Efeito da música sobre o controle autonômico cardíaco e fluência em indivíduos com gagueira
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2020-09-11
Autores
Rosário, Marília Palmieri do [UNESP]
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Universidade Estadual Paulista (Unesp)
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Introdução: Gagueira é um distúrbio complexo com base neurobiológica, com muitos impactos na vida do falante. A fluência de um indivíduo que gagueja pode melhorar de acordo com alguns fatores, como o canto, a retroalimentação auditiva atrasada, a leitura em coro entre outros. Sabe-se que, a música contemporânea instrumental tem como efeito característico a ativação do sistema nervoso parassimpático e redução do sistema nervoso simpático, além de redução da frequência cardíaca. A variabilidade da frequência cardíaca (VFC) é um método bem reconhecido pela literatura que analisa a regulação cardíaca autonômica. Entretanto, não está claro na literatura se a exposição a música contemporânea instrumental com o fone de ouvido pode afetar a regulação autonômica cardíaca e a fluência de indivíduos com gagueira. Objetivo: Analisar os efeitos da música contemporânea instrumental sobre o desempenho da fluência e o controle autonômico da frequência cardíaca em indivíduos com gagueira. Método: O estudo foi realizado em 10 indivíduos com gagueira do neurodesenvolvimento persistente, de ambos os sexos, na faixa etária de 7 a 27 anos de idade. Os participantes foram analisados em dois dias, aplicando-se uma sequência aleatória dos protolocos, controle e música: 1) Passaram pela avaliação da fluência e análise da variabilidade da frequência cardíaca (VFC), em seguida permaneceram com fone de ouvido desligado e imediatamente realizaram a avaliação da fluência e nova análise da variabilidade da frequência cardíaca, e; 2) Passaram pela avaliação da fluência e análise da variabilidade da frequência cardíaca (VFC), em seguida foram expostos à música por fone de ouvido e imediatamente realizaram a avaliação da fluência e nova análise da variabilidade da frequência cardíaca. Resultados: Os resultados mostraram que não houve diferença estatística na comparação entre os parâmetros da fluência, ou seja, as frequências de disfluências típicas da gagueira, outras disfluências e total das disfluências, fluxos de sílabas e de palavras por minuto, entre as amostras de fala pré e pós-silêncio (controle), e pré e pós-música. Os escores do Intrumento de Gravidade da Gagueira também não revelou alteração significante nas duas condições analisadas (silêncio e música). Não foi encontrado nenhum efeito significante na VFC, ou seja, na raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacente (RMDSSD), na high frequency (HF) e no desvio-padrão dispersão dos pontos perpendiculares à linha de identidade no plot de Poincaré (SD1) entre as medidas de pré e pós-silêncio, e pré e pós-música. Conclusão: A partir da análise crítica dos resultados do presente estudo, foi possível concluir que o estímulo auditivo musical não alterou a VFC nem a fluência, de modo que os efeitos do silêncio e da música contemporânea instrumental foram similares. No entanto, vale ressaltar que houve um subgrupo de indivíduos com gagueira que mostraram resultados favoráveis no protocolo música em todas as medidas analisadas, ou seja, houve redução da frequência de difluências típicas da gagueira, de um grau de gravidade do distúrbio e aumento da velocidade de fala.
