Aspectos respiratórios, posturais e vocais da doença de Parkinson considerações teóricas

Abstract

This study aimed to review the specialized literature on respiratory, postural and vocal manifestations, associated to stages in Parkinson´s Disease and its possible interrelations, as well as, aging in phonation. Method: Some researches were carried based in articles in some databases: Lilacs, Bireme, PubMed, MedLine, Scielo and Google Schoolar, besides books, theses, dissertations and the Internet. Results: senescence is a physiological process to all human beings, generating anatomical and functional changes, especially at the age of 60, as muscular atrophy, calcification of the laryngeal cartilage, and reduction in respiratory capacity, reflecting on the voice through changes in pitch, instability, decrease in the maximum phonation time and restriction of vocal intensity. Parkinson´s Disease causes a series of functional alterations, e.g., rigidity, shaking, bradikinesia, reduction in the respiratory muscular strength, in maximum phonation time and vocal intensity, as well as postural changes. Its repercussions occur simultaneously, due to the muscle chains, body posture, respiratory and, consequently, phonation. Postural deviations, as the head forward positioning, shoulder protrusion and chest hyperciphosis are common in aging and PD and contribute to vocal disturbances through biomechanic disadvantages, especially in the cervical-scapular segment. Associated to postural alterations, is the decreasing in the respiratory muscular strength, causing the chest to expand less, reduction in the lungs volume and capacity, interfering in vocal production. There is a tendency for these disturbances to occur more frequently and with more gravity according to the stage in which the parkinsonian is. Conclusion: Based in the premisse that the human movement and its disorders, as well as the comunication disturbances, from aging and neurological diseases are interrelated by means of complex neural and muscle-skeleton nets, it becomes essential for a better understanding of the integration of physiotherapy and speech therapy, in order to have a complementarity, aiming the Parksonian's well-being.