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Pulmonary Function, Functional Capacity, Voice, and Sleep in Post-COVID-19 Individuals With and Without Inspiratory
Marthina Carbone Dos Santos1, Thamires Alessandra Silveira da Silva1, Alessandra Hofstadler Deiques Fleig2
1Graduate Program in Human Communication Disorders, Federal University of Santa Maria, Av. nº 1000 - Camobi, Santa Maria, RS 97105-900.
Objective:
To compare pulmonary function, functional capacity, voice, and sleep in post-COVID-19 individuals with and without inspiratory muscle weakness, as well as to investigate the association between vocal deviations, respiratory muscle strength, pulmonary function, functional capacity, and sleep parameters.
Methods:
Cross-sectional study with 28 post-COVID-19 adults, distributed into groups with (n = 14) and without (n = 14) inspiratory muscle weakness (maximal inspiratory pressure -MIP-<70% of the predicted value). Pulmonary function was assessed by spirometry; respiratory muscle strength by maximal respiratory pressures; inspiratory muscle endurance with a load of 60% of MIP; functional capacity by the Six-Minute Walk Test; and fatigue by the Fatigue Severity Scale and Chalder Fatigue Scale; voice was assessed using the Vocal Handicap Index (VHI), Vocal Fatigue Index (VFI), and Maximum Phonation Time (MPT); and sleep was assessed using the Insomnia Severity Index, Epworth Sleepiness Scale, and nocturnal oximetry.
Results:
Individuals with inspiratory muscle weakness presented a higher prevalence of fatigue (P = 0.02), higher scores in the physical domain (P = 0.008) and in the total VHI score (P = 0.01), greater occurrence of vocal functional impact (functional domain of the VHI) when analyzed in a categorized way (P = 0.02), higher scores in the VFI (factor one P = 0.008; factor two P = 0.002; factor three P = 0.002; total score P = 0.03), and lower MPT of the phonemes /s/ and /z/ (P = 0.02; P = 0.03) when analyzing continuous and categorical variables. A negative correlation was observed between the total VFI score and MIP (r = -0.467; P = 0.01), as well as between the VFI and the percentage of predicted MIP (r = -0.396; P = 0.03), indicating that lower levels of inspiratory muscle strength were associated with greater vocal fatigue.
Conclusion:
Inspiratory muscle weakness in post-COVID-19 individuals is associated with greater fatigue and poorer vocal outcomes, underscoring the importance of respiratory assessment in understanding the interaction between breathing and voice.
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