Treatment Efficacy of Dysarthria in Patients with Multiple System Atrophy using Water Resistance Therapy

Chae, Hye Rim; Choi, Seong Hee; Choi, Chul-Hee

doi:10.12963/csd.20734

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…The results for reading intelligibility were promising and in line with other therapies [ 24 , 27 , 29 ]. The results were less clear for the monologue task due to variable performance of participants.…”

Section: Discussionsupporting

confidence: 75%

“…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%

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

et al. 2022

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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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Section: Discussionsupporting

confidence: 75%

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

show abstract

“…The results for the intelligibility component were promising for reading and in line with other therapies [24, 27, 29]. The results were less clear for the monologue task where only some speakers showed improvements and group statistics were not significant.…”

Section: Discussionmentioning

confidence: 71%

“…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%

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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“…This is particularly true for ataxic speech problems, as opposed to Parkinsonian symptoms which have been investigated much more widely. However, a number of trials have recently been reported that focused on people with MSA-C [8][9][10], in addition to studies on other types of progressive ataxias which can lead to similar speech problems [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

ClearSpeechTogether versus standard NHS speech intervention: Study protocol for a single, mixed method, rater blinded pilot randomised controlled trial for people living with MSA-C

Lowit

Beith

Young

et al. 2023

Preprint

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Background: Speech and communication problems are a common symptom of cerebellar Multiple System Atrophy (MSA-C). While recent studies have suggested that these patients can benefit from speech therapy, no properly controlled, large scale investigation of effectiveness has been conducted to date. Furthermore, studies have not focused on how novel, often workload intensive approaches compare to existing standard care. The aim of the current project is to establish feasibility and acceptability of a intensive, mixed individual / group, peer supported speech therapy approach (ClearSpeechTogether) in a group of patients with MSA-C, and to pilot a two-arm RCT comparing it to standard individual therapy. Methods: This protocol outlines a pilot study for a mixed-method registered controlled trial. 24 patients will be allocated in a 1:1 ratio to either existing speech \& language therapy provision or ClearSpeechTogether. Two pre-therapy speech assessments will be carried out followed by 6 weeks of therapy, a post-therapy assessment and a follow-up assessment after 8 weeks. These assessments will evaluate physiological functioning, impairment and participation. Three qualitative interviews will also be conducted at pre, post and follow-up to investigate patients' experiences of the interventions. Discussion: Demonstrating acceptability, feasibility and communication benefits in the current pilot would set the basis for a larger registered controlled trial. If indications of additional benefits of ClearSpeechTogether over existing provisions are found a full superiority trial would be conducted. Trial registration: ISRCTN, ISRCTN44652664. Registered 16 December 2022, https://www.isrctn.com/ISRCTN44652664

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Treatment Efficacy of Dysarthria in Patients with Multiple System Atrophy using Water Resistance Therapy

Cited by 4 publications

References 38 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

ClearSpeechTogether versus standard NHS speech intervention: Study protocol for a single, mixed method, rater blinded pilot randomised controlled trial for people living with MSA-C

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