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1.
Am Fam Physician ; 104(5): 471-475, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34783512

RESUMO

Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with inspiratory stridor or wheezing; sudden, severe dyspnea (without hypoxia, tachypnea, or increased work of breathing); throat or chest tightness; and anxiety, particularly in females. Common triggers include exercise, asthma, gastroesophageal reflux disease, postnasal drip, upper or lower respiratory tract infection, and irritants. Nasolaryngoscopy and pulmonary function testing, with provocative exercise and methacholine, can help diagnose vocal cord dysfunction and are helpful to evaluate for other etiologies. Conditions that can trigger vocal cord dysfunction should be optimally treated, particularly asthma, gastroesophageal reflux disease, and postnasal drip, while avoiding potential irritants. Therapeutic breathing maneuvers and vocal cord relaxation techniques are first-line therapy for dyspnea that occurs with vocal cord dysfunction. A subset of vocal cord dysfunction leads to dysphonia, as opposed to dyspnea, secondary to abnormal laryngeal muscle spasms (vocal cord closure is less severe). OnabotulinumtoxinA injections may be helpful for spasmodic dysphonia and for treating dyspnea in certain cases, although evidence is limited.


Assuntos
Laringoscopia/métodos , Disfunção da Prega Vocal , Manuseio das Vias Aéreas/métodos , Humanos , Testes de Função Respiratória , Terapia Respiratória/métodos , Fonoterapia/métodos , Disfunção da Prega Vocal/diagnóstico , Disfunção da Prega Vocal/etiologia , Disfunção da Prega Vocal/fisiopatologia , Disfunção da Prega Vocal/terapia , Prega Vocal/diagnóstico por imagem
3.
BMC Neurol ; 21(1): 450, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789195

RESUMO

BACKGROUND: Non-progressive dysarthria is an acquired motor speech disorder resulting from neurological diseases such as stroke and traumatic brain injury. The evidence base for the assessment of non-progressive dysarthria remains limited with professional practices relying mainly on therapists' clinical experience. Limited information on the assessment practices of Lebanese speech and language therapists (SLTs) is available. Such information is crucial for the development of adequate therapy services for clients with non-progressive dysarthria. This study aims to explore the assessment practices and attitudes of Lebanese SLTs working with adults with non-progressive dysarthria and to investigate their adherence to the framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). METHODS: A cross-sectional study was conducted in Lebanon between March and May 2021. Data was collected through an online survey that included information on socio-demographic characteristics, practices, and attitudes of SLTs who assess adults with non-progressive dysarthria. RESULTS: A total of 50 Lebanese SLTs responded to the survey. The majority of SLTs (78%) assessed clients with non-progressive dysarthria across all ICF domains. SLTs reported dissatisfaction with the available assessment tools (64%) and reliance on informal tools (84%). In addition, 68% of the SLTs suggested the crucial need for the development of Arabic formal assessments that can quantitatively evaluate dysarthria and determine severity. The survey also showed that the respondents demonstrated a preference for the use of impairment-based tools. CONCLUSION: It can be concluded that the assessment practices of Lebanese SLTs, generally, follow the international trend and the recommended professional guidelines. Further research initiatives should be held to develop Arabic formal assessment tools for non-progressive dysarthria.


Assuntos
Disartria , Fala , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Disartria/diagnóstico , Humanos , Terapia da Linguagem , Líbano , Fonoterapia
4.
BMC Geriatr ; 21(1): 642, 2021 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781875

