Spencer Kristie A, Paul Jennifer, Brown Katherine A, Ellerbrock Taylor, Sohlberg McKay Moore
Department of Speech and Hearing Sciences, University of Washington, Seattle.
University of Oregon, Eugene.
Am J Speech Lang Pathol. 2020 Feb 7;29(1):1-19. doi: 10.1044/2019_AJSLP-19-0078. Epub 2019 Nov 7.
Purpose Cognitive deficits are common in Parkinson's disease (PD) and can have a detrimental effect on daily activities. To date, most cognitive treatments have had an impairment-based focus with primary outcome measures of formal neuropsychological test scores. Few, if any, studies have focused on functional improvement or patient-centered goals. Method Three individuals with idiopathic PD participated in an 8-week pilot treatment program to train for the use of compensatory external aids to achieve personalized goals. Goal attainment scaling was the primary outcome measure, which was independently judged by multiple raters at baseline, postintervention, and 1 month posttreatment and analyzed via -score analysis. Descriptive measures, including self-report and spouse-report rating scales of cognitive functioning, were employed. Results All 3 participants improved in the majority of their laboratory and home goals posttreatment, as measured by goal attainment scaling, and maintained gains for the majority of goals 1 month posttreatment. Conclusions This is the 1st known study to implement an external aids treatment program with patient-centered goals for individuals with cognitive deficits from PD. Positive outcomes were likely influenced by 3 factors: (a) a theoretically motivated focus on external aids; (b) a well-documented, systematic approach to instruction; and (c) the personalization of goals. Supplemental Material https://doi.org/10.23641/asha.10093493.
认知缺陷在帕金森病（PD）中很常见，并且会对日常活动产生不利影响。迄今为止，大多数认知治疗都以损伤为重点，主要结局指标是正式神经心理测试分数。很少有研究关注功能改善或以患者为中心的目标。方法：三名特发性PD患者参加了一个为期8周的试点治疗项目，训练使用补偿性外部辅助工具以实现个性化目标。目标达成量表是主要结局指标，由多名评估者在基线、干预后和治疗后1个月进行独立评估，并通过得分分析进行分析。采用了描述性测量方法，包括认知功能的自我报告和配偶报告评定量表。结果：通过目标达成量表测量，所有3名参与者在治疗后其大多数实验室和家庭目标都有所改善，并且在治疗后1个月，大多数目标的改善得以维持。结论：这是已知的第一项针对患有PD认知缺陷的个体实施以患者为中心目标的外部辅助工具治疗项目的研究。积极结果可能受到三个因素的影响：（a）理论上对外部辅助工具的关注；（b）记录充分、系统的指导方法；（c）目标的个性化。补充材料https://doi.org/10.23641/asha.10093493
