Eficácia do treinamento auditivo musical em idosos usuários de próteses auditivas
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Data
2020-06-30
Autores
Alcântara, Yara Bagali [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Os idosos com presbiacusia queixam-se de dificuldade no reconhecimento de fala no ruído, que pode ter como causa déficits no processamento auditivo neural. O treinamento auditivo musical foi desenvolvido como uma nova proposta de treinamento auditivo voltada para a estimulação das habilidades auditivas centrais de idosos usuários de próteses auditivas. No entanto, a compreensão dos efeitos desse treinamento nos mecanismos centrais da audição que interferem nos processos de adaptação e reabilitação auditiva em idosos ainda é um desafio. Objetivo: Analisar a eficácia do Treinamento Auditivo Musical associado à adaptação de prótese auditiva de idosos com presbiacusia. Método: Ensaio clínico randomizado unicego que foi aprovado pelo comitê de ética em pesquisa sob o número n. º 02848918.2.0000.5406. Participaram do estudo oito idosos, novos usuários de próteses auditivas, com idade entre 65 e 80 anos, distribuídos em dois grupos: Grupo Prótese Auditiva: que somente fez uso de próteses auditivas e Grupo Treinamento Auditivo: submetidos a reabilitação auditiva com o treinamento auditivo musical por 16 sessões de 30 minutos com o objetivo de trabalhar as habilidades auditivas de processamento temporal (resolução e ordenação temporal), localização, fechamento auditivo e atenção seletiva. Todos os participantes foram submetidos aos testes de potencial evocado auditivo cortical com estímulo verbal, teste de reconhecimento de sentenças no ruído e questionário de auto avaliação do handicap auditivo. Os testes foram realizados em dois momentos distintos: Avaliação inicial, realizada antes da adaptação das próteses auditivas e do treinamento auditivo, e após três meses, avaliação final ao fim do treinamento auditivo. Todos os participantes foram adaptados bilateralmente, com próteses auditivas mini retroauriculares, de um mesmo fabricante e de igual processamento do sinal digital, mesma regra prescritiva NAL-NL2, de adaptação aberta, ajustadas de acordo com seus audiogramas individuais. Realizou-se análise descritiva (média e desvio padrão) e inferencial dos dados, com teste de normalidade Shapiro-Wilk, seguido pelo teste t de Student para amostras independentes para comparação entre os grupos. Para analisar o efeito principal do grupo e do tempo, e a interação entre grupo e tempo foi realizada a Anova mista de medidas repetidas Resultados: Para o teste eletrofisiológico, houve diminuição significante da latência do componente P3a do Grupo Treinamento Auditivo na comparação entre avaliação inicial e final. Com relação ao teste de reconhecimento de fala no ruído não houve diferença estatisticamente significante para nenhum dos grupos, tanto para Limiar de Reconhecimento de Sentenças no Ruído quanto Índice Percentual de Reconhecimento de Sentenças no Ruído. Para o questionário de autoavaliação houve diferença estatisticamente significante para o escore total e subtotal social para o Grupo Treinamento Auditivo quando comparadas as avaliações inicial e final. Conclusão: O Treinamento Auditivo Musical associado ao uso de próteses auditivas em idosos com presbiacusia mostrou-se eficaz na reabilitação auditiva ao gerar mudanças neurais para atenção, reconhecimento acústico e associação auditivo-linguística e reduzir os impactos da perda auditiva nas atividades de vida diária de idosos com presbiacusia.