RESUMO

BACKGROUND: Primary progressive aphasia is a language-led dementia resulting in a gradual dissolution of language. Primary progressive aphasia has a significant psychosocial impact on both the person and their families. Speech and language therapy is one of the only available management options, and communication partner training interventions offer a practical approach to identify strategies to support conversation. The aim of this study was to define and refine a manual and an online training resource for speech and language therapists to deliver communication partner training to people with primary progressive aphasia and their communication partners called Better Conversations with primary progressive aphasia. METHODS: The Better Conversations with primary progressive aphasia manual and training program were developed using the Medical Research Council framework for developing complex interventions. The six-stage development process included 1. Exploratory review of existing literature including principles of applied Conversation Analysis, behaviour change theory and frameworks for chronic disease self-management, 2. Consultation and co-production over 12 meetings with the project steering group comprising representatives from key stakeholder groups, 3. Development of an initial draft, 4. Survey feedback followed by a consensus meeting using the Nominal Group Techniques with a group of speech and language therapists, 5. Two focus groups to gather opinions from people with PPA and their families were recorded, transcribed and Thematic Analysis used to examine the data, 6. Refinement. RESULTS: Co-production of the Better Conversations with primary progressive aphasia resulted in seven online training modules, and a manual describing four communication partner training intervention sessions with accompanying handouts. Eight important components of communication partner training were identified in the aggregation process of the Nominal Group Technique undertaken with 36 speech and language therapists, including use of video feedback to focus on strengths as well as areas of conversation breakdown. Analysis of the focus groups held with six people with primary progressive aphasia and seven family members identified three themes 1) Timing of intervention, 2) Speech and language therapists' understanding of types of dementia, and 3) Knowing what helps. These data informed refinements to the manual including additional practice activities and useful strategies for the future. CONCLUSIONS: Using the Medical Research Council framework to develop an intervention that is underpinned by a theoretical rationale of how communication partner training causes change allows for the key intervention components to be strengthened. Co-production of the manual and training materials ensures the intervention will meet the needs of people with primary progressive aphasia and their communication partners. Gathering further data from speech and language therapists and people living with primary progressive aphasia and their families to refine the manual and the training materials enhances the feasibility of delivering this in preparation for a phase II NHS-based randomised controlled pilot-feasibility study, currently underway.


Assuntos
Afasia Primária Progressiva , Pesquisa Biomédica , Afasia Primária Progressiva/diagnóstico , Afasia Primária Progressiva/terapia , Comunicação , Humanos , Idioma , Fonoterapia
5.
Trials ; 22(1): 837, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819130

RESUMO

BACKGROUND: People with post-stroke aphasia commonly receive speech-language therapy (SLT) when they are admitted to hospitals. Commonly, these patients reported communication difficulties in in-patient settings. Augmentative and alternative communication (AAC) has been reported as an effective treatment approach to improve communication effectiveness, language performance, decreasing depression, and improving quality of life for this population. However, little evidence has demonstrated the use of AAC intervention (AACT) in early recovery from people with post-stroke aphasia in in-patient rehabilitation settings for improving these patients' communication effectiveness. The pilot randomized controlled trial (RCT) will explore the effectiveness and feasibility of including AACT in regular SLT for in-patient people with post-stroke aphasia. METHOD: This pilot RCT is a single-blind, randomized controlled trial with two parallel groups. Both groups receive a 1-h treatment session, including either both AACT and SLT or SLT only for ten consecutive days. We aim to include 22 in-patient participants with post-stroke aphasia in each group. Participants will be assessed at pre- and post-intervention and 2 weeks after intervention. The primary outcomes are the ability of communication measured by the communication of basic needs subtest in the Functional Assessment of Communication Skills for Adult (FACS) and the overall language performance measured by the Chinese Standard Aphasia Battery (ABC). The secondary outcomes include a 10-min conversation, the 10-item Hospital version of the Stroke Aphasic Depression Questionnaire (SADQH-10), the Stroke-Specific Quality of Life Scale (SS-QOL), and a patient and caregiver satisfaction questionnaire. DISCUSSION: This pilot RCT will contribute to new scientific evidence to the field of aphasia rehabilitation in early recovery during the in-patient period. The paper describes the trial, which will explore the effect of combining AACT and SLT and SLT only, our choice of primary and secondary outcome measures, and proposed analyses. The study results will provide information for implementing AACT in the regular in-patient SLT of future RCTs. TRIAL REGISTRATION: Chinese Clinical Trial Registry database (ChiCTR) ChiCTR2000028870 . Registered on 5 January 2020.


