Kim Kyung Min, Park Sang Ah, Hwang Seong Hye, Park Alyssia, Kim Hyang Hee, Hwang Jihye, Cho Sung-Rae
Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Digit Health. 2025 Jan 31;11:20552076251315296. doi: 10.1177/20552076251315296. eCollection 2025 Jan-Dec.
With advancements in digital health technologies, telepractice has become crucial for providing accessible medical interventions. Cerebral palsy (CP) frequently results in comorbidities including dysarthria and dysphagia, leading to restrictions in activities. This study evaluates the efficacy of both in-person and telepractice-based intensive voice therapy in improving speech, swallowing functions, and related quality of life measures in adults with CP.
The Lee Silverman Voice Treatment (LSVT) LOUD, a speech-behavior therapy, was administered to 16 CP subjects (9 men and 7 women; mean age = 43.4 ± 10.43 years) via in-person extended version of LSVT LOUD (LSVT-X), and telepractice program of LSVT-X (LSVT-X e-LOUD). Outcomes, including maximum phonation time (MPT), voice intensity, diadochokinetic rate (DDK), Voice Handicap Index (VHI), swallowing quality of life (SWAL-QOL), and Videofluoroscopic Dysphagia Scale (VDS), were assessed pre- and post-treatment.
Significant improvements were noted in speech functions: MPT (= 0.006), voice intensity (= 0.004), DDK /puh/ (= 0.043), and DDK/puh-tuh-kuh/ (= 0.031). Swallowing function improved significantly in the pharyngeal phase on the VDS. Quality of life measures showed improvement in physical (= 0.003), emotional (= 0.000), total score of VHI (= 0.001), fear (= 0.031), sleep (= 0.013), fatigue (= 0.003), and total score of SWAL-QOL (= 0.019). These improvements were consistent in both LSVT-X and LSVT-X e-LOUD groups.
Both in-person and telepractice-based LSVT-X enhance speech, swallowing functions, and quality of life in adults with CP. LSVT-X e-LOUD can be utilized as a digital therapeutic intervention for dysphagia and dysarthria, offering accessible and flexible treatment options aligned with digital health advancements.
随着数字健康技术的进步，远程医疗实践对于提供可及的医疗干预变得至关重要。脑瘫（CP）常伴有构音障碍和吞咽困难等合并症，导致活动受限。本研究评估面对面和基于远程医疗实践的强化嗓音治疗对改善成年脑瘫患者的言语、吞咽功能及相关生活质量指标的疗效。
对16名脑瘫受试者（9名男性和7名女性；平均年龄 = 43.4 ± 10.43岁）实施言语行为疗法李·西尔弗曼嗓音治疗（LSVT）LOUD，通过LSVT LOUD的面对面扩展版（LSVT-X）和LSVT-X的远程医疗实践项目（LSVT-X e-LOUD）进行。在治疗前后评估各项指标，包括最长发声时间（MPT）语音强度、重复发声率（DDK）、嗓音障碍指数（VHI）、吞咽生活质量（SWAL-QOL）和电视荧光吞咽造影评分（VDS）。
言语功能有显著改善：MPT（= 0.006）、语音强度（= 0.004）、DDK /puh/（= 0.043）和DDK/puh-tuh-kuh/（= 0.031）。VDS显示吞咽功能在咽期有显著改善。生活质量指标显示身体方面（= 0.003）、情感方面（= 0.000）、VHI总分（= 0.001）、恐惧（= 0.031）、睡眠（= 0.013）、疲劳（= 0.003）和SWAL-QOL总分（= 0.019）均有改善。这些改善在LSVT-X组和LSVT-X e-LOUD组中均一致。
面对面和基于远程医疗实践的LSVT-X均可改善成年脑瘫患者的言语、吞咽功能及生活质量。LSVT-X e-LOUD可作为吞咽困难和构音障碍的数字治疗干预手段，提供与数字健康进步相契合且可及、灵活的治疗选择。
