Speech treatment in Parkinson's disease: Randomized controlled trial (RCT)

Autor: Angela Halpern, Katherine Freeman, Jennifer Spielman, Cynthia Fox, Lorraine O. Ramig
Rok vydání: 2018
Předmět:
Zdroj: Movement Disorders. 33:1777-1791
ISSN: 0885-3185
DOI: 10.1002/mds.27460
Popis: Background As many as 89% of people with Parkinson's disease (PD) develop speech disorders. Objectives This randomized controlled trial evaluated two speech treatments for PD matched in intensive dosage and high-effort mode of delivery, differing in subsystem target: voice (respiratory-laryngeal) versus articulation (orofacial-articulatory). Methods PD participants were randomized to 1-month LSVT LOUD (voice), LSVT ARTIC (articulation), or UNTXPD (untreated) groups. Speech clinicians specializing in PD delivered treatment. Primary outcome was sound pressure level (SPL) in reading and spontaneous speech, and secondary outcome was participant-reported Modified Communication Effectiveness Index (CETI-M), evaluated at baseline, 1, and 7 months. Healthy controls were matched by age and sex. Results At baseline, the combined PD group (n = 64) was significantly worse than healthy controls (n = 20) for SPL (P 0.05). For CETI-M, between-group comparisons showed greater improvements for LSVT LOUD and LSVT ARTIC than UNTXPD at 1 month (P = 0.02; P = 0.02). At 7 months, CETI-M between-group differences were not significant (P = 0.08). Within-group CETI-M improvements for LSVT LOUD were maintained through 7 months (P = 0.0011). Conclusions LSVT LOUD showed greater improvements than both LSVT ARTIC and UNTXPD for SPL at 1 and 7 months. For CETI-M, both LSVT LOUD and LSVT ARTIC improved at 1 month relative to UNTXPD. Only LSVT LOUD maintained CETI-M improvements at 7 months. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
Databáze: OpenAIRE
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