Introduction: Stuttering is a complex disorder from a neurobiological basis, with many impacts on the speaker's life. Fluency of an individual who stutters may improve based on some factors, such as singing, delayed auditory feedback, reading in chorus, among others. It is known that contemporary instrumental music has a characteristic effect of activating the parasympathetic nervous system and reducing the sympathetic nervous system, as well as reducing heart rate. Heart rate variability (HRV) is a well recognized method in the literature that analyzes cardiac autonomic regulation. However, it is not clear in the literature whether exposure to contemporary instrumental music by headset can affect cardiac autonomic regulation and fluency of individuals who stutter. Objective: To analyze the effects of contemporary instrumental music on the fluency performance and the autonomic control of heart rate in individuals who stutter. Method: Study conducted on 10 individuals with persistent neurodevelopment stuttering, both sexes, aged 7 to 27 years old. The participants were analyzed in two days, applying a random sequence of protocols, control and music: 1) They underwent the fluency assessment and the heart rate variability (HRV) analysis, then remained with the headset off and immediately performed fluency assessment and a new analysis of heart rate variability, and; 2) They underwent fluency assessment and heart rate variability (HRV) analysis, then were exposed to music by headset and immediately underwent fluency assessment and a new analysis of heart rate variability. Results: Results showed that there was no statistical difference in the comparison between fluency parameters, such as stuttering-like disfluencies, other disfluencies and total disfluencies, flows of syllables and words per minute, between the speech samples pre and post-silence (control), and pre and post-music. Stuttering Severity Instrument scores also did not show a significant change in the two conditions analyzed (silence and music). Significant effect was not found on HRV, that is, on the square root of the mean of the square of differences between adjacent normal RR intervals (RMDSSD), on the high frequency (HF) and on the standard deviation dispersion of the perpendicular points to the identity line in the Poincaré plot (SD1) between the pre and post-silence measurements, and pre and post music-measurements. Conclusion: From a critical analysis of the results of this study, it was possible to conclude that musical auditory stimulus did not change HRV or fluency, so that the effects of silence and contemporary instrumental music were similar. However, it is noteworthy that there was a subgroup of individuals with stuttering who showed favorable results in the music protocol in all measures analyzed, that is, there was a reduction in the frequency of stuttering-like difluences, a degree of stuttering severity and an increase in speech rate.
Introduction: Stuttering is a complex disorder from a neurobiological basis, with many impacts on the speaker's life. Fluency of an individual who stutters may improve based on some factors, such as singing, delayed auditory feedback, reading in chorus, among others. It is known that contemporary instrumental music has a characteristic effect of activating the parasympathetic nervous system and reducing the sympathetic nervous system, as well as reducing heart rate. Heart rate variability (HRV) is a well recognized method in the literature that analyzes cardiac autonomic regulation. However, it is not clear in the literature whether exposure to contemporary instrumental music by headset can affect cardiac autonomic regulation and fluency of individuals who stutter. Objective: To analyze the effects of contemporary instrumental music on the fluency performance and the autonomic control of heart rate in individuals who stutter. Method: Study conducted on 10 individuals with persistent neurodevelopment stuttering, both sexes, aged 7 to 27 years old. The participants were analyzed in two days, applying a random sequence of protocols, control and music: 1) They underwent the fluency assessment and the heart rate variability (HRV) analysis, then remained with the headset off and immediately performed fluency assessment and a new analysis of heart rate variability, and; 2) They underwent fluency assessment and heart rate variability (HRV) analysis, then were exposed to music by headset and immediately underwent fluency assessment and a new analysis of heart rate variability. Results: Results showed that there was no statistical difference in the comparison between fluency parameters, such as stuttering-like disfluencies, other disfluencies and total disfluencies, flows of syllables and words per minute, between the speech samples pre and post-silence (control), and pre and post-music. Stuttering Severity Instrument scores also did not show a significant change in the two conditions analyzed (silence and music). Significant effect was not found on HRV, that is, on the square root of the mean of the square of differences between adjacent normal RR intervals (RMDSSD), on the high frequency (HF) and on the standard deviation dispersion of the perpendicular points to the identity line in the Poincaré plot (SD1) between the pre and post-silence measurements, and pre and post music-measurements. Conclusion: From a critical analysis of the results of this study, it was possible to conclude that musical auditory stimulus did not change HRV or fluency, so that the effects of silence and contemporary instrumental music were similar. However, it is noteworthy that there was a subgroup of individuals with stuttering who showed favorable results in the music protocol in all measures analyzed, that is, there was a reduction in the frequency of stuttering-like difluences, a degree of stuttering severity and an increase in speech rate.
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Audição, Som, Sistema cardiovascular, Gagueira, Hearing, Sound, Cardiovascular system, Stuttering