Assuntos
Afasia , Reabilitação do Acidente Vascular Cerebral , Adulto , Afasia/diagnóstico , Afasia/etiologia , Humanos , Idioma , Terapia da Linguagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Fonoterapia
6.
Semin Speech Lang ; 42(5): 395-418, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34729727

RESUMO

The purpose of this study was to examine and describe experiences and perceptions of speech-language pathologists (SLPs) serving children and families from culturally and linguistically diverse populations. Twenty SLPs were interviewed using an online audio platform regarding common practices, resources and supports, challenges, and communication. Participants' responses to the semi-structured questions were transcribed and analyzed to identify themes in experiences. Results suggested six overall themes including: considerations for assessment; cultural impact; linguistic access and barriers; professional preparedness; impact of COVID-19; and helpful tips and resources. The discussion includes recommendations and resources to address obstacles.


Assuntos
Atitude do Pessoal de Saúde , Multilinguismo , Fonoterapia , Patologia da Fala e Linguagem , Adolescente , Criança , Pré-Escolar , Atenção à Saúde , Família , Humanos , Lactente , Adulto Jovem
7.
Codas ; 33(6): e20200225, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34705996

RESUMO

PURPOSE: Describe the preventive strategies used during the COVID-19 pandemic in the return of academic and health care activities in a Speech Therapy Teaching Clinic at a Brazilian public university. METHODS: This is a descriptive study based on documentary research. The strategies were based on official recommendations from national and international institutions and/or organizations to combat COVID-19 published between March and June 2020. The strategic plan included an analysis of the clinic's infrastructure, material and human resources, and user profile. The results are presented descriptively. RESULTS: Actions based on the health recommendations to face the COVID-19 pandemic published until then considered adaptations to the infrastructure, care for the environment, and planning and implementation of a new health care routine and a biosafety protocol. The technical-scientific support provided by professionals in the field of biosafety was essential to assess local risks and establish preventive measures. CONCLUSION: A detailed description of strategies is a guiding instrument for the return to activities in the safest manner. To be effective, strategies to combat infections of any nature should be formulated considering the particularities of each health care environment. The new routines should contemplate the local socioeconomic reality and fulfill the academic and social objectives of the Speech Therapy Teaching Clinic, but they should be revised by the management team periodically or as the local health situation evolves.


Assuntos
COVID-19 , Pandemias , Brasil , Humanos , SARS-CoV-2 , Fonoterapia
8.
S Afr J Commun Disord ; 68(1): e1-e9, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34636594

RESUMO

BACKGROUND: The need for communication-related services in sub-Saharan Africa to support individuals experiencing communication disability is a longstanding and well-documented situation. We posit the inequities highlighted by coronavirus disease 2019 (COVID-19) make this a relevant time for speech language therapists and the professional bodies that govern us to broadly consider our roles and practices in education, health and disability in local, national and global contexts. OBJECTIVE: To illustrate what services developed with local knowledge can look like in Kenya in order to promote dialogue around alternative speech language therapy models, particularly in contexts where there are insufficient services, few trained speech language therapists and limited structures to support the emerging profession. METHOD: This article examines three clinical case studies from Western Kenya, using a conceptual framework for responsive global engagement. RESULTS: Service needs in Western Kenya well exceed a direct one-on-one model of care that is common in the minority world. The service delivery models described here emphasise training, skills sharing and engaging the myriad of communication partners available to individuals with communication disabilities. CONCLUSION: We offer up these case studies of collaborative practice as contextual realities that may be present in any speech language therapy programming in under-resourced communities. We dispel the idea that success in this work has been linear, progressed on planned time frames or come to fruition with targeted goal attainment. The fact that our relationships have endured in these communities since 2007 is our primary success.


Assuntos
COVID-19 , Terapia da Linguagem , Humanos , Quênia , Idioma , SARS-CoV-2 , Fala , Fonoterapia
9.
Rev Assoc Med Bras (1992) ; 67(3): 454-461, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34468614

RESUMO

We performed an integrative review on the scientific literature about the use of telehealth in audiology care. Through high criteria search of published studies on the "Biblioteca Virtual em Saúde" - Virtual Health Library, PubMed, and Scientific Electronic Library Online databases, nine articles were selected. It was possible to verify that the use of telehealth in audiology is feasible and efficient, because it could promote audiological care for patients from away places. This process reaches more patients and communities by breaking down geographic barriers, and it offers a specific service not available with less cost and more quickly when compared with traditional speech therapy care.


