Yorkston Kathryn, Baylor Carolyn, Mach Helen
University of Washington, Seattle.
J Speech Lang Hear Res. 2017 Jun 22;60(6S):1791-1797. doi: 10.1044/2017_JSLHR-S-16-0206.
People with amyotrophic lateral sclerosis frequently experience bulbar impairment and dysarthria that may restrict their ability to take part in everyday communication situations. The aim of this study is to examine selected variables that may contribute to restrictions in communicative participation.
Community-dwelling participants with amyotrophic lateral sclerosis (N = 70) who reported communication changes but continued to use natural speech completed a survey, including the Communicative Participation Item Bank, demographics (age, sex, living situation, employment status, education, and time since diagnosis), and self- reported symptom-related variables (physical activity, emotional problems, fatigue, pain, speech severity, speech usage, and cognitive and communication skills). To identify predictors of restrictions in communicative participation, these variables were entered into a backward stepwise multiple linear regression analysis.
Three variables (speech severity, swallowing severity, and speech usage) were included in the final model and accounted for 55% of the variability.
Better speech and swallowing skills and higher speech usage are associated with better communicative participation in this sample. Thus, when making clinical decisions regarding intervention, clinicians should continue their efforts to target speech and swallow abilities, while recognizing other variables that have the potential of restricting communicative participation.
肌萎缩侧索硬化症患者经常出现延髓功能障碍和构音障碍，这可能会限制他们参与日常交流的能力。本研究的目的是检查可能导致交流参与受限的特定变量。
居住在社区的肌萎缩侧索硬化症患者（N = 70）报告有交流变化但仍继续使用自然语言，他们完成了一项调查，包括交流参与项目库、人口统计学信息（年龄、性别、生活状况、就业状况、教育程度和确诊后的时间）以及自我报告的与症状相关的变量（身体活动、情绪问题、疲劳、疼痛、言语严重程度、言语使用情况以及认知和交流技能）。为了确定交流参与受限的预测因素，将这些变量纳入向后逐步多元线性回归分析。
最终模型纳入了三个变量（言语严重程度、吞咽严重程度和言语使用情况），它们解释了55%的变异性。
在这个样本中，更好的言语和吞咽技能以及更高的言语使用频率与更好的交流参与相关。因此，在做出关于干预的临床决策时，临床医生应继续努力针对言语和吞咽能力进行治疗，同时认识到其他可能限制交流参与的变量。
