Programa de terapia integrativa da fala associada à estimulação transcraniana por corrente contínua na paralisia cerebral

• Ano de defesa: 2016
• Autor(a) principal: Lima, Vânia Lúcia Costa de Carvalho [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Cerebral palsy; Rehabilitation of speech and language disorders; Transcranial direct current stimulation; Paralisia cerebral; Reabilitação dos transtornos da fala e da linguagem; Estimulação transcraniana por corrente contínua
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4675743; http://repositorio.unifesp.br/handle/11600/46441

Purpose: The aim of this study was to evaluate the effects of the combination of an integrative speech therapy program (ISTP) and transcranial direct current stimulation(tDCS) on speech in cerebral palsy. Method: Longitudinal and prospective study (CAAE - 25914514.6.0000.5505 / 2014). This study combined two neuromodulatory techniques: Transcranial Direct Current Stimulation- tDCS, that modulates the cortical activity enhance the functional gain of therapies, and the Integrative Speech Therapy(IST). Eight children with cerebral palsy and speech disorders were allocated to two groups: Control Group (GC = sham tDCS+ ISP) and Experimental Group (GE = atDCS + ISTP). They underwent ten sessions combining ISTP with tDCS over Broca?s area(active and sham). The participants were assessed before and after the intervention with regard to aspects of speech, oral motor skills and cognition: (1) Percentage of Corrects Consonants (PCC) and Percentage of Corrects Consonants ? Revised(PCCR) applied to phonological ABFW evaluation; (2) phonetic inventory and (3)AMIOFE - Oral motricity protocol. The participants attended to ten sessions, in 30 minutes, with 1mA of atDCS combined to ISTP. Results: The primary outcome was assessed by comparing the difference of variables between groups, pre and post intervention, through the Wilcoxon and Wilcoxon-Mann-Whitney test. The parameters evaluated for this outcome were: (1) Percentage of Correct Consonants (PCC) and Percentage of Correct Consonants Revised (PCCR) at naming and imitation of the items listed in phonology protocol of child language ABFW test; (2) phonetic inventory. The experimental group showed better results than the control group in the indices: PCCR naming (p = 0.029) and imitation (p = 0.028); number of phoneme (phonetic inventory) (p = 0.017). Conclusion: tDCS on Broca's area combined with Integrative Therapy Program Speech showed positive results in CP children speech rehabilitation, with the increasing number of acquired phonemes analyzed the phonetic inventory and PCCR.