Assuntos
Audiologia , Telemedicina , Humanos , Fonoterapia
10.
Codas ; 33(6): e20200312, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34586329

RESUMO

PURPOSE: to verify the effectiveness of a Speech Therapy intervention program to decrease the risk of falls in elderly people. METHODS: Exploratory and intervention study where upon 148 volunteers from community, both genders, with an average of 68.6(± 6.5) years were submitted to the Dynamic Gait Index (DGI)- Brazilian brief and the Timed Up and Go (TUG). Volunteers with or without potential risk for falling were invited to participate in a 50-minutes long intervention program carried out for five consecutive weeks, based on Cawthorne and Cooksey exercises. Seventy-two volunteers 68.1(±6.5) years presented in at least three meeting, were reassessed. The results were analyzed by Wilcoxon, Chi-square, Spearman and Correlation Matrix tests, with p≤5.0%. RESULTS: Thirty-seven (25.0%) and 106 (71.6%) participants presented, respectively, risks for falls in the DGI-Brazilian brief and TUG. There was negative correlation between the DGI-Brazilian brief (p=0.034) and positive with the TUG (p=0.0071) with age and both instruments (p=0.00000016). Through the comparison the initial and final data a positive correlation was found for the DGI-Brazilian brief and for TUG in the Chi-square test and by Wilcoxon's. Better performance was observed in both tests after the intervention. CONCLUSION: The intervention was effective in decreasing the risk for falls and improving gait performance, and functional and dynamic balance.


Assuntos
Acidentes por Quedas , Fonoterapia , Acidentes por Quedas/prevenção & controle , Idoso , Envelhecimento , Feminino , Marcha , Humanos , Masculino , Equilíbrio Postural
11.
PLoS One ; 16(9): e0257462, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34534254

RESUMO

CONTEXT: Aphasia is a post-stroke condition that can dramatically impact a person with aphasia's (PWA) communication abilities. To date, few if any studies have considered the cost and cost-effectiveness of functional change in aphasia nor considered measures of patient's value for aphasia treatment. OBJECTIVE: To assess the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia. DESIGN: Twenty PWA completed between 5 and 12 telehealth rehabilitation sessions of 45-60 minutes within a 6-week time frame using a Language-Oriented Treatment (LOT) designed to address a range of language issues among individuals with aphasia. National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL) were completed prior to and at the completion of rehabilitation to obtain baseline and treatment measures. RESULTS: Age, education, and race are significantly correlated with improvement in the NOMS verbal expression. African Americans (OR = 2.0917) are twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increases with each additional year of education (OR = 1.002) but decrease with age (OR = 0.9463). A total of 15 PWA showed improvement in NOMS comprehension and nine patients showed improvement in NOMS verbal expression. Improving patients attended between five and 12 treatment sessions. The average cost of improvement in NOMS comprehension was $1,152 per patient and NOMS verbal expression was $1,128 per patient with individual treatment costs varying between $540 and $1,296. However, on average, the monetary equivalent in patient's improved QCL was between $1,790.39 to $3,912,54-far exceeding the financial cost of treatment. CONCLUSIONS: When measuring the functional improvement of patients with aphasia, patient's quality of communication life received from treatment exceeded financial cost of services provided.


