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言语失用症的发声治疗与韵律节奏疗法比较:单病例实验设计

A Comparison of Sound Production Treatment and Metrical Pacing Therapy for Apraxia of Speech: A Single-Case Experimental Design.

作者信息

King Charlotte R, Wambaugh Julie L, Maas Edwin

机构信息

Rocky Mountain University of Health Professions, Provo, UT.

Siskin Hospital for Physical Rehabilitation, Chattanooga, TN.

出版信息

Am J Speech Lang Pathol. 2023 Oct 17;32(5S):2493-2511. doi: 10.1044/2023_AJSLP-22-00302. Epub 2023 Sep 1.

Abstract

PURPOSE

The purpose of this investigation was to compare the effects of two specific treatment protocols for acquired apraxia of speech (AOS): Sound Production Treatment (SPT) and Metrical Pacing Therapy (MPT), and to examine changes in communicative participation.

METHOD

Four speakers with chronic AOS and aphasia were each administered SPT and MPT in a replicated crossover design (ABACA/ACABA) with nonconcurrent multiple baselines across participants and behaviors. Treatment outcomes were compared with respect to whole word correctness (WWC) for treated and untreated multisyllabic word targets. Speech intelligibility was assessed using the Chapel Hill Multilingual Intelligibility Test, and communicative participation was measured using the Communicative Participation Item Bank at baseline, washout, and follow-up phases.

RESULTS

Three of the four participants experienced statistically significant improvements in WWC with SPT, and three of the four participants with MPT. Based on a priori criteria, three participants demonstrated relatively greater benefit from SPT and one participant demonstrated relatively greater benefit from MPT. There were measurable improvements in intelligibility following SPT for three of the four participants. Only one participant in this investigation reported a significant change in communicative participation, and only following MPT.

CONCLUSIONS

This study demonstrated that individuals in the chronic stages of AOS can benefit from both SPT and MPT, corroborating prior research on articulatory kinematic and rate and/or rhythm control treatment approaches. It contributes a comparison of two protocols for AOS with respect to whole word targets, intelligibility, and individual self-report of communicative participation changes. More participants showed a relative advantage of SPT over MPT. One individual reported communicative participation improvement after MPT.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23971929.

摘要

目的

本研究旨在比较两种针对后天性言语失用症(AOS)的特定治疗方案的效果:发声治疗(SPT)和韵律节奏疗法(MPT),并研究交流参与度的变化。

方法

四名患有慢性AOS和失语症的患者分别接受SPT和MPT治疗,采用重复交叉设计(ABACA/ACABA),参与者和行为采用非同期多基线。比较治疗后和未治疗的多音节词目标的全词正确率(WWC)的治疗结果。使用教堂山多语言可懂度测试评估言语可懂度,并在基线、洗脱期和随访阶段使用交流参与项目库测量交流参与度。

结果

四名参与者中有三名在接受SPT治疗后WWC有统计学意义的改善,四名接受MPT治疗的参与者中有三名也是如此。根据预先设定的标准,三名参与者从SPT中获益相对更大,一名参与者从MPT中获益相对更大。四名参与者中有三名在接受SPT治疗后可懂度有可测量的改善。本研究中只有一名参与者报告交流参与度有显著变化,且仅在接受MPT治疗后出现。

结论

本研究表明,AOS慢性期患者可从SPT和MPT中获益,这证实了先前关于发音运动学以及速率和/或节奏控制治疗方法的研究。它对AOS的两种方案在全词目标、可懂度和交流参与度变化的个体自我报告方面进行了比较。更多参与者显示SPT相对于MPT具有相对优势。一名个体在接受MPT治疗后报告交流参与度有所改善。

补充材料

https://doi.org/10.23641/asha.23971929

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