Introduction: Elderly individuals with presbycusis complain about difficulty recognizing speech in noise, which may be caused by deficits in neural auditory processing. Music auditory training was developed as a new proposal for auditory training aimed at stimulating central auditory abilities of elderly hearing aids users. However, understanding the effects of this training on the auditory central mechanisms that interfere with hearing fitting and rehabilitation process for elderly individuals is still a challenge. Objective: To analyze the effectiveness of Musical Auditory Training associated with hearing aids fitting of elderly individuals with presbycusis. Method: Single-blind randomized clinical trial that was approved by the research ethics committee under number 02848918.2.0000.5406. Eight elderly individuals, new hearing aids users, aged 65 to 80 years, participated in this study, divided into two groups: Hearing Aids Group: which only wore hearing aids and Auditory Training Group: undergone auditory rehabilitation with musical auditory training for 16 sessions lasting 30 minutes to work temporal processing (resolution and temporal ordering), localization, auditory closure and selective attention abilities. All participants were undergone cortical auditory evoked potential with verbal stimulus, sentence recognition test in noise and auditory handicap self-assessment questionnaire. The tests were conducted at two different moments: Initial evaluation, carried out before hearing aids fitting and auditory training, and after three months, final evaluation at the end of auditory training. All participants were bilaterally fitted, with mini-behind the ears (BTE) hearing aids, from the same manufacturer and with the same digital signal processing, the same prescription rule NAL-NL2, with open fitting, set based on their individual audiograms. Descriptive analysis (mean and standard deviation) and inferential analysis of the data were conducted, with the Shapiro-Wilk normality test, followed by the Student`s t-test for independent samples to compare groups. To analyze the main effect of the group and time, and the interaction between group and time, the mixed repeated measures ANOVA was applied. Results: For the electrophysiological test, there was a significant decrease in the P3a component latency of the Auditory Training Group when comparing the initial and final evaluations. Regarding the speech recognition test in noise, there was no statistically significant difference for any groups, both for Recognition threshold of the sentences in noise and Percentual indexes of sentences recognition in noise. For the self-assessment questionnaire, there was a statistically significant difference for the total and subtotal social score for the Auditory Training Group when comparing the initial and final evaluations. Conclusion: The Auditory Musical Training associated with the use of hearing aids in elderly individuals with presbycusis showed to be effective to auditory rehabilitation by generating neural changes for attention, acoustic recognition and auditory-linguistic association and reducing the impacts of hearing loss in the daily life activities for elderly individuals with presbycusis.
Introduction: Elderly individuals with presbycusis complain about difficulty recognizing speech in noise, which may be caused by deficits in neural auditory processing. Music auditory training was developed as a new proposal for auditory training aimed at stimulating central auditory abilities of elderly hearing aids users. However, understanding the effects of this training on the auditory central mechanisms that interfere with hearing fitting and rehabilitation process for elderly individuals is still a challenge. Objective: To analyze the effectiveness of Musical Auditory Training associated with hearing aids fitting of elderly individuals with presbycusis. Method: Single-blind randomized clinical trial that was approved by the research ethics committee under number 02848918.2.0000.5406. Eight elderly individuals, new hearing aids users, aged 65 to 80 years, participated in this study, divided into two groups: Hearing Aids Group: which only wore hearing aids and Auditory Training Group: undergone auditory rehabilitation with musical auditory training for 16 sessions lasting 30 minutes to work temporal processing (resolution and temporal ordering), localization, auditory closure and selective attention abilities. All participants were undergone cortical auditory evoked potential with verbal stimulus, sentence recognition test in noise and auditory handicap self-assessment questionnaire. The tests were conducted at two different moments: Initial evaluation, carried out before hearing aids fitting and auditory training, and after three months, final evaluation at the end of auditory training. All participants were bilaterally fitted, with mini-behind the ears (BTE) hearing aids, from the same manufacturer and with the same digital signal processing, the same prescription rule NAL-NL2, with open fitting, set based on their individual audiograms. Descriptive analysis (mean and standard deviation) and inferential analysis of the data were conducted, with the Shapiro-Wilk normality test, followed by the Student`s t-test for independent samples to compare groups. To analyze the main effect of the group and time, and the interaction between group and time, the mixed repeated measures ANOVA was applied. Results: For the electrophysiological test, there was a significant decrease in the P3a component latency of the Auditory Training Group when comparing the initial and final evaluations. Regarding the speech recognition test in noise, there was no statistically significant difference for any groups, both for Recognition threshold of the sentences in noise and Percentual indexes of sentences recognition in noise. For the self-assessment questionnaire, there was a statistically significant difference for the total and subtotal social score for the Auditory Training Group when comparing the initial and final evaluations. Conclusion: The Auditory Musical Training associated with the use of hearing aids in elderly individuals with presbycusis showed to be effective to auditory rehabilitation by generating neural changes for attention, acoustic recognition and auditory-linguistic association and reducing the impacts of hearing loss in the daily life activities for elderly individuals with presbycusis.
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Palavras-chave
Potenciais evocados auditivos, Auxiliares de audição, Presbiacusia/reabilitação, Auditory evoked potentials, Hearing aids, Presbycusis/rehabilitation