Assuntos
Afasia/economia , Custos de Cuidados de Saúde , Avaliação de Resultados em Cuidados de Saúde/economia , Telerreabilitação/economia , Afro-Americanos , Fatores Etários , Afasia/etnologia , Afasia/reabilitação , Escolaridade , Grupo com Ancestrais do Continente Europeu , Humanos , Modelos Logísticos , Razão de Chances , Qualidade de Vida , Fonoterapia , Telerreabilitação/métodos
12.
J Speech Lang Hear Res ; 64(10): 3969-3982, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34491769

RESUMO

Purpose A core outcome set (COS; an agreed minimum set of outcomes) was developed to address the heterogeneous measurement of outcomes in poststroke aphasia treatment research. Successful implementation of a COS requires change in individual and collective research behavior. We used the Theoretical Domains Framework (TDF) to understand the factors influencing researchers' use and nonuse of the Research Outcome Measurement in Aphasia (ROMA) COS. Method Aphasia trialists and highly published treatment researchers were identified from the Cochrane review of speech and language therapy for aphasia following stroke and through database searches. Participants completed a theory-informed online survey that explored factors influencing COS use. Data were analyzed using descriptive statistics and qualitative content analysis. Results Sixty-four aphasia researchers from 13 countries participated. Most participants (81%) were aware of the ROMA COS, and participants identified more facilitators than barriers to its use. The TDF domain with the highest agreement (i.e., facilitator) was "knowledge" (84% agree/strongly agree). Participants had knowledge of the measures included in the ROMA COS, their associated benefits, and the existing recommendations. The TDF domains with the least agreement (i.e., barriers) were "reinforcement" (34% agree/strongly agree); "social influences" (41% agree/strongly agree); "memory, attention, and decision processes" (45% agree/strongly agree); and "behavioral regulation" (49% agree/strongly agree). Hence, participants identified a lack of external incentives, collegial encouragement, and monitoring systems as barriers to using the ROMA COS. The suitability and availability of individual measurement instruments, as well as burden associated with collecting the COS, were also identified as reasons for nonuse. Conclusions Overall, participants were aware of the benefits of using the ROMA COS and believed that its implementation would improve research quality; however, incentives for routine implementation were reported to be lacking. Findings will guide future revisions of the ROMA COS and the development of theoretically informed implementation strategies. Supplemental Material https://doi.org/10.23641/asha.16528524.


Assuntos
Afasia , Acidente Vascular Cerebral , Afasia/etiologia , Afasia/terapia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Fonoterapia , Acidente Vascular Cerebral/complicações , Inquéritos e Questionários
13.
J Speech Lang Hear Res ; 64(10): 3769-3785, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34525308

RESUMO

Purpose The purpose of this article is to provide trial-by-trial practice performance data in relation to learning (outcome probe data) as collected from 18 treatment sessions provided to children with severe speech sound disorders. The data illustrate the practice-learning paradox: Specific, perfect practice performance is not required for speech production learning. Method We detailed how nine student speech-language pathologists (SSLPs) implemented and modified the motor learning practice conditions to reach a proposed challenge point during speech practice. Eleven participants diagnosed with a severe speech sound disorder received high-intensity speech therapy 3 times per week for 6 weeks. SSLPs implemented treatment procedures with the goal of achieving at least 100 practice trials while manipulating practice parameters to maintain practice at the challenge point. Specifically, child performance was monitored for accuracy in five-trial increments, and practice parameters were changed to increase functional task difficulty when the child's performance was high (four or five correct responses) or to decrease functional task difficulty when the child's performance was low (fewer than four correct responses). The practice stimulus, type and amount of feedback, structure of practice, or level of support might be changed to ensure practice at the challenge point. Results On average, the children achieved 102 practice trials per session at a level of 58% correct responses. Fast achievement of connected speech with the lowest amount of support was associated with high scores on generalization probes. Even with high levels of error during practice, the children improved percent consonants correct with maintenance of learning 3 months posttreatment. Conclusion The results of this study show that it may not be necessary to overpractice or maintain a high degree of performance accuracy during treatment sessions to achieve transfer and retention of speech production learning.


