ALTERAÇÕES CERVICAIS EM MULHERES DISFÔNICAS

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

This study correlates cervical and voice changes that can cause muscle shortening, pain and fatigue in the cervical region and scapular waist if such disorders compromise the vocal tract and the musculoskeletal neck region. Vocal fatigue may be seen as loss of functional balance with signs of hyper or hypo-function in both physical and mental fields. This study chose women suffering from voice disorders and complaining of constant cervical pain. The size of the larynx in women requires them to increase the intensity of the voice to be heard. Thus, just as there are usual comments and citations to dysphonic patients, there are clinical features that frequently happen in dysphonia cases such as postural changes and the relation between psycho-emotional aspects with voice. Objective: The present study aimed at evaluating and identifying cervical changes in women with vocal disorders and cervical pain through parameters of posture, muscle shortening, presence of pain and trigger-points, and women without vocal changes independent of cervical pain complaints. Method: This cross-sectional study examined 32 individuals in the dysphonic group and 18 subjects in the control group, aged between 25 and 55 years (mean = 31.4 years), female. The individuals were subjected to otolaryngological orthopedic, physiotherapeutic and voice records evaluations, where the anterior, lateral and posterior profiles were seen; test of muscle shortenings, and palpation was used to identify the place of pain and presence of trigger-points. Results: For the relief of cervical pain, the resource that was mostly used by the dysphonic group was stretching, but there are significant differences in the use of stretching and medicine (p = 0.0377) between the two groups; that is, the non-dysphonic group practiced more stretching and used more medication than the dysphonic group. By the examination of simple radiology, there was a significant difference in the normality parameter (p = 0.0051). As for cervical changes, the dysphonic group presented cervical rotation in 62.0% of cases and 83.0% in the non-dysphonic group with significant difference (p = 0.0051); hyperkyphosis of the first thoracic vertebra occurred in the non-dysphonic group in 77.0% of cases and the dysphonic group with significant value (p = 0.0091). In the dysphonic group, there were muscle shortenings in the trapezius muscles (upper fibers) in 96.0% of cases, sternocleidomastoid (78.0%) and spine erectors (25.0%). On examination of palpation, pain was detected in trapezius muscles (upper fibers) in 81.0% of cases and bilateral inferior neck line (31.0%) in the dysphonic group. The trigger-points were identified in the trapezius muscles (upper fibers) in both groups. Conclusion: Significant cervical changes in both dysphonic and non-dysphonic groups were identified, but the deviations of head posture and muscle shortening were most significant in the non-dysphonic group.

ASSUNTO(S)

disfonia cervicalgia fonoaudiologia posture postura dysphonia cervical pain

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