Speech pathology management of non-progressive dysarthria: a systematic review of the literature.

Purpose: The purpose of this study is to conduct a systematic review of interventions for the treatment of non-progressive dysarthria in adults.Materials and methods: Five electronic databases (PubMed, Embase, CINAHL, PSYCINFO, Cochrane Collaboration) were searched for all studies that described and evaluated treatment used for non-progressive dysarthria in adults. Studies were included if (1) participants were adults (18+ years) with a confirmed diagnosis of non-progressive dysarthria, (2) participants received intervention with pre-post outcome data, and (3) the article was published between 2006 and 2017 (including early online publications). Data extracted included the number of participants; etiology; dysarthria type and severity; age; gender; presence of a control group; intervention tasks, frequency and duration; outcome measures; and conclusions. Data extraction was completed by a member of the research team independently and crosschecked by another team member.Results: Of the 6728 articles identified, 21 met the inclusion criteria. The predominant study design was a case study or case series. The methodological quality of the studies varied. Typically, the interventions included impairment-based and activity level tasks targeting conversation. Approximately half of the interventions adhered to a treatment manual.Conclusions: The evidence base to guide treatment for non-progressive dysarthria is increasing, with interventions showing promise in results, participant numbers, and positive participant feedback.Implications for rehabilitationThe evidence base to guide treatment for non-progressive dysarthria is increasing, but remains limited.The majority of evidence is of moderate methodological quality.The emergence of new research indicates that health professionals need to be continuously aware and critically appraise new literature in the area.

Delivering group speech maintenance therapy via telerehabilitation to people with Parkinson's disease: A pilot study.

Purpose: This study aimed to determine the feasibility of delivering a group speech maintenance programme (eLoud and Proud) to people with Parkinson's disease via telerehabilitation. Method: Treatment was delivered to eight participants who had previously received LSVT LOUD®. The programme focussed on using a "loud" voice within conversational and cognitively loaded tasks, and was delivered in two 90-minute sessions per week for four weeks. Data pertaining to sound pressure level (SPL) (for sustained phonation, reading and monologue tasks), maximum frequency range, maximum phonation duration and impact of dysarthria on quality of life were collected at three time points: (1) pre-treatment (PRE); (2) immediately post-treatment (POST); and (3) three months post-treatment (FU). Participant satisfaction with telerehabilitation was also obtained at POST. Result: Significant improvements were identified for all SPL measures PRE-POST and maintained for sustained phonation and reading tasks at FU. No significant differences were identified for the remaining outcome measures. Participants were overall highly satisfied with telerehabilitation and considered it to be an acceptable alternative to traditional service delivery. Conclusion: This study demonstrated the feasibility of delivering group speech maintenance therapy via telerehabilitation, and the potential for eLoud and Proud to improve and maintain vocal loudness in people with PD.

Be Clear: A New Intensive Speech Treatment for Adults With Nonprogressive Dysarthria.

PURPOSE: This article describes the effects of a new intensive dysarthria treatment program (Be Clear) on speech intelligibility in adults with dysarthria secondary to stroke and traumatic brain injury. METHOD: A small group-repeated measures research design was used to examine the effects of treatment on the speech of 8 participants with nonprogressive dysarthria. Treatment consisted of a 1-hr prepractice session followed by 1-hr therapy sessions, 4 times per week, for 4 weeks (16 sessions). Paired-comparison ratings of speech intelligibility served as the primary outcome measure for the study. Perceptual data, quality of life, and communication partner opinion were obtained at 3 time intervals: (a) prior to treatment, (b) immediately posttreatment, and (c) 1-3 months posttreatment. RESULTS: Following treatment, group data demonstrated substantial improvements in speech intelligibility as perceived by naive listeners on a paired-comparison rating task. Word intelligibility was clinically significantly improved posttreatment and sentence intelligibility demonstrated statistically significant improvement. Communication partner ratings of speech intelligibility and overall communicative function were statistically significantly improved posttreatment. CONCLUSIONS: The results of this study suggest that this new intensive treatment may have potential as an effective intervention for nonprogressive dysarthria. However, controlled studies are required to establish treatment efficacy.