Assuntos
Apraxias , Transtorno Fonológico , Criança , Humanos , Fala , Medida da Produção da Fala , Transtorno Fonológico/terapia , Fonoterapia
14.
Codas ; 33(4): e20200088, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34346949

RESUMO

PURPOSE: To verify the effectiveness of the speech language intervention in the communicative behavior in group of individuals diagnosed with schizophrenia. METHODS: This is a semi-experimental, quantitative analytical-exploratory study. Users of a Psychosocial Care Center III (CAPS III) with a diagnosis of schizophrenia were included, divided into 2 groups: Experimental Group (EG), comprising the Speech Therapy Intervention Group (STIG) and Control Group (CG). The communicative behavior was evaluated through the Brief MAC Battery. The STIG was performed in 2 weekly sessions, during 12 weeks, totalizing 24 sessions. After this period, individuals were reassessed. Data were analyzed through Mann Whitney non-parametric Test, and Pearson's Correlation Test. RESULTS: A total of 19 individuals of both sexes participated, who are between 19 and 59 years old with a minimum schooling of 5 years, 14 participating in EG and 5 in CG. In the EG, it was possible to observe that there was improvement in the communicative behavior after the speech language intervention in all the tasks evaluated, except in the writing task. In CG, no significant changes were observed comparing evaluation and reevaluation after 12 weeks. CONCLUSION: The speech-language intervention in group was effective as a socialization tool and contributing to the improvement of the living conditions of these people with schizophrenia.


Assuntos
Transtornos da Comunicação , Esquizofrenia , Adulto , Comunicação , Transtornos da Comunicação/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/complicações , Esquizofrenia/terapia , Fala , Fonoterapia , Adulto Jovem
15.
Brain Behav ; 11(8): e02094, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34343416

RESUMO

INTRODUCTION: Speech therapy is the primary management followed the physical management through surgery for children with nonsyndromic cleft lip and palate (NSCLP). However, the topological pattern of the resting-state network after rehabilitation remains poorly understood. We aimed to explore the functional topological pattern of children with NSCLP after speech rehabilitation compared with healthy controls. METHODS: We examined 28 children with NSCLP after speech rehabilitation (age = 10.0 ± 2.3 years) and 28 healthy controls for resting-state functional MRI. We calculated functional connections and the degree strength, betweenness centrality, network clustering coefficient (Cp), characteristic path length (Lp), global network efficiency (Eg), local network efficiency (Eloc), modularity index (Q), module number, and participation coefficient for the between-group differences using two-sample t tests (corrected p < .05). Additionally, we performed a correlation analysis between the Chinese language clear degree scale (CLCDS) scores and topological properties in children with NSCLP. RESULTS: We detected significant between-group differences in the areas under the curve (AUCs) of degree strength and betweenness centrality in language-related brain regions. There were no significant between-group differences in module number, participation coefficient, Cp, Lp, Eg, or Eloc. However, the Q (density: 0.05-0.30) and QAUC (t = 2.46, p = .02) showed significant between-group differences. Additionally, there was no significant correlation between topological properties of statistical between-group differences and CLCDS scores. CONCLUSIONS: Although nodal metric differences existed in the language-related brain regions, the children with NSCLP after speech rehabilitation had similar global network properties, module numbers, and participation coefficient, but increased modularity. Our results suggested that children with NSCLP achieved speech rehabilitation through function specialization in the language-related brain regions. The resting-state topology pattern could be of substantive neurobiological importance and potential imaging biomarkers for speech rehabilitation.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Humanos , Fala , Fonoterapia
16.
Am J Speech Lang Pathol ; 30(5): 2329-2333, 2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34379514

RESUMO

Purpose The purpose of this article is to promote the viewpoint that speech-language pathologists (SLPs) are well positioned to actively encourage individuals with cognitive-communication disorders following acquired brain injury (ABI) to engage in ongoing, long-term, cognitive exercise post-therapy discharge. Method This viewpoint article draws on evidence from the well-researched area of physical exercise, reports findings of early-stage research in the much less studied area of cognitive exercise, and highlights relevant aspects of motivational theory informing exercise participation. Informed by these, an evidence-supported model of cognitive exercise engagement is offered to inform ABI-targeted cognitive wellness empowerment efforts, and a case study illustrates clinical application of the model. Conclusions Exercise provides an opportunity to sustain or improve long-term health, function, and quality of life outcomes. It is within SLP scope of practice to collaborate with family members and other caregivers to empower individuals post-ABI, especially those with decreased self-management skills, to engage in long-term computerized and noncomputerized cognitive exercise following SLP therapy discharge. Ongoing research will further inform the evidence supporting the scholarly opinion presented in this viewpoint.


