel /a/ was performed using the Multi-Dimensional Voice Program Advanced (Kay Pentax®) and Praat (version 6.4.01) software, to extract acoustic measures of the glottal source and vocal tract filter. Additionally, auditory-perceptual analysis was performed using the GRBASI scale by blinded judges. For the characterization and intra- and intergroup comparisons pre- and post-therapy, for each aspect evaluated, Fleiss' Kappa, Cohen's Kappa, paired Student's t-test, and McNemar tests were used; p < 0.05 was adopted. Results: In the study group, there was a significant improvement in the physical subscore of the Voice Handicap Index, as well as in the total scores and subscales of the Vocal Symptoms Scale and the Vocal Tract Discomfort Scale, whose data also revealed an expressive reduction in the frequency and intensity of specific sensory symptoms (dryness, irritation, and throat pain), while the sensation of "lump in the throat" remained stable. No significant changes were observed in the acoustic parameters of the glottal source, vocal tract filter, or in the auditory-perceptual evaluation. Conclusion: The protocol reduced discomfort, peripheral sensory symptoms, and vocal handicap (physical score), improving the voice-related quality of life of the teachers. Although no immediate changes occurred in the auditory-perceptual and acoustic (source/filter) measures or in the emotional score, the intervention proved to be an effective complementary tool for relieving phonatory effort and biomechanical overload, whose consolidation depends on an integrated approach between Physical Therapy and Speech-Language Pathology.