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多发性硬化症患者生活质量与构音障碍之间的关系。

Relationship between quality of life and dysarthria in patients with multiple sclerosis.

作者信息

Piacentini Valentina, Mauri Ilaria, Cattaneo Davide, Gilardone Marco, Montesano Angelo, Schindler Antonio

机构信息

IRCCS Santa Maria Nascente, Fondazione Don Gnocchi ONLUS, Milan, Italy.

Department of Rehabilitation Medicine, Casa di Cura Privata del Policlinico, Milan, Italy.

出版信息

Arch Phys Med Rehabil. 2014 Nov;95(11):2047-54. doi: 10.1016/j.apmr.2014.04.023. Epub 2014 May 14.

Abstract

OBJECTIVE

To evaluate dysarthria and dysarthria-related quality of life (QOL) and analyze its relations with duration of disease, severity, and general QOL in patients with multiple sclerosis (MS).

DESIGN

Cross-sectional observational study.

SETTING

Rehabilitation center.

PARTICIPANTS

Consecutive patients with MS (N=163) were recruited (mean age, 52 ± 10.4 y; mean MS duration, 19 ± 10.4 y).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Presence of dysarthria; dysarthria characteristics; MS severity and duration; and dysarthria-related and generic QOL were evaluated by means of the therapy outcome measure scale; Robertson profile; Expanded Disability Status Scale (EDSS), years of disease; QOL of the dysarthric speaker questionnaire; and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), respectively.

RESULTS

The mean EDSS score was 6.5 ± 1.3. Dysarthria affected 57 (35%) of the 163 patients. Dysarthria severity was mild in most of the 57 patients with dysarthria. Median Robertson profile scores were slightly but significantly higher in the nondysarthric group compared with the dysarthric group (P=.001). The QOL for the dysarthric speaker questionnaire was significantly more compromised in patients with dysarthria (P=.001). No difference on the SF-36 scores between patients with and without dysarthria was found, with the exception of the physical activity and physical pain subscales. The QOL for the dysarthric speaker questionnaire showed no correlation with MS duration and a weak correlation with EDSS score (r=.25). Correlations between the SF-36 and QOL for the dysarthric speaker scores were few and weak, with the exception of the role limitations because of emotions (r=-.428) and mental health subscales (r=-.383).

CONCLUSIONS

Dysarthria-related QOL is compromised in patients with MS and dysarthria and might be used as a supplementary measure in clinical practice and research for patients who have MS.

摘要

目的

评估多发性硬化症(MS)患者的构音障碍及与构音障碍相关的生活质量(QOL),并分析其与疾病持续时间、严重程度及总体生活质量的关系。

设计

横断面观察性研究。

地点

康复中心。

参与者

招募了163例连续的MS患者(平均年龄52±10.4岁;平均MS病程19±10.4年)。

干预措施

不适用。

主要观察指标

通过治疗结果测量量表、罗伯逊量表、扩展残疾状态量表(EDSS)、病程、构音障碍者生活质量问卷及医学结局研究简明健康调查36项量表(SF-36)分别评估构音障碍的存在情况、构音障碍特征、MS严重程度和病程以及与构音障碍相关的和一般的生活质量。

结果

平均EDSS评分为6.5±1.3。163例患者中有57例(35%)受构音障碍影响。在57例有构音障碍的患者中,大多数患者的构音障碍严重程度为轻度。与构音障碍组相比,非构音障碍组的罗伯逊量表中位数得分略高但差异有统计学意义(P = 0.001)。构音障碍者生活质量问卷显示,构音障碍患者的生活质量受到更显著的损害(P = 0.001)。除身体活动和身体疼痛分量表外,有构音障碍和无构音障碍患者的SF-36评分无差异。构音障碍者生活质量问卷显示与MS病程无相关性,与EDSS评分呈弱相关性(r = 0.25)。除因情绪导致的角色限制分量表(r = -0.428)和心理健康分量表(r = -0.383)外,SF-36与构音障碍者生活质量评分之间的相关性较少且较弱。

结论

MS合并构音障碍患者的构音障碍相关生活质量受到损害,可作为MS患者临床实践和研究中的一项补充测量指标。

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