Assuntos
Lesões Encefálicas , Patologia da Fala e Linguagem , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/terapia , Cognição , Exercício Físico , Humanos , Alta do Paciente , Qualidade de Vida , Fala , Fonoterapia , Sobreviventes
17.
J Commun Disord ; 93: 106145, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34399133

RESUMO

BACKGROUND: After a stroke, it is highly likely that an individual will experience substantial fatigue that can significantly affect recovery and function; stroke survivors also have more than a 50% chance of having at least one speech-language disorder. Current reviews of post-stroke fatigue have not provided evidence focused on speech-language disorders or the potential influence they may have on post-stroke fatigue and related recovery. OBJECTIVES: The aim of this review was to determine how speech-language disorders are represented in post-stroke fatigue research and to catalogue methods used to identify speech-language disorders and measure fatigue. METHODS: A systematic scoping review was conducted to identify studies measuring post-stroke fatigue. To identify these studies, a comprehensive literature search was conducted using relevant databases and grey literature sources, followed by several stages of review that adhered to PRISMA guidelines. We evaluated these studies using pre-established eligibility criteria and extracted data regarding the inclusion/exclusion of persons with speech-language disorders and the assessment methods used. RESULTS: The scoping review analysis was conducted on 161 studies. Of these, 41 (26%) excluded all speech-language disorders, 71 (44%) excluded severe speech-language disorders, and 49 (30%) included participants with speech-language disorders. Of the 120 studies that did not explicitly exclude all speech-language disorders, only 34 were confirmed to report data from at least one person with a speech-language disorder. Further, only 5 studies reported data that could be used to determine a relationship between speech-language disorders and fatigue. CONCLUSIONS: Persons with speech-language disorders are underrepresented in post-stroke fatigue research and very few studies have examined the relationship between post-stroke fatigue and speech-language disorders, limiting conclusions that can be drawn. This is problematic because medical professionals relying on this evidence to guide clinical practice are likely to be treating individuals with co-occurring fatigue and speech-language disorders and the current research does not provide enough information about the potential impact of fatigue on speech-language disorders or vice versa. To bridge this gap, we suggest methods of assessment that could provide ways to more accurately 1) reflect the real population in post-stroke fatigue studies, and 2) measure and document fatigue in post-stroke speech-language disorder studies. We also propose the Filter-Funnel Model of Post-Stroke Fatigue, which considers the role of speech-language disorders and communicative demands in the context of post-stroke fatigue.


Assuntos
Transtornos da Comunicação , Transtornos da Linguagem , Fadiga/etiologia , Humanos , Fala , Fonoterapia
18.
Medicine (Baltimore) ; 100(31): e26840, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397854

RESUMO

RATIONALE: We report on a patient whose arcuate fasciculus (AF) and corticobulbar tract (CBT) recovered following an infarct in the middle cerebral artery (MCA) territory, demonstrated on serial diffusion tensor tractography (DTT). PATIENT CONCERNS: The patient showed moderate conduction aphasia on the Western Aphasia Battery with an aphasia quotient of 46.5‰ (spontaneous speech: 35.0‰, auditory comprehension: 36.0‰, and naming: 53.1‰) at 1 month after onset. His aphasia improved with an aphasia quotient of 49‰ (spontaneous speech: 71.0‰, auditory comprehension: 52.0‰, and naming: 59.0‰) at 10 months after onset. DIAGNOSIS: A 44-year-old right-handed male patient presented with aphasia and quadriplegia, which occurred at the onset of an infarct in the left MCA territory. INTERVENTION: Diffusion tensor imaging data were acquired twice (1 month and 10 months after onset). OUTCOMES: On one-month DTT, the discontinuation of the left AF and severe narrowing of the right CBT were observed. However, on ten-month DTT, the left AF was connected to the opposite AF by a new tract that passed through the splenium of corpus callosum, and the right CBT had become thicker. LESSONS: We believe that our results suggest a recovery mechanism of injured AF and CBT in stroke patients.


