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帕金森病运动减少型构音障碍的强化言语治疗:通过临床和仪器评估针对言语产生的五个子系统

Intensive Speech Therapy for Hypokinetic Dysarthria in Parkinson's Disease: Targeting the Five Subsystems of Speech Production with Clinical and Instrumental Evaluation.

作者信息

Gison Annalisa, Ruggiero Marco, Tufarelli Davide, Proietti Stefania, Moscariello Daniela, Valente Marianna

机构信息

IRCCS San Raffaele Roma, 00163 Rome, Italy.

Physical and Rehabilitation Medicine 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

出版信息

NeuroSci. 2025 Jan 16;6(1):7. doi: 10.3390/neurosci6010007.

Abstract

: Hypokinetic dysarthria is a speech disorder observed in almost 90% of PD patients that can appear at any stage of the disease, usually worsening as the disease progresses. Today, speech therapy intervention in PD is seen as a possible therapeutic option to alleviate and slow down the progression of symptoms. This study aims to investigate the validity of traditional speech therapy in dysarthria with the aim of improving the quality of life of PD patients, by comparing subjective clinical assessment with objective instrumental measures (IOPI and voice analysis). : This is an observational study of 30 patients with hypokinetic dysarthria due to PD. The patients underwent speech therapy treatment with a frequency of three times per week for 12 consecutive weeks. Patients were evaluated at the time of enrollment (T0), at the start of treatment (T1), and at the end of the same (T2). Six months after the end of treatment (T3), a follow-up was performed based on disability and phonatory evaluation. : This study showed significant improvements (<0.001) from the start (T1) to the end of treatment (T2), with increases in the Barthel Index score, Robertson Dysarthria Profile, and IOPI measurements for tongue and lip strength, along with enhanced phonometer scores and tongue endurance. Correlations highlighted that tongue endurance decreased with age, CIRS, and MDS-UPDRS, while showing a positive association with MoCA scores. : Significant improvements were observed in tongue and lip strength, phonatory duration, intensity, and vocal quality between pre- (T1) and post-treatment (T2). This study underscores the importance of early and continuous speech therapy treatment for comprehensive speech function enhancement.

摘要

运动减少型构音障碍是一种在近90%的帕金森病患者中观察到的言语障碍,可出现在疾病的任何阶段,通常随疾病进展而恶化。如今,帕金森病的言语治疗干预被视为缓解和减缓症状进展的一种可能的治疗选择。本研究旨在通过将主观临床评估与客观仪器测量(IOPI和嗓音分析)进行比较,探讨传统言语治疗对构音障碍的有效性,以改善帕金森病患者的生活质量。

这是一项对30例因帕金森病导致运动减少型构音障碍患者的观察性研究。患者接受每周三次、连续12周的言语治疗。在入组时(T0)、治疗开始时(T1)和治疗结束时(T2)对患者进行评估。治疗结束后6个月(T3),基于残疾和发声评估进行随访。

本研究显示从治疗开始(T1)到结束(T2)有显著改善(<0.001),Barthel指数评分、罗伯逊构音障碍量表得分以及IOPI测量的舌和唇力量增加,同时声强计得分和舌耐力增强。相关性分析表明,舌耐力随年龄、CIRS和MDS-UPDRS评分降低,而与MoCA评分呈正相关。

治疗前(T1)和治疗后(T2)在舌和唇力量、发声持续时间、强度和嗓音质量方面观察到显著改善。本研究强调了早期和持续的言语治疗对全面增强言语功能的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/830b/11755597/3dbb039604d3/neurosci-06-00007-g001.jpg

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