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PM & R : the Journal of Injury,... Mar 2021To define methods to measure dysarthria due to stroke and guide physicians in delineating a diagnostic protocol using the best current strategies.
OBJECTIVE
To define methods to measure dysarthria due to stroke and guide physicians in delineating a diagnostic protocol using the best current strategies.
DESIGN
Systematic review.
LITERATURE SURVEY
A search was conducted on PubMed, EMBASE, the Cochrane Library, and Web of Science to identify measurement methods for dysarthria severity in adults after stroke.
METHODS
Two reviewers independently reviewed articles and came to a consensus about which ones to include. The authors excluded all duplicates, articles involving individuals with aphasia or other speech problems other than dysarthria, and articles unrelated to stroke. Articles were included if diagnostic measures were used to examine the effectiveness of speech rehabilitation in stroke patients.
SYNTHESIS
The search identified 1154 articles with the keywords "stroke" OR "ictus" OR "cerebral vascular accident" AND "dysarthria" OR "Speech and Language Disorders" AND "diagnosis" OR "assessment." The reviewers analyzed 86 full texts. There were 37 publications that met the criteria and were included in the systematic review. These articles were used to describe the main methods used for measuring the severity of stroke-related dysarthria before and after speech rehabilitation.
CONCLUSION
Despite the range of diagnostic tools available, robust trials are lacking, and the diagnostic approaches are always different. More research is needed to find the best diagnostic methodologies and delineate a definitive diagnostic protocol.
Topics: Adult; Aphasia; Dysarthria; Humans; Speech Disorders; Speech Therapy; Stroke
PubMed: 32818305
DOI: 10.1002/pmrj.12469 -
Neurology Apr 2021To determine whether specific speech, language, and oromotor profiles are associated with different patterns of polymicrogyria, we assessed 52 patients with...
OBJECTIVE
To determine whether specific speech, language, and oromotor profiles are associated with different patterns of polymicrogyria, we assessed 52 patients with polymicrogyria using a battery of standardized tests and correlated findings with topography and severity of polymicrogyria.
METHODS
Patients were identified via clinical research databases and invited to participate, irrespective of cognitive and verbal language abilities. We conducted standardized assessments of speech, oromotor structure and function, language, and nonverbal IQ. Data were analyzed according to normative assessment data and descriptive statistics. We conducted a correlation analysis between topographic pattern and speech and language findings.
RESULTS
Fifty-two patients (33 male, 63%) were studied at an average age of 12.7 years (range 2.5-36 years). All patients had dysarthria, which ranged from mild impairment to anarthria. Developmental speech errors (articulation and phonology), oral motor structure and function deficits, and language disorder were frequent. A total of 23/29 (79%) had cognitive abilities in the low average to extremely low range. In the perisylvian polymicrogyria group (36/52), speech, everyday language, and oral motor impairments were more severe, compared to generalized (1 patient), frontal (3), polymicrogyria with periventricular nodular heterotopia (3), parasagittal parieto-occipital (1), mesial occipital (1), and other (7) patterns.
CONCLUSIONS
Dysarthria is a core feature of polymicrogyria, often accompanied by receptive and expressive language impairments. These features are associated with all polymicrogyria distribution patterns and more severe in individuals with bilateral polymicrogyria, particularly in the perisylvian region.
Topics: Adolescent; Adult; Child; Child, Preschool; Dysarthria; Female; Humans; Language Development Disorders; Magnetic Resonance Imaging; Male; Polymicrogyria; Young Adult
PubMed: 33589534
DOI: 10.1212/WNL.0000000000011698 -
American Journal of Speech-language... Jul 2023This study investigated perceived speech naturalness estimated by adult listeners in typically developing children and children with dysarthria. We aimed to identify...
PURPOSE
This study investigated perceived speech naturalness estimated by adult listeners in typically developing children and children with dysarthria. We aimed to identify predictors of naturalness among auditory-perceptual parameters and to evaluate the concept of naturalness as a clinical marker of childhood dysarthria.
METHOD
In a listening experiment, naive adult listeners rated speech naturalness of 144 typically developing children (3-9 years old) and 28 children with neurological conditions (5-9 years old) on a visual analog scale. Speech samples were recorded using the materials of the Bogenhausen Dysarthria Scales-Childhood Dysarthria, which also provides for auditory-perceptual judgments covering all speech subsystems.
RESULTS
Children with dysarthria obtained significantly lower naturalness ratings compared to typically developing children. However, there was a substantial age effect observable in the typically developing children; that is, younger typically developing children were also perceived as somewhat unnatural. The ratings of the typically developing children were influenced by the occurrence of developmental speech features; for the children with neurological conditions, specific symptoms of dysarthria had an additional effect. In both groups, the perception of naturalness was predominantly determined by the children's articulation and intelligibility.
CONCLUSIONS
Both symptoms of childhood dysarthria and developmental speech features (e.g., regarding articulation and intelligibility) were associated to some extent with unnatural speech by the listeners. Thus, perceived speech naturalness appears less suitable as a marker of dysarthria in children than in adults.
Topics: Adult; Humans; Child, Preschool; Child; Speech; Dysarthria; Speech Production Measurement; Auditory Perception; Judgment; Speech Intelligibility
PubMed: 37343549
DOI: 10.1044/2023_AJSLP-23-00023 -
Journal of Speech, Language, and... Feb 2022We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework,...
PURPOSE
We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, linking acoustics, intelligibility, and communicative participation in the context of dysarthria.
