Articulatory speech measures can be related to the severity of multiple sclerosis

BackgroundDysarthria is one of the most frequent communication disorders in patients with Multiple Sclerosis (MS), with an estimated prevalence of around 50%. However, it is unclear if there is a relationship between dysarthria and the severity or duration of the disease.ObjectiveDescribe the speech pattern in MS, correlate with clinical data, and compare with controls.MethodsA group of MS patients (n = 73) matched to healthy controls (n = 37) by sex and age. Individuals with neurological and/or systemic conditions that could interfere with speech were excluded. MS group clinical data were obtained through the analysis of medical records. The speech assessment consisted of auditory-perceptual and speech acoustic analysis, from recording the following speech tasks: phonation and breathing (sustained vowel/a/); prosody (sentences with different intonation patterns) and articulation (diadochokinesis; spontaneous speech; diphthong/iu/repeatedly).ResultsIn MS, 72.6% of the individuals presented mild dysarthria, with alterations in speech subsystems: phonation, breathing, resonance, and articulation. In the acoustic analysis, individuals with MS were significantly worse than the control group (CG) in the variables: standard deviation of the fundamental frequency (p = 0.001) and maximum phonation time (p = 0.041). In diadochokinesis, individuals with MS had a lower number of syllables, duration, and phonation time, but larger pauses per seconds, and in spontaneous speech, a high number of pauses were evidenced as compared to CG. Correlations were found between phonation time in spontaneous speech and the Expanded Disability Status Scale (EDSS) (r = − 0.238, p = 0.043) and phonation ratio in spontaneous speech and EDSS (r = −0.265, p = 0.023), which indicates a correlation between the number of pauses during spontaneous speech and the severity of the disease.ConclusionThe speech profile in MS patients was mild dysarthria, with a decline in the phonatory, respiratory, resonant, and articulatory subsystems of speech, respectively, in order of prevalence. The increased number of pauses during speech and lower rates of phonation ratio can reflect the severity of MS

Assessment of Nonverbal and Verbal Apraxia in Patients with Parkinson’s Disease

Objective. To assess the presence of nonverbal and verbal apraxia in patients with Parkinson’s disease (PD) and analyze the correlation between these conditions and patient age, education, duration of disease, and PD stage, as well as evaluate the correlation between the two types of apraxia and the frequency and types of verbal apraxic errors made by patients in the sample. Method. This was an observational prevalence study. The sample comprised 45 patients with PD seen at the Movement Disorders Clinic of the Clinical Hospital of Porto Alegre, Brazil. Patients were evaluated using the Speech Apraxia Assessment Protocol and PD stages were classified according to the Hoehn and Yahr scale. Results. The rate of nonverbal apraxia and verbal apraxia in the present sample was 24.4%. Verbal apraxia was significantly correlated with education (p≤0.05). The most frequent types of verbal apraxic errors were omissions (70.8%). The analysis of manner and place of articulation showed that most errors occurred during the production of trill (57.7%) and dentoalveolar (92%) phonemes, consecutively. Conclusion. Patients with PD presented nonverbal and verbal apraxia and made several verbal apraxic errors. Verbal apraxia was correlated with education levels

Validation of Content and Reliability of the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson’s Disease (PADAF)

