Aspectos respiratórios e vocais e sintomas osteomusculares em gestantes

Abstract

Objective: To d escri be , compare and correlate vocal self assessment s , musculoskeletal symptoms, and aerodyna mic and manovacuometry voice measurements of pregnant women. Methods: F ield, cross sectional, observational, prospective and quantitative study. After sample selection using inclusion and exclusion criteria, 49 pregnant women from the second and third gest ational trimesters, aged between 18 and 40 years, were evaluated using the Nordic Musculoskeletal Questionnaire and the Voice Related Quality of Life instrument ; respiratory muscle strength, Maximum Phonation Time of /a/, habitual , minimum and maximum sou nd pressure level were also evaluated. The data were analyzed by the R environment, using the T, Chi square, Wald, Mann Whitney and Wilcoxon tests. Results : Voice Related Quality of Life : average scores of the total score and of the socioemotional domain s ignificantly within the cutoff points; greater number of pregnant women significantly below expectations in the physical domain, which was also significantly lower than the other domains . Nordic Musculoskeletal Questionnaire: most aspects investigated had a significant negative response The only ones with positive significance were presence of pain and tingling in the lower back . Pregnant women who presented complaints and musculoskeletal impairments also showed a significant decrease in the three Voice Re lated Quality of Life domains, mainly in the physical one . Regarding aerodynamic vocal measurements, the Maximum Phonation Time of /a/ and the maximum inspiratory and expiratory pressures were significantly below expectations. Habitual , minimum and maximum sound pressure levels were significantly higher than expected. The maximum sound pressure level showed a weak positive correlation with the maximum phonation time of /a/. There were moderate positive correlations between: minimum maximum sound pressure le vel and habitual sound pressure level ; maximum and minimum sound pressure level; and maximum expiratory pressure and maximum sound pressure level. A strong positive correlation occurred between maximum expiratory pressure and maximum inspiratory pressure. Conclusion : The pregnant women showed worsening of the ir Voice Related Q uality of Life regarding physical aspects and presence of pain and tingling in the lower back. Those who presented complaints and musculoskeletal impairments also showed a decrease i n the ir Voice Related Quality of Life , mainly in the physical domain. The pregnant women presented decreased maximum phonation time of /a/ decreased respiratory pressures and increased sound pressure levels. This suggests that pregnancy affects the respi ratory dynamics regarding support of phonation and respiratory strength, which may generate a possible vocal abuse with the increase in sound pressure levels without proper respiratory support