Assuntos
Afasia , Encéfalo , Área de Broca , Infarto da Artéria Cerebral Média , Área de Wernicke , Adulto , Afasia/diagnóstico , Afasia/etiologia , Afasia/reabilitação , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Humanos , Infarto da Artéria Cerebral Média/diagnóstico , Infarto da Artéria Cerebral Média/fisiopatologia , Infarto da Artéria Cerebral Média/reabilitação , Masculino , Vias Neurais/patologia , Vias Neurais/fisiopatologia , Reabilitação Neurológica/métodos , Tratos Piramidais/patologia , Recuperação de Função Fisiológica , Fonoterapia/métodos , Resultado do Tratamento
19.
J Commun Disord ; 93: 106147, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34461556

RESUMO

INTRODUCTION: This exploratory study compared the effects of two speech therapy approaches on speech characteristics of young adults with congenital dysarthria resulting from various etiologies: a) articulation training focusing on consonant articulation exercises at various levels (isolation, syllables, and words), and b) the Beatalk method, based on human beatboxing, i.e., producing various instrumental sounds in an a-cappella musical context. Both interventions were designed to increase participants' speech intelligibility. METHODS: Twelve adults with congenital dysarthria and reduced speech intelligibility participated in treatment groups for eight weeks. Six participants were assigned to the articulation training group, and six to the Beatalk group. Intelligibility of single words and continuous speech, voice measures, and oral-diadochokinesis rates were measured before and after the treatment. RESULTS: The results showed that the Beatalk intervention yielded a significant overall pre- to post-treatment effect. Specifically, it resulted in gains in articulatory accuracy and intelligibility for single words. Improvements were not noted following articulation training. CONCLUSIONS: The results present initial evidence of the positive effect of the Beatalk method as an intervention tool for adults with congenital dysarthria. This relatively easy-to-learn technique shows promise, as it involves intense and repetitive production of speech sounds while controlling rhythm and breathing in an enjoyable context.


Assuntos
Disartria , Inteligibilidade da Fala , Disartria/etiologia , Disartria/terapia , Humanos , Testes de Articulação da Fala , Medida da Produção da Fala , Fonoterapia , Adulto Jovem
20.
J Speech Lang Hear Res ; 64(9): 3398-3415, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34433000

RESUMO

Purpose The purpose of this study was to compare the effect of speech intervention provided with a low intensity with speech intervention provided with a high intensity on the speech and health-related quality of life (HRQoL) in Dutch-speaking children with a cleft palate with or without a cleft lip (CP ± L) between 4 and 12 years. Method A longitudinal, prospective, randomized controlled trial with a multiple baseline design was used. Twelve children with a CP ± L (M age = 8.0 years, SD = 1.54) were divided into two groups using block randomization stratified by age and gender: One group received low-intensity speech intervention (LISI; n = 6) and one group received high-intensity speech intervention (HISI; n = 6). Children in the LISI group received intervention with a session duration of 1 hr, a dose frequency of 1 session per week, and a total intervention duration of 10 weeks. Children in the HISI group received intervention with a session duration of 1 hr, a dose frequency of 5 sessions per week, and a total intervention duration of 2 weeks. The cumulative intervention intensity was kept constant. Both groups received identical therapy programs provided by the same experienced speech therapist. Perceptual speech assessments were performed on baseline and posttreatment data points. Changes in HRQoL were assessed using the Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) questionnaire. Both groups were compared over time using (generalized) linear mixed models. Results No significant Time × Group interactions were observed for the percentage of correctly produced consonants at the word and sentence levels, indicating no differences in evolution over time among the two groups. The variables speech understandability, speech acceptability, and the total VELO scores significantly improved following HISI, but not following LISI. Conclusions Children in the HISI group made equal and, for some variables, even superior progress in only 2 weeks of therapy compared to children in the LISI group who received 10 weeks of therapy. HISI is a promising strategy to improve speech outcomes and HRQoL in a shorter time period.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/terapia , Fissura Palatina/complicações , Humanos , Estudos Prospectivos , Qualidade de Vida , Fala , Fonoterapia
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