Treating disordered speech and voice in Parkinson's disease online: a randomized controlled non-inferiority trial
Treating disordered speech and voice in Parkinson's disease online: a randomized controlled non-inferiority trial
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DOI：
10.3109/13682822.2010.484848
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发表时间：
2011-01-01
影响因子：
2.4
通讯作者：
Wootton, Richard
中科院分区：
文献类型：
--
作者：
Constantinescu, Gabriella;Theodoros, Deborah;Wootton, Richard
背景资料：远程康复可能是一个可行的解决方案所面临的问题与帕金森氏症的人在访问speech pathology services.Aim：调查的有效性和可靠性的在线交付的李西尔弗曼语音治疗（LSVT（R））的语言和语音障碍与帕金森氏症。方法和程序：34名患有帕金森病和轻中度运动功能减退性构音障碍的参与者参加了随机对照非劣效性实验室试验，并在在线或面对面环境中接受了LSVT（R）。在线会议是通过两个以个人计算机为基础的视频会议系统进行的，该系统具有实时和存储转发功能，可在128 kbit/s的互联网连接上运行。参与者进行了评估前和治疗后的平均声乐声压级，发声时间，最大基频范围，声音，发音精度和语音intelligibility.Outcomes和结果的感知措施的声学措施：非劣效性的在线LSVT（R）模式被确认为主要的结果测量的平均变化在一个独白任务的声压级。此外，对于所有结果测量，获得了LSVT（R）环境、构音障碍严重程度和相互作用效应的非显著主效应。在LSVT（R）之后，大多数措施也有了重大改善。LSVT（R）成功地在网上交付，尽管在几个场合遇到了一些网络困难。高参与者的满意度整体reported.Conclusions及影响：运动功能减退性构音障碍与帕金森病相关的在线治疗似乎是临床有效和可靠的。对未来的研究提出了建议。
Background: Telerehabilitation may be a feasible solution to the current problems faced by people with Parkinson's disease in accessing speech pathology services.Aim: To investigate the validity and reliability of online delivery of the Lee Silverman Voice Treatment (LSVT (R)) for the speech and voice disorder associated with Parkinson's disease.Method & Procedures: Thirty-four participants with Parkinson's disease and mild-to-moderate hypokinetic dysarthria took part in the randomized controlled non-inferiority laboratory trial and received the LSVT (R) in either the online or the face-to-face environment. Online sessions were conducted via two personal computer-based videoconferencing systems with real-time and store-and-forward capabilities operating on a 128 kbit/s Internet connection. Participants were assessed pre- and post-treatment on acoustic measures of mean vocal sound pressure level, phonation time, maximum fundamental frequency range, and perceptual measures of voice, articulatory precision and speech intelligibility.Outcomes & Results: Non-inferiority of the online LSVT (R) modality was confirmed for the primary outcome measure of mean change in sound pressure level on a monologue task. Additionally, non-significant main effects for the LSVT (R) environment, dysarthria severity, and interaction effects were obtained for all outcomes measures. Significant improvements following the LSVT (R) were also noted on the majority of measures. The LSVT (R) was successfully delivered online, although some networking difficulties were encountered on a few occasions. High participant satisfaction was reported overall.Conclusions & Implications: Online treatment for hypokinetic dysarthria associated with Parkinson's disease appears to be clinically valid and reliable. Suggestions for future research are outlined.