Nozaki Sonoko, Fujiu-Kurachi Masako, Tanimura Takako, Ishizuka Kimiyo, Miyata Eri, Sugishita Shuhei, Imai Takahisa, Nishiguchi Maiko, Furuta Mitsuru, Yorifuji Shiro
Wakakusa Tatsuma Rehabilitation Hospital, Daito, Japan.
Kansai Rosai Hospital, Amagasaki, Japan.
Prog Rehabil Med. 2021 Feb 20;6:20210012. doi: 10.2490/prm.20210012. eCollection 2021.
Progressive supranuclear palsy (PSP) is an uncommon progressive neurodegenerative disease with no effective cure at present. The initial symptoms resemble those of Parkinson's disease; however, the prevalence of PSP is about one-tenth that of Parkinson's disease. In many cases, dysphagia is severe, and the development of dysphagia is an early predictor of life expectancy. The aim of the current study was to define the effects of Lee Silverman Voice Treatment (LSVT LOUD) on swallowing and voice/speech in seven patients with PSP.
: Each patient underwent swallowing and voice/speech evaluations before and after 4 weeks of LSVT. Swallowing motility disorders were defined, temporal measures of swallowing were determined by videofluoroscopic evaluation, and voice measures of maximum phonation and speech intelligibility in reading and monologue were examined.
After LSVT, the median duration of opening of the upper esophageal sphincter (from the beginning of the posterior movement of the bolus to upper esophageal sphincter opening) on videofluoroscopy was significantly shortened from 0.42 to 0.38 s (Wilcoxon signed-rank test P=0.016). The oral transit duration was decreased in five patients, but the decrease was not significant. Voice changes after LSVT included increases in voice intensity and in sustained duration were not significant.
In this small study, it was found that LSVT may improve swallowing functions in patients with PSP.
进行性核上性麻痹（PSP）是一种罕见的进行性神经退行性疾病，目前尚无有效治愈方法。其初始症状与帕金森病相似；然而，PSP的患病率约为帕金森病的十分之一。在许多病例中，吞咽困难严重，吞咽困难的出现是预期寿命的早期预测指标。本研究的目的是确定李·西尔弗曼嗓音治疗（LSVT LOUD）对7例PSP患者吞咽及嗓音/言语的影响。
每位患者在接受LSVT治疗4周前后均接受吞咽及嗓音/言语评估。定义吞咽运动障碍，通过电视荧光透视评估确定吞咽的时间指标，并检查最大发声以及阅读和独白时言语可懂度的嗓音指标。
LSVT治疗后，电视荧光透视显示食管上括约肌开放的中位持续时间（从食团向后移动开始至食管上括约肌开放）从0.42秒显著缩短至0.38秒（Wilcoxon符号秩检验P=0.016）。5例患者的口腔运送时间缩短，但缩短不显著。LSVT治疗后的嗓音变化包括嗓音强度增加，持续时间增加不显著。
在这项小型研究中，发现LSVT可能改善PSP患者的吞咽功能。
