An RCT of a telemedicine intervention for hypokinetic dysarthria in PD

远程医疗干预治疗 PD 低运动性构音障碍的随机对照试验

• 批准号: 10391336
• 负责人: DAVID W. SPARROW
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10391336
• 关键词: Acoustics; Articulation; Caring; Communication; Communities; Control Groups; Dysarthria; Effectiveness; Foxes; Future; Goals; Grant; Health education; Home; Impairment; Individual; Intervention; Lead; Life; Loudness; Measures; Mediating; Mediator of activation protein; Methods; Nature; Operative Surgical Procedures; Outcome; Parkinson Disease; Patients; Performance; Persons; Pharmacology; Phonation; Quality of life; Randomized; Randomized Controlled Trials; Severities; Speech; Speech Acoustics; Speech Disorders; Speech Intelligibility; Technology; Telemedicine; Testing; Time; Training; Variant; Veterans; Voice; Voice Disorders; Voice Quality; base; design; exercise intervention; improved; indexing; intervention effect; intervention program; motor symptom; novel; programs; response; virtual

Project Background/Rationale. The great majority of individuals with Parkinson's disease (PD) develop speech impairments (Ho et al., 1999; Miller et al., 2007; Schalling et al., 2017), most of which are grouped together and called hypokinetic dysarthria. Hypokinetic dysarthria is typically characterized by altered prosody (e.g., reduced loudness and pitch variation), phonation (e.g., breathy or harsh voice), and articulation (e.g., imprecise consonants, centralized vowels) (Fox & Ramig, 1997; Ho et al., 1999; Hillenbrand & Houde, 1996). Changes in speech may appear early in PD (Miller et al., 2008; Rusz et al., 2011; Skodda et al., 2013) and progress in severity over time (Skodda et al., 2013; Skodda et al., 2009; Skodda, Flasskamp et al., 2011). Further, such changes in speech lead to significant declines in functional communication and quality of life (Miller et al., 2006 & 2007). Pharmacological and surgical interventions that alleviate motor symptoms in PD are largely ineffective or sometimes even detrimental for speech. Project Objectives. Based on results from our recently completed VA SPiRE project, we propose to conduct a pilot randomized, controlled trial (RCT) in patients with hypokinetic dysarthria in PD to assess the potential effectiveness of a novel home-based exercise intervention with interactive automated speech response features that encourage a higher level of speech performance. We hypothesize that patients in the intervention program will improve in speech intelligibility and self-perceived communication ability over 6 months, as compared with patients in a health education program. Project Methods. A total of 104 community-dwelling veterans with hypokinetic dysarthria in mild-to-moderate PD will be randomized to the exercise intervention or to the health education control. We will test the effects of the intervention at 6 months for the outcomes speech intelligibility and self-perceived communication ability.

项目背景/理由。绝大多数患有帕金森氏病（PD）的人发表演讲 障碍（Ho等，1999; Miller等，2007; Schalling等，2017），其中大多数是将 并被称为肌源肌音障碍。低迷肌纳心thria通常以韵律改变为特征（例如 响度和音高变化减少），发声（例如呼吸或刺耳的声音）和发音（例如，不精确 辅音，集中元音）（Fox＆Ramig，1997; Ho等，1999; Hillenbrand＆Houde，1996）。更改 在PD中，语音中可能出现在PD早期（Miller等，2008； Rusz等，2011; Skodda等，2013）和进展 随着时间的流逝，严重程度（Skodda等，2013; Skodda等，2009; Skodda，Flasskamp等，2011）。此外，这样的 语音变化导致功能传播和生活质量的大幅下降（Miller等，2006 ＆2007）。减轻PD运动症状的药理和手术干预措施在很大程度上无效 有时甚至不利于言语。 项目目标。根据我们最近完成的VA Spire项目的结果，我们建议进行 PD中低在上构音障碍患者的试验，随机对照试验（RCT），以评估潜力 具有交互式自动化语音响应的新型家庭运动干预的有效性 鼓励更高语音表现的功能。我们假设干预中的患者 计划将在6个月内提高语音清晰度和自我感知的沟通能力，如 与健康教育计划中的患者相比。 项目方法。总共有104名社区居民退伍军人，低于中度至中度 PD将被随机分配给运动干预或健康教育控制。我们将测试 6个月的干预措施使语音清晰度和自我感知的沟通能力。