Objetivo: Elaborar e realizar a validação de conteúdo, assim como verificar a confiabilidade entre examinador do Protocolo de Avaliação dos Distúrbios Adquiridos de Fala em Indivíduos com Doença de Parkinson (PADAF). Método: O estudo foi realizado em três etapas. Na primeira, foi elaborado o protocolo e validado seu conteúdo mediante análise de sete especialistas. Na segunda, aplicou-se o instrumento em 25 indivíduos com doença de Parkinson (DP) idiopática. Na terceira e última etapa, verificou-se a confiabilidade entre-examinador. Resultados: A versão final do PADAF foi composta de 32 itens que avaliam a respiração, a fonação, a ressonância, a articulação e a prosódia. Mostrou-se válido, com índice de validade de conteúdo (IVC) bem acima daquele estabelecido na literatura e com perfeita concordância na verificação da confiabilidade entre examinador. Conclusão: O PADAF para indivíduos com DP foi desenvolvido e teve seu conteúdo validado com perfeita confiabilidade do instrumento.Purpose: To develop a protocol for the evaluation of acquired speech disorders in individuals with Parkinson’s disease (PADAF) and to validate its content and determine its inter-judge reliability. Methods: The study was carried out in three stages: in the first one, the protocol was prepared and its content validated through the analysis of seven specialists; in the second, the instrument was applied to 25 individuals with idiopathic Parkinson’s disease (PD); in the third and last stage, the inter-judge reliability was determined. Results: The final version of PADAF consisted of 32 items that evaluated breathing, phonation, resonance, articulation, and prosody. It was shown to be valid, with a content validity index (CVI) much higher than that established in the literature, and with perfect agreement in the determination of inter-judge reliability. Conclusion: PADAF for PD individuals was developed and its content was validated, showing perfect instrument reliability

Therapy speech impact in quality of life in patients with Machado-Joseph disease

A doença de Machado-Joseph é uma doença degenerativa e atualmente considerada a ataxia espinocerebelar mais frequente. O processo degenerativo da doença afeta diferentes regiões e funções do sistema nervoso central e/ou periférico. A disfagia é um dos sintomas presentes na doença de Machado-Joseph, sendo responsável pelas complicações clínicas e pela pneumonia aspirativa, sua principal causa de morte. O objetivo deste trabalho é verificar o impacto da terapia fonoaudiológica na qualidade de vida em pacientes com doença de Machado-Joseph. Participaram da pesquisa quatro pacientes diagnosticados com a doença, três do sexo feminino e um do sexo masculino, com média de idade de 46,5 anos (±18) e queixa de disfagia. Na primeira sessão, todos os pacientes responderam ao questionário de Avaliação da Qualidade de Vida em Disfagia, SWAL-QOL, foram avaliados quanto aos aspectos estruturais e funcionais da deglutição e classificados de acordo com a Escala Funcional de Ingestão por Via Oral (FOIS). Após seis sessões de tratamento fonoaudiológico, realizaram nova avaliação clínica da deglutição, novamente classificados de acordo com a escala FOIS e responderam o SWAL-QOL. Conclusões: Após a intervenção fonoaudiológica, todos os pacientes apresentaram melhor conceito nos domínios medo de alimentar-se, alimentação como um fardo e fadiga, podendo-se inferir que houve uma melhora na satisfação com o processo alimentar e, consequentemente, qualidade de vida dos sujeitos acompanhados.The Machado-Joseph disease is a degenerative disease, currently considered the most frequent spinocerebellar ataxia. The degenerative process of the disease affects several regions and functions of the central and/or peripheral nervous system. The dysphagia is one of the symptoms of Machado-Joseph disease, being responsible for the clinical complications and for the aspiration pneumonia, its main cause of death. The goal of this paper is to verify the impact of the speech-language therapy in the quality of life of the Machado-Joseph disease patients. Four patients diagnosed with Machado-Joseph disease attended to the research, three female and one male, with age average in 46,5 years-old (± 18), and complaining about dysphagia. In the first session, all patients answered the protocol of quality of life in dysphagia assessment of Quality of Life in Dysphagia, SWAL -QOL were assessed for structural and functional aspects of swallowing and classified according to Functional Intake Scale for Oral (FOIS). After six speech therapy sessions conducted a new clinical evaluation of swallowing, again classified according to FOIS and answered the SWAL -QOL. Conclusions: After speech therapy, all patients showed better concept in the field fear of eating, food as a burden and fatigue, which can be inferred that there was an improvement in satisfaction with food processes and hence the quality of life accompanied subjects

Edad subjetiva en ancianos activos : estudio comparativo con edad cronológica, aspectos sociodemigráficos y autoevaluación de la salud

