Neurodegenerative dysarthria: Respiratory/phonatory (Perry et al., 2024)

Purpose: This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals with dysarthria due to neurodegenerative disease.Method: Multiple electronic database searches and hand searches of prominent speech-language pathology journals were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards.Results: The search yielded 1,525 articles, from which 88 met inclusion criteria and were reviewed by two blinded co-investigators. A large range of therapeutic approaches have been added to the evidence base since the last review, including expiratory muscle strength training, singing, and computer- and device-driven programs, as well as a variety of treatment modalities, including teletherapy. Evidence for treatment in several different population groups—including cerebellar ataxia, myotonic dystrophy, autosomal recessive spastic ataxia of Charlevoix–Saguenay, Huntington’s disease, multiple system atrophy, and Lewy body dementia—were added to the current review. Synthesis of evidence quality provided strong evidence in support of only one behavioