Te Kura Mahi ā-Hirikapo | School of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand.
New Zealand Brain Research Institute, Christchurch, New Zealand.
J Speech Lang Hear Res. 2024 Oct 8;67(10):3631-3642. doi: 10.1044/2024_JSLHR-24-00018. Epub 2024 Sep 12.
Up to 90% of people with Parkinson's disease (PD) develop communication difficulties over the course of the disease. While the negative effect of dysarthria on communicative participation has been well-documented, the impact of the occurrence of acquired stuttered disfluencies on communication in different speech situations is unknown. This study aimed to determine if the frequency of occurrence of stuttered disfluencies affects communicative participation in individuals with PD, and whether such a relationship is mediated by examiner- and self-rated measures of disease severity.
Conversational speech samples were collected from 100 people with PD aged 53-91 years to calculate the frequency of occurrence of stuttered disfluencies. Participants completed the Communicative Participation Item Bank to assess participation in communicative situations. Information on overall speech, cognitive, and motor performance was collected using both self-rated and examiner-rated methods.
Participants with PD presented with 0.2%-9.9% stuttered disfluencies during conversation. Overall, participants with PD reported their communicative participation to be impacted "a little" (19.5 ± 7.0), but there was considerable interindividual variation. A higher frequency of stuttered disfluencies was associated with significantly lower communicative participation (ρ = -0.32, < .01). In addition, examiner-rated frequency of stuttered disfluencies ( < .01), speech ( < .01), and motor severity ( = .04) were all significant predictors of communicative participation. Using self-ratings, speech ( < .01) and cognitive ( < .01) measures significantly predicted communicative participation.
In people with PD, communicative participation was significantly worse for those with a higher frequency of stuttered disfluencies. Examiner- and self-rated measures of disease severity contributed different information related to communicative constraints. Together, these results highlight the importance of individualized and holistic speech therapy that considers a wide variety of symptoms, including stuttered disfluencies, to ensure positive functional outcomes.
多达 90%的帕金森病（PD）患者在疾病过程中会出现沟通困难。虽然构音障碍对交际参与的负面影响已经得到充分证实，但获得性口吃不流畅的发生对不同言语情境下的交流的影响尚不清楚。本研究旨在确定口吃不流畅的发生频率是否会影响 PD 患者的交际参与，以及这种关系是否受疾病严重程度的检查者和自我评定测量的影响。
从 100 名 53-91 岁的 PD 患者中收集会话语音样本，以计算口吃不流畅的发生频率。参与者完成了交际参与项目库，以评估在交际情境中的参与情况。使用自我评定和检查者评定方法收集了有关整体言语、认知和运动表现的信息。
PD 患者在对话中出现了 0.2%-9.9%的口吃不流畅。总体而言，PD 患者报告他们的交际参与受到了“一点”（19.5 ± 7.0）的影响，但存在相当大的个体间差异。更高的口吃不流畅频率与显著较低的交际参与相关（ρ=-0.32， <.01）。此外，检查者评定的口吃不流畅频率（ <.01）、言语（ <.01）和运动严重程度（ =.04）均为交际参与的显著预测因素。使用自我评定，言语（ <.01）和认知（ <.01）测量显著预测了交际参与。
在 PD 患者中，口吃不流畅频率较高的患者的交际参与明显较差。疾病严重程度的检查者和自我评定测量提供了与交际限制相关的不同信息。这些结果共同强调了个体化和全面的言语治疗的重要性，考虑到各种症状，包括口吃不流畅，以确保积极的功能结果。
