School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia.
Int J Lang Commun Disord. 2019 Mar;54(2):170-188. doi: 10.1111/1460-6984.12400. Epub 2018 Jun 19.
Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). Maintenance of functional communication and swallowing over time is challenging for the person with PD and their families and may lead to social isolation and reduced quality of life if not addressed. Speech and language therapists (SLTs) face the conundrum of providing sustainable and flexible services to meet the changing needs of people with PD. Motor, cognitive and psychological issues associated with PD, medication regimens and dependency on others often impede attendance at a centre-based service. The access difficulties experienced by people with PD require a disruptive service approach to meet their needs. Technology-enabled management using information and telecommunications technologies to provide services at a distance has the potential to improve access, and enhance the quality of SLT services to people with PD.
To report the status and scope of the evidence for the use of technology in the management of the communication and swallowing disorders associated with PD.
METHODS & PROCEDURES: Studies were retrieved from four major databases (PubMed, CINAHL, EMBASE and Medline via Web of Science). Data relating to the types of studies, level of evidence, context, nature of the management undertaken, participant perspectives and the types of technologies involved were extracted for the review.
A total of 17 studies were included in the review, 15 of which related to the management of communication and swallowing disorders in PD with two studies devoted to participant perspectives. The majority of the studies reported on the treatment of the speech disorder in PD using Lee Silverman Voice Treatment (LSVT LOUD ). Synchronous and asynchronous technologies were used in the studies with a predominance of the former. There was a paucity of research in the management of cognitive-communication and swallowing disorders.
CONCLUSIONS & IMPLICATIONS: Research evidence supporting technology-enabled management of the communication and swallowing disorders in PD is limited and predominantly low in quality. The treatment of the speech disorder online is the most developed aspect of the technology-enabled management pathway. Future research needs to address technology-enabled management of cognitive-communication and swallowing disorders and the use of a more diverse range of technologies and management approaches to optimize SLT service delivery to people with PD.
沟通和吞咽障碍在帕金森病（PD）患者中非常普遍。对于 PD 患者及其家人来说，随着时间的推移保持功能沟通和吞咽能力是一项挑战，如果不加以解决，可能会导致社交孤立和生活质量下降。言语治疗师（SLT）面临着提供可持续和灵活的服务以满足 PD 患者不断变化的需求的难题。与 PD 相关的运动、认知和心理问题、药物治疗方案以及对他人的依赖，常常阻碍了他们参加以中心为基础的服务。PD 患者所经历的就诊困难要求提供一种打破常规的服务方法来满足他们的需求。使用信息和电信技术远程提供服务的技术支持管理有可能改善就诊机会，并提高 SLT 为 PD 患者提供服务的质量。
报告在 PD 相关的沟通和吞咽障碍管理中使用技术的现状和证据范围。
从四个主要数据库（PubMed、CINAHL、EMBASE 和 Medline via Web of Science）中检索研究。为综述提取了与研究类型、证据水平、背景、所进行管理的性质、参与者观点以及所涉及技术类型相关的数据。
综述共纳入 17 项研究，其中 15 项与 PD 患者的沟通和吞咽障碍管理有关，两项研究涉及参与者观点。大多数研究报告了使用 Lee Silverman 语音治疗（LSVT LOUD）治疗 PD 中的语音障碍。研究中使用了同步和异步技术，前者占主导地位。在认知沟通和吞咽障碍管理方面的研究相对较少。
支持 PD 患者沟通和吞咽障碍的技术支持管理的研究证据有限，且主要质量较低。在线治疗语音障碍是技术支持管理途径中最发达的方面。未来的研究需要解决认知沟通和吞咽障碍的技术支持管理以及使用更广泛的技术和管理方法，以优化 SLT 为 PD 患者提供的服务。
