Arquivo do autor:Tatiana Simões Chaves

Sobre Tatiana Simões Chaves

Coordenadora do Serviço de Fonoaudiologia do Hospital Risoleta Tolentino Neves/ Belo Horizonte - MG Especialista em Motricidade Orofacial pelo CEFAC/2006 MBA em Gestão Hospitalar/2012

Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation

  • Balbino Rivail Ventura NepomucenoJr
  • Mayana de Sá Barreto, 
  • Naniane Cidreira Almeida, 
  • Caroline Ferreira Guerreiro, 
  • Eveline Xavier-Souza and 
  • Mansueto Gomes Neto

Fonte Imagem:


The early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications.


This is a double-blind randomised controlled trial. Subjects in the intervention group underwent an inspiratory muscle training loaded with 50% maximum inspiratory pressure twice daily for 4 weeks from study enrolment. Patients were randomly assigned to an inspiratory muscle training group or a sham inspiratory muscle training group. All patients received conventional physiotherapy interventions. Baseline and post-intervention respiratory and peripheral muscle strength, functionality (performance of activities of daily living), length of hospital stay, and death were evaluated. Clinical outcomes were assessed until hospital discharge. This study was approved by the Institutional Hospital Ethics Committee (03/2014).


Thirty-one patients assigned to the inspiratory muscle training group and 34 to the sham inspiratory muscle training group were analysed. Patients in the inspiratory muscle training group had a shorter mean length of hospital stay (35.3 ± 2.7 vs. 41.8 ± 3.5 days, p< 0.01) and a lower risk of endotracheal intubation (relative risk (RR) = 0.36; 95% confidence interval (CI) 0.27–0.97; p= 0.03) as well as muscle weakness (RR = 0.36; 95% CI 0.19–0.98; p= 0.02) and mortality (RR = 0.23; 95% CI 0.2–0.94; p= 0.04). The risk of adverse events did not differ significantly between groups.


Inspiratory muscle training was a protective factor against endotracheal intubation, muscle weakness, and mortality.

Trial registration, ID: NCT02459444. Registered on 19 May 2015.



Clinical Importance of Peak Cough Flow in Dysphagia Evaluation of Patients Diagnosed With Ischemic Stroke.

Ann Rehabil Med. 2018 Dec;42(6):798-803. doi: 10.5535/arm.2018.42.6.798. Epub 2018 Dec 28.


OBJECTIVE: To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke.

METHODS: This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups.

RESULTS: The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups.

CONCLUSION: Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.


Influência do modelo da seringa nos resultados do teste de fluxo para líquidos proposto pela International Dysphagia Diet Standardisation Initiative

Roberto Oliveira Dantas; Luciana Oliveira

Rev. CEFAC. 2018 Maio-Jun; 20(3):382-387


Objetivo: investigar se duas seringas diferentes provocam resultados diferentes do teste de avaliação da consistência de líquidos proposto pela International Dysphagia Diet Standardisation Initiative (IDDSI flowtest).

Métodos: foram comparadas duas seringas de 10 ml (Bencton e Dickinson, fabricada nos Estados Unidos, e Saldanha Rodrigues, fabricada no Brasil). Foi medido, imediatamente após o preparo, eapós 8 horas e 24 horas, o fluxo de água com espessante alimentar (maltodextrin, goma xantana e cloreto de potássio) em três concentrações, e sulfato de bário em três concentrações.

Resultados: o fluxo foi maior com a seringa Bencton e Dickinson, para a água e sulfato de bário, com discordâncias na classificação descritas pela International Dysphagia Diet Standardisation Initiative.

Conclusão: na avaliação da consistência de líquidos pelo método descrito pela International Dysphagia Diet Standardisation Initiative deve ser seguida a orientação preconizada pelo grupo, tendo como instru- mento a seringa Bencton e Dickinson.


Photobiomodulation improves the frontal cognitive function of older adults. Review article

Chan AS, et al. Int J Geriatr Psychiatry. 2018.

Fonte: Google Images


OBJECTIVES: The frontal lobe hypothesis of age-related cognitive decline suggests that the deterioration of the prefrontal cortical regions that occurs with aging leads to executive function deficits. Photobiomodulation (PBM) is a newly developed, noninvasive technique for enhancing brain function, which has shown promising effects on cognitive function in both animals and humans. This randomized, sham-controlled study sought to examine the effects of PBM on the frontal brain function of older adults.

