Treating Speech Movement Hypokinesia in Parkinson's Disease: Does Movement Size Matter?

Abstract

Purpose This study evaluates the effects of a novel speech therapy program that uses a verbal cue and gamified augmented visual feedback regarding tongue movements to address articulatory hypokinesia during speech in individuals with Parkinson's disease (PD). Method Five participants with PD participated in an ABA single-subject design study. The treatment aimed to increase tongue movement size using a combination of a verbal cue and augmented visual feedback and was conducted in 10 45-min sessions over 5 weeks. The presence of visual feedback was manipulated during treatment. Articulatory working space of the tongue was the primary outcome measure and was examined during treatment and in cued and uncued sentences pre- and posttreatment. Changes in speech intelligibility in response to a verbal cue pre- and posttreatment were also examined. Results During treatment, 4/5 participants showed a beneficial effect of visual feedback on tongue articulatory working space. At the end of the treatment, they used larger tongue movements when cued, relative to their pretreatment performance. None of the participants, however, generalized the effect to the uncued sentences. Speech intelligibility of cued sentences was judged as superior posttreatment only in a single participant. Conclusions This study demonstrated that using an augmented visual feedback approach is beneficial, beyond a verbal cue alone, in addressing articulatory hypokinesia in individuals with PD. An optimal degree of articulatory expansion might, however, be required to elicit a speech intelligibility benefit.

Digital games for rehabilitation of speech disorders: A scoping review

“…The number of sessions for using digital games ranged from 1 37,38 to 4 32,33 per week, and the duration of each session was from 5 24,36 to 45 min. 34,37 The number of sessions was not mentioned in the 2 articles. 31,39 3.9 | Outcome Although the reviewed articles revealed the positive impact of digital games on speech [32][33][34]36,38 and the patients' motivation during the therapy, 24,31,32,37,39 2 articles (20%) mentioned that personalized speech therapy should be considered in designing digital games.…”

A review of data collection practices using electromagnetic articulography

“…Nevertheless, several studies have tested children from five years of age onwards (e.g., Katz & Bharadwaj, 2001;Cheng et al, 2007;Schötz et al, 2013), giving important insights into the development of individual articulators during the process of early speech acquisition. Articulographs have also frequently been used to study disordered speech in individuals suffering from various conditions that can impact speech production and/or speech motor control, ranging from speech disorders such as stuttering and cluttering (Didirkova & Hirsch, 2019;McClean, Tasko, & Runyan, 2004;Hartinger & Mooshammer, 2008) or apraxia or speech (e.g., Bartle-Meyer, Goozée, & Murdoch, 2009;Nijland, Maassen, Hulstijn, & Peters, 2004); hypokinetic dysarthria (e.g., Kearney et al, 2018;Mefferd & Dietrich, 2019) or Amyotrophic Lateral Sclerosis (e.g., Lee & Bell, 2018;Shellikeri et al, 2016) to congenital conditions such as cleft lip (e.g., van Lieshout, Rutjes, & Spauwen, 2002) or congenital blindness (e.g., Trudeau-Fisette, Tiede, & Ménard, 2017). Using EMA to study disordered speech (more studies can be found in the Appendix) is important to provide insight into the underlying issues of speech motor control that cannot be detected through acoustics only.…”

“…The reference sensors can alternatively be prepared and placed on a pair of goggles, on the frame of a pair of plastic glasses, or on a headband (e.g., Ji, Berry, & Johnson, 2013;Mefferd, 2019;Thompson & Kim, 2019;Kearney et al, 2018). The Appendix shows additional information regarding individual researchers' strategies to place reference sensors.…”

Motor-cognitive Approach and Aerobic Training: A Synergism for Rehabilitative Intervention in Parkinson’s Disease

“…It therefore follows that, from a cognitive and motor learning perspective, rehabilitation in PD should aim to foster the re-acquisition of lost habitual, goal-based motor behavior [37]. To achieve this result, clinicians may take advantage of multidisciplinary approaches [26] including physiotherapy, occupational therapy [62], speech and swallowing therapies [63].…”