METHOD
Speech samples and communicative participation scores were collected from individuals with dysarthria ( = 32). Speech was analyzed for two acoustic metrics (i.e., articulatory precision and speech rate), and an objective measure of intelligibility was generated from listener transcripts. Mediation analysis was used to evaluate pathways of effect between acoustics, intelligibility, and communicative participation.
RESULTS
We observed a strong relationship between articulatory precision and intelligibility and a moderate relationship between intelligibility and communicative participation. Collectively, data supported a significant relationship between articulatory precision and communicative participation, which was almost entirely mediated through intelligibility. These relationships were not significant when speech rate was specified as the acoustic variable of interest.
CONCLUSION
The statistical corroboration of our causal instantiation of the ICF framework with articulatory acoustics affords important support toward the development of a comprehensive causal framework to understand and, ultimately, address restricted communicative participation in dysarthria.
Topics: Acoustics; Dysarthria; Humans; Speech Acoustics; Speech Intelligibility; Speech Production Measurement
PubMed: 34958608
DOI: 10.1044/2021_JSLHR-21-00306 -
Muscle & Nerve Sep 2018Herein we present an exploratory study of orofacial function in children with congenital myotonic dystrophy (CDM) vs. healthy controls.
INTRODUCTION
Herein we present an exploratory study of orofacial function in children with congenital myotonic dystrophy (CDM) vs. healthy controls.
METHODS
We evaluated 41 children with CDM and 29 healthy controls for speech and swallow function and for lingual and labial strength.
RESULTS
The Iowa Oral Performance Instrument (IOPI), measuring tongue strength, and a lip force meter (LFM), measuring lip strength, had excellent interrater reliability with intraclass correlation coefficients (ICCs) of 0.75 (n = 19, P < 0.001) and 0.96 (n = 20, P < 0.001), respectively. Mean overall lingual strength was 3.5-fold less and labial strength was about 7-fold less in CDM patients than in healthy controls. Eighteen of 24 children with CDM demonstrated dysarthria and an additional 11 participants were nonverbal. Dysarthria correlated moderately with lingual strength, age, and dysphagia. Strength measures correlated moderately with dysphagia.
DISCUSSION
Children with CDM have impaired orofacial functioning that affects communication and swallowing. Reliability of strength measures may be useful for future therapeutic trials. Muscle Nerve 58: 413-417, 2018.
Topics: Adolescent; Child; Child, Preschool; Deglutition Disorders; Dysarthria; Facial Muscles; Female; Humans; Infant; Lip; Male; Muscle Strength; Myotonic Dystrophy; Tongue
PubMed: 29901230
DOI: 10.1002/mus.26176 -
RoFo : Fortschritte Auf Dem Gebiete Der... Feb 2017
Topics: Brain Diseases; Corpus Callosum; Diagnosis, Differential; Dysarthria; Female; Humans; Incidental Findings; Magnetic Resonance Imaging; Middle Aged
PubMed: 27627447
DOI: 10.1055/s-0042-115818 -
Laryngo- Rhino- Otologie Dec 2017
Topics: Aged; Audiometry, Speech; Cochlear Implantation; Diagnosis, Differential; Disease Progression; Dysarthria; Female; Humans; Interdisciplinary Communication; Intersectoral Collaboration; Magnetic Resonance Imaging; Neuroma, Acoustic; Postoperative Complications; Reoperation; Speech Perception
PubMed: 28666284
DOI: 10.1055/s-0043-113041 -
Disability and Rehabilitation Jun 2022This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication...
PURPOSE
This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing.
MATERIALS AND METHODS
A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication.
RESULTS
21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; 321). Treatment approaches included singing therapy ( = 10), loudness therapy ( = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) ( = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches.
CONCLUSION
There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.IMPLICATIONS FOR REHABILITATIONGroup therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease.Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures.Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD. CRD42015029374.
Topics: Adult; Dysarthria; Humans; Language Therapy; Parkinson Disease; Singing; Speech Therapy
PubMed: 33356634
DOI: 10.1080/09638288.2020.1859629 -
International Journal of... Apr 2022This study investigated the practice patterns used by Malaysian speech-language pathologists (SLPs) with patients with dysarthria, identified challenges perceived by...
This study investigated the practice patterns used by Malaysian speech-language pathologists (SLPs) with patients with dysarthria, identified challenges perceived by SLPs and explored strategies to address perceived barriers for improving dysarthria management. Two studies were conducted. Study 1 disseminated a 30-item survey questionnaire electronically via google link to SLPs in the Malaysian Speech-Language-Hearing Association through e-mail lists. Responses were analysed using descriptive statistics. In Study 2, semi-structured interviews of twelve SLPs who managed patients with dysarthria were conducted. Data were transcribed verbatim and analysed using the thematic analysis method. Three major themes and ten sub-themes emerged from the interviews, including "assessment and treatment practices", "challenges", and "overcoming challenges". SLPs' practice of assessment and treatment of dysarthria were predominantly impairment-based. Respondents (64%) who never used standardised assessment tools valued textbooks more as sources of evidence and had a lower level of confidence in their knowledge about dysarthria compared to those who used standardised tools. Focus now needs to be on the education needs of our SLPs, on both the university training and continuing education levels, for direction of the development of professional training courses. Ongoing research and public awareness are required to guide clinical management decisions.
Topics: Communication Disorders; Dysarthria; Humans; Pathologists; Speech; Speech-Language Pathology; Surveys and Questionnaires
PubMed: 34348530
DOI: 10.1080/17549507.2021.1958921 -
Practical Neurology Apr 2023
Topics: Humans; Dysarthria; Myasthenia Gravis; Deglutition Disorders
PubMed: 36283805
DOI: 10.1136/pn-2022-003528