Group climate in the voice therapy of patients with Parkinson's Disease

Mapping of the characteristics in the CoDAS journal publications in the voice area: a scoping review

PURPOSE

To map and describe the characteristics present in the publications of the CoDAS journal in the voice segment.

RESEARCH STRATEGIES

The research was carried on the Scielo database using the descriptor voice.

SELECTION CRITERIA

CoDAS publications in the field of voice.

DATA ANALYSIS

Specific data collected according to delineation, summarized by descriptive analysis and analyzed in narrative format.

RESULTS

Studies published in 2019 and with cross-sectional delineation were more frequent. The most frequent result in the cross-sectional studies was the vocal self-assessment. Most intervention studies were of immediate single-session-only effect. The most frequent procedures in the validation studies were translation and transcultural adaptation.

CONCLUSION

There was a gradual increase in the number of publications of voice studies, though these had heterogeneous characteristics.

HiCommunication as a novel speech and communication treatment for Parkinson's disease: A feasibility study

INTRODUCTION

Speech and communication problems are common in Parkinson's disease (PD) and can result in social withdrawal and reduced quality of life. Intervention may improve symptoms but transfer and maintenance remain challenging for many. Access to treatment may also be limited. Group intervention incorporating principles for experience-dependent plasticity may address these challenges. The aim of this study was to develop and study feasibility aspects of a new intervention program for group training of speech and communication in people with PD.

MATERIALS & METHODS

Development and content of the program called HiCommunication is described. Core target areas are voice, articulation, word-finding and memory. Five participants with mild-moderate PD completed this feasibility trial. Attendance rate and possible adverse events as well as the participants' experiences were documented. A speech recording and dysarthria testing were completed to study feasibility of the assessment procedure and evaluate possible changes in voice sound level and intelligibility.

RESULTS

Attendance rate was 89%. No adverse events occurred. Participants reported a positive experience and limited fatigue. Assessment was completed in approximately 30 min and was well tolerated. Four of five participants had an increased voice sound level during text-reading postintervention and mean intelligibility improved.

CONCLUSIONS

Results indicate that HiCommunication is feasible for people with mild-moderate PD. The program was appreciated and well tolerated. Positive outcomes regarding voice sound level and intelligibility were observed; however, the number of participants was very limited. The results motivate that effects of HiCommunication are further studied in a randomized controlled trial, which is ongoing.

A systematic review of group intervention for acquired dysarthria in adults

PURPOSE

This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing.

MATERIALS AND METHODS

A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication.

RESULTS

21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; n = 321). Treatment approaches included singing therapy (n = 10), loudness therapy (n = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) (n = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches.

CONCLUSION

There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.IMPLICATIONS FOR REHABILITATIONGroup therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease.Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures.Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD.PROSPERO registration number: CRD42015029374.

Acoustic Voice Quality Index - AVQI para o português brasileiro: análise de diferentes materiais de fala

RESUMO Objetivo Verificar a melhor amostra de fala para validação do AVQI para o português-brasileiro; identificar o contexto de fala com melhor correlação perceptivo-acústica e que possui maior acurácia diagnóstica com o AVQI. Método Gravações de 50 sujeitos (disfônicos e vocalmente saudáveis), incluindo: vogal/a/; meses do ano; números (1 a 20) e repetição das frases do CAPE-V. As amostras de fala foram editadas para conter três diferentes durações mais vogal: D1-fala completa; D2-fala com 3s de segmentos sonoros; D3-fala com ponto de corte pré-determinado. Três avaliadores realizaram a análise perceptivoauditiva (APA) das amostras combinadas em 3 contextos seguidos da vogal e deram um único escore do desvio vocal (G:0 a 3). Verificou-se qual estímulo de fala possuía melhor correlação perceptivo-acústica considerando o Gmédio; analisou-se qual estímulo possuía melhor acurácia diagnóstica considerando como presença ou ausência G<0,5 e G<0,68. Resultados A correlação perceptivo-acústica variou de r = 0,482 a r = 0,634 (Correlação de Spearman); números apresentou os valores mais elevados. O AVQI foi altamente específico e pouco sensível. Considerando G<0,5, a melhor sensibilidade e valor da curva ROC foi para frases em D3 (0,578;0,72). Considerando G<0,68, houve boa acurácia diagnóstica para números de 1 a 10 e maior sensibilidade para números de 1 a 20. Conclusão Melhor correlação perceptivo-acústica foi para números, 1 a 10. As frases do CAPE-V produziram melhor acurácia diagnóstica com G<0,5, números apresentou elevada acurácia diagnóstica com G<0,68. Números é bastante usual na clínica brasileira, logo, sugere-se seu uso para validação e análises do AVQI.