Objetivo: analisar a idade subjetiva de idosos ativos, participantes de programa de universidade aberta e verificar a associação com variáveis sociodemográficas e de autopercepção de saúde e bem-estar. Métodos: estudo transversal, retrospectivo e observacional Dados obtidos a partir de entrevista realizada no ato da matrícula de idosos em programa universitário, na qual são coletadas informações sobre dados sociodemográficos, de saúde e de escolaridade. Com relação à saúde, bem-estar. memória e estado físico, os idosos deveriam atribuir uma nota autoavaliativa. Sobre a idade subjetiva, o questionamento era: "Que idade o senhor(a) sente que tem?" As variáveis foram descritas por média e desvio padrão com testes t de Student e coeficiente de correlação de Spearman. Resultados: foram analisados dados de 395 idosos. sendo 359 (00.9%) mulheres A idade cronológica variou entre 50 e 96 anos, com média de idade cronológica de 71,5+6,8 anos. Já a média da idade subjetiva foi de 57.2+14,0 anos, havendo diferença significativa entre elas (p<0,001). Verificou-se correlação somente entre a idade subjetiva e a saúde percebida (rs=-0,149: p=0,003). Conclusão: os dados evidenciaram que no grupo de idosos ativos avaliado, houve diferença entre a idade cronológica e a idade subjetiva, sendo a subjetiva significativamente menor. Houve associação entre saúde percebida e idade subjetiva.Aims: analyze the subjective age of active elderly people, participating in an open university program and verify the association with sociodemographic and self-perceived health and well-being variables. Methods: cross-sectional, retorspective and observational study. Data obtained from an interview conducted at the time of enrolling the elderly in a university program, in which information on socio-demographic, health and education data is collected. Regarding health, well-being. memory and physical condition. the elderly should give a self-assessment score. Regarding subjective age. the question was: "How old do you feelyou are?" The variables were described as mean and standard deviation with Student's t-tests and Spearman's correlation coefficient. Results: data from 395 elderly people were analyzed, 359 (00.95) women. The chronological age varied between 60 and 96 years. with a mean chronological age of 715 + 6.8 years. The mean subjective age was 57.2 + 14.0 years, with a significant difference between them (p <0.001). There was a correlation only between subjective age and perceived health (rs = -0.149: p = 0.003). Conclusions: the data showed that in the group of active elderly people evaluated, there was a difference between chronological age and subjective age, with the subjective age being significantly lower. There was an association between perceived health and subjective age.Objetivos: analizar la edad subjetiva de los ancianos activos que participan en un programa de universidad abierta y verificar la asociación con variables sociodemográficas y de salud y bienestar autopercibidas. Métodos: estudio transversal, retrospectivo y observacional. Datos obtenidos de una entrevista realizada en el momento de la matriculaciôn del adulto mayor en un programa universitario, en la que se recoge información sobre datos sociodemográficos, sanitarios y educativos. En cuanto a la salud, el bienestar. la memoria y la condición física, las personas mayores deben otorgar una puntuación de autoevaluación. En cuanto a la edad subjetiva, la pregunta fue: "Que edad te sientes que tienes?" Las variables se describieron como media y desviaciôn estândar con las pruebas t-Student y elcoeficiente de correlaciôn de Spearman. Resultados: se analizaron datos de 305 ancianos, 359 (90.05) mujeres. La edad cronológica varió entre 60 y 96 aÃos. con una edad cronológica media de 71,5 + 6,8 anos. La edad subjetiva media fue de 57.2 + 14,0 ahos, con diferencia significativa entre ellos (p <0,001). Sólo hubo correlación entre la edad subjetiva y la salud percibida (rs = -0,140: p = 0.003). Conclusiones: los datos mostraron que en el grupo de ancianos activos evaluados hubo diferencia entre ta edad cronológica y la edad subjetiva, siendo la edad subjetiva significativamente menor. Hubo una asociación entre la salud percibida y la edad subjetiva