Programa de Pós-graduação Saúde, Interdisciplinaridade e Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil.
Codas. 2021 Jan 29;33(1):e20190214. doi: 10.1590/2317-1782/20202019214. eCollection 2021.
To evaluate speech intelligibility and dysarthria, correlated to the functional assessment of Amyotrophic Lateral Sclerosis (ALS).
Quantitative-descriptive study approved by REC under No. CAAE 62912416.4.0000.5404, comprised of 19 individuals with sporadic or familiar ALS. Data were collected using the Dysarthria Protocol and the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-Re). We used visual analogue scale (VAS) to assess speech intelligibility and summary measures; and Spearman's coefficients of correlation for the instruments with significance level of 5%.
Speech intelligibility is compromised (41.37±39.73) in varied degrees with positive correlation with the general degree of dysarthria (p=<.0001), and with all the analyzed speech parameters, indicating impact on the speech deterioration of the studied group. There is negative correlation between speech intelligibility and the results of the bulbar sections - speech and deglutition (p=0.0166), arm - activities with the upper limb (p=0.0064) and leg - activities with the lower limb (p=0.0391). Breathing (p=0.0178), phonation (p=0.0334) and resonance (p=0.0053) parameters showed a negative correlation with the item "speech" of the ALSFRS-Re.
Results show impaired speech intelligibility and dysarthria, and evidence breathing, phonation and resonance as important markers of the disease progression. A thorough and early evaluation of the oral motor production allows for a better management of alterations in ALS.
评估言语清晰度和构音障碍，与肌萎缩侧索硬化症（ALS）的功能评估相关。
这是一项经 REC 批准的定量描述性研究，注册号为 CAAE 62912416.4.0000.5404，纳入了 19 名散发或家族性 ALS 患者。使用构音障碍协议和修订肌萎缩侧索硬化功能评定量表（ALSFRS-R）收集数据。我们使用视觉模拟评分（VAS）评估言语清晰度和综合指标，并使用 Spearman 相关系数分析各仪器间的相关性，检验水准为 5%。
言语清晰度不同程度受损（41.37±39.73），与总体构音障碍程度呈正相关（p<0.0001），且与所有分析的言语参数均呈正相关，表明对研究组言语恶化有影响。言语清晰度与延髓节-言语和吞咽（p=0.0166）、上肢-上肢活动（p=0.0064）和下肢-下肢活动（p=0.0391）的结果呈负相关。呼吸（p=0.0178）、发声（p=0.0334）和共振（p=0.0053）参数与 ALSFRS-R 的“言语”项目呈负相关。
结果表明存在言语清晰度受损和构音障碍，且呼吸、发声和共振可作为疾病进展的重要标志物。全面和早期评估口腔运动功能有助于更好地管理 ALS 患者的改变。
