title: Evaluation of Electrostimulation Effect in Women With Vocal Nodules.
abstract: OBJECTIVE
  To evaluate the effect of transcutaneous electrical nerve stimulation (TENS) with and without tongue trills in women with vocal nodules.
  
  
  METHODS
  Randomized, prospective, comparative intra-subject study.
  
  
  METHODS
  A total of 60 women aged 18-55 years were included. Visual-perceptual assessment of laryngeal configuration, auditory-perceptual assessment of voice quality, acoustic analyses, and self-assessment of phonation effort were assessed after TENS. Sixty participants participants were randomized into two experimental groups: (1) subjects receiving TENS (EG1), (2) subjects receiving TENS plus tongue trills (EG2). The control group was composed of 15 subjects of EG1 and 15 subjects of EG2. The TENS condition involved electrostimulation for 20 minutes. Audio and video perceptual assessments were performed by three speech therapists with expertise in voice; all were blinded to the experimental conditions. The acoustic parameters included were fundamental frequency, jitter, and shimmer during sustained phonation. Subjects also reported the degree of vocal effort before and after TENS.
  
  
  RESULTS
  TENS applied alone or combined with tongue trills aided in glottal closure and in improved comfort during phonation. When the TENS was administered with tongue trills, roughness of voice quality improved.
  
  
  CONCLUSIONS
  TENS applied alone or combined with tongue trills was associated with improved glottal closure and phonation comfort. TENS associated with tongue trills yielded improved voice quality.
authors.affiliation: Department of Speech-Language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Juscelina Kubitscheck de Oliveira
authors.initials: JK
authors.lastname: Santos
authors.affiliation: Department of Speech Language Pathology, University of São Paulo/USP Bauru, Sao Paulo, Brazil.
authors.forename: Kelly Cristina Alves
authors.initials: KC
authors.lastname: Silvério
authors.affiliation: Otorhinolaryngology Service of OTOMED, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Neide Fátima Cordeiro
authors.initials: NF
authors.lastname: Diniz Oliveira
authors.affiliation: Department of Speech-Language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address: anacgama@medicina.ufmg.br.
authors.forename: Ana Cristina Côrtes
authors.initials: AC
authors.lastname: Gama
mesh_terms: D000162:Acoustics; D000293:Adolescent; D000328:Adult; D001938:Brazil; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007600:Judgment; D007818:Laryngeal Diseases / Q000150:complications* / Q000175:diagnosis; D007828:Laryngoscopy; D008875:Middle Aged; D010699:Phonation; D011446:Prospective Studies; D020127:Recovery of Function; D012649:Self Concept; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D011795:Surveys and Questionnaires; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D014741:Video Recording; D014827:Vocal Cords / Q000294:innervation*; D014833:Voice Quality; D055815:Young Adult
keywords: Dysphonia; TENS; Transcutaneous electrical nerve stimulation; Voice; Voice disorders