Swallowing Outcomes Following Voice Therapy in Multiple System Atrophy with Dysphagia: Comparison of Treatment Efficacy with Parkinson’s Disease

Park, Alyssa; Jang, Su Jeong; Kim, No Eul; Kim, Tae Hui; Sohn, Young H.; Kim, HyangHee; Cho, Sung Rae

doi:10.1007/s00455-021-10265-9

Cited by 17 publications

(23 citation statements)

References 32 publications

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“…The lack of improvement in relation to maximum phonation time stands in contrast with previous trials focusing on this aspect [25,26,59]. There are several possible explanations for this outcome.…”

Section: Effectivenesscontrasting

confidence: 86%

“…Together these studies have highlighted a range of potential communication benefits across all areas of the International Classification of Functioning and Disability (ICF) model, i.e., impairment (e.g. breath support, voice quality, loudness [23][24][25][26][27][28]), activity (intelligibility and naturalness, [24,27,29]) and participation [27,28]. There is thus mounting evidence that speech intervention can have benefits both for speech and wider communication impact in people with progressive ataxias.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia

Lowit

Cox

Loucas

et al. 2022

Preprint

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BackgroundProgressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach.A new model of care – ClearSpeechTogether – is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias.MethodThe study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over two weeks followed by 20 patient-led group sessions over four weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation.ResultsNine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved intelligibility for reading, and increased participation and confidence. Participant interviews highlighted the value of group support, from psychosocial perspectives and in supporting speech strategy internalisation and generalisation.DiscussionClearSpeechTogether presented an effective intervention in a small group of people with progressive ataxia. It matched or exceeded the outcomes previously reported for intensive, individual therapy while minimising clinician time demands. Furthermore, its unique peer led group intervention design appeared effective in addressing intractable psychosocial issues. ClearSpeechTogether is potentially cost-effective, providing intensive delivery with few clinician sessions, thus maximising the input available from health care providers.

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Section: Effectivenesscontrasting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia

Lowit

Cox

Loucas

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The lack of improvement in relation to maximum phonation time was not surprising given that the majority of participants’ pre-treatment performance fell within the normal range [ 25 , 26 , 61 ]. Importantly, those with considerably reduced MPTs did show some improvements.…”

Section: Discussionmentioning

confidence: 99%

“…Together these studies have highlighted a range of potential communication benefits across all areas of the International Classification of Functioning and Disability (ICF) model, i.e., impairment (e.g. breath support, voice quality, loudness [23][24][25][26][27][28]), activity (intelligibility and naturalness, [24,27,29,30]) and participation and communication confidence [27,28,31]. There is thus mounting evidence that speech intervention can have benefits both for speech and wider communication impact in people with progressive ataxias.…”

Section: Introductionmentioning

confidence: 99%

ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia

et al. 2022

View full text Add to dashboard Cite

Background Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias. Method This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation. Results Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing. Discussion ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.

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“…Twelve full-text articles were excluded, as they did not mention voice training interventions for OPD; 11 articles were non-experimental studies; 2 articles were not available; 2 articles were published in English; data could not be extracted from 3 articles, while five studies had a lack of available data. Overall, eight articles met this review's objective and inclusion criteria [6,[19][20][21][22][23][24][25].…”

Section: Literature Retrievalmentioning

confidence: 99%

The effect of voice training interventions on patients with oropharyngeal dysphagia: a systematic review

Niu

Zhou

Wang

et al. 2022

Eur Arch Otorhinolaryngol

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Background Voice training has been proposed as an intervention to improve swallowing function in patients with dysphagia. However, little is known about the effects of voice training on swallowing physiology. Objectives This systematic review investigates the effect of voice training on the swallowing function of patients with oropharyngeal dysphagia and provides the theoretical basis for improving the swallowing function and life quality of patients with oropharyngeal dysphagia. Data sources A systematic review using a narrative synthesis approach of all published studies was sought with no date restrictions. Five electronic databases (EMBASE, PubMed, CINAHL, Web of Science, and The Cochrane Library) were searched from inception to April 2022. Study selection Eight studies were included. Two researchers screened the literature according to inclusion and exclusion criteria, extracted data, and carried out quality control according to the Cochrane handbook5.1.0. Data were analyzed narratively and descriptively. Conclusions In general, statistically significant positive therapy effects were found. Voice training improves the oral and pharyngeal stages of swallowing in patients with neurological causes of dysphagia, such as stroke, and in patients with non-neurological causes of dysphagia, such as head and neck cancer. However, the current literature is limited and further primary research is required to provide more evidence to support voice training intervention in dysphagia. Future studies could further refine the content of voice training interventions, increase the number of patients enrolled, assess the long-term effects of voice training interventions and add associated assessments of the quality of life after treatment.

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Swallowing Outcomes Following Voice Therapy in Multiple System Atrophy with Dysphagia: Comparison of Treatment Efficacy with Parkinson’s Disease

Cited by 17 publications

References 32 publications

ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia

ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia

ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia

The effect of voice training interventions on patients with oropharyngeal dysphagia: a systematic review

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