METHODS/DESIGNS: Thirty older adults without a neuropsychiatric history performed cognitive tests of frontal function (ie, the Eriksen flanker and category fluency tests) before and after a single 7.5-minute session of real or sham PBM. The PBM device consisted of three separate light-emitting diode cluster heads (633 and 870 nm), which were applied to both sides of the forehead and posterior midline, and delivered a total energy of 1349 J.

RESULTS: Significant group (experimental, control) × time (pre-PBM, post-PBM) interactions were found for the flanker and category fluency test scores. Specifically, only the older adults who received real PBM exhibited significant improvements in their action selection, inhibition ability, and mental flexibility after vs before PBM.

CONCLUSIONS: Our findings support that PBM may enhance the frontal brain functions of older adults in a safe and cost-effective manner.


Laserterapia na Fonoaudiologia – Possibilidades Terapêuticas/ IV Aula solidária Núcleo Reabilite

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Tema: Laserterapia na Fonoaudiologia – Possibilidades Terapêuticas


Fga. Vanessa Mouffron

Fga. Tatiana Chaves

Data: 07/12/2018

Horário: 18:30/21:30

Local: Associação Médica de Minas Gerais (Avenida João Pinheiro, 161 – Centro)

Belo Horizonte/ MG

Effects of Tongue-Hold Swallows on Suprahyoid Muscle Activation According to the Relative Tongue Protrusion Length in the Elderly Individuals

  • Jong-Chi Oh

Dysphagia (2018).

Imagem: Google


This study investigated differences in suprahyoid muscle activity in elderly adults during tongue-hold swallowing (THS) according to tongue protrusion length to determine the most effective tongue protrusion length during THS. A total of 52 healthy participants (34 females and 18 males) aged 69–92 years were included. Changes in suprahyoid muscle activation during normal swallowing and THS with 1/3rd and 2/3rd tongue protrusions using surface electromyography were observed. Suprahyoid muscle activation significantly increased with the increasing tongue protrusion length (p< 0.05). Depending on the responses of the participants based on tongue protrusion length, participants were categorized into the increase group [increased suprahyoid muscle activity with tongue protrusion, n= 36 (1/3rd THS compared to normal swallowing) or 38 (2/3rd THS compared to normal swallowing)] or decrease group [decreased suprahyoid muscle activity with tongue protrusion, n= 16 (1/3rd THS compared to normal swallowing) or 14 (2/3rd THS compared to normal swallowing)]. The functional reserve of the increase group was significantly higher than that of the decrease group (p< 0.05). Many elderly people were found to have increased activation of the suprahyoid muscle during THS; however, others showed the opposite. Therefore, it is necessary to confirm the degree of suprahyoid muscle activation during THS so that the patient can perform the exercise at the tongue protrusion length that can maximize the effect of the exercise. For individuals who cannot overcome even a small amount of tongue protrusion (e.g., 1/3rd MTPL), replacing THS with another exercise may be considered.


Curso: Práticas Respiratórias e estratégias ventilatórias no paciente disfágico neurogênico

✔ Palestrantes:

Dra. Ana Lucia Chiappetta

Ms. Celiana Figueiredo

✔Data e horário:

26/10- 14 às 21h

27/10 – 08 às 17h

✏ O curso visa favorecer conhecimento e estratégias ventilatórias utilizadas no paciente disfágico neurogênico com abordagem interdisciplinar para a avaliação e tratamento miofuncional.


➖ Conceitos de neuroanatomia e neurofisiologia do sistema respiratório e da deglutição

➖ Avaliação do paciente disfágico neurogênico

➖ Prescrição e Discussão de exercícios fonoterápicos e respiratórios para pacientes disfágicos neurogênicos

➖ Uso de Ambu e suas diferentes técnicas

➖ Uso de cough assist

➖ Uso de INCENTIVADORES RESPIRATÓRIOS threshold, respiron (diferentes níveis) Shaker, EMST, VUP e voldayne

➖ Válvula de fala

➖ Disfagia X Prevenção de Complicações pulmonares

➖ Atuação em equipe interdisciplinar

➖ Discussão de casos

✔ Carga horária: 20 h/aula


– *590,00 para grupos de 5 alunos (dividido de 2x 295,00)*

– R$640,00 à vista *

– R$690,00 em 4x (4x 172,50)

* Valor à vista em 3x para alunos Núcleo Reabilite (3x 213,00)

**10% para estudantes no último período, residentes e recém formados mediante comprovação.

*obs:* descontos não cumulativos.

Os descontos não se aplicam à pagamentos com cartão

*VAGAS LIMITADAS!* Não haverá reserva de vagas, as inscrições serão efetivadas somente mediante o comprovante de pagamento da primeira parcela.

Tatiana Chaves

CPos BH/ Núcleo Reabilite