Avaliação multidimensional dos efeitos da intervenção vocal em indivíduos com deficiência isolada do hormônio do crescimento

Abstract

Introduction: the voice is one of the most striking characteristics of each person's identity. In northeastern Brazil there is a cohort of individuals with congenital and isolated growth hormone deficiency (DIGH), resulting in severe short stature and high-pitched voice. Despite the normal general quality of life, the quality of life and voice (V-RQOL) scores are reduced, suggesting that these individuals cope better with short stature than with their voice. Objective: To evaluate the effect of vocal intervention the therapy with of semioccluded vocal tract (SOVTT) phonation in silicone tube and choir training on the voice of individuals with DIGH. Method: this is a prospective clinical study with comparison before and after vocal intervention in 13 sessions for 90 days. For comparison, multidimensional vocal assessment was performed: acoustic analysis (Praat), auditoryperceptual (GRBAS) with recording of the sustained vowel's phonatory tasks and chained speech; and the V-RQOL questionnaire and voice self-assessment were applied to 17 adult individuals with DIGH. Statistical analysis was execute in the SPSS program: Shapiro- Wilk test, normal distribution, mean T test (standard deviation), acoustic measurements and QVV scores, and median Wilcoxon test (interquartile range), shimmer and jitter; Cronbach's alpha coefficient (0.70 to 0.90) of the GRBAS scale, McNemar test, p<0.05 and power of 0.8 To compare vocal self-assessment. Results: The vocal intervention significantly reduced the second formant (p= 0.046) and jitter (p= 0.048). The GRBAS scale showed a reduction in the general degree of vocal deviation (p= 0, 0001), roughness (p = 0, 0001), breathiness (p = 0, 0001) and strain (p= 0, 0001). Likewise, a significant increase in total V-RQOL (p= 0.0001), physical (p= 0.0002) and socioemotional scores (p= 0.0001) and vocal self-assessment (p= 0.004) was observed. Conclusion: The prolonged vocal intervention provided effects on the voice of individuals with DIGH, observed in the acoustic analysis, reduction of F2 and jitter, in the auditory-perceptual evaluation, GBRAS scale, absence of breathiness and asthenia and reduction of the general degree of vocal deviation, roughness, breathiness and strain, positive vocal impact on quality of life and voice, good to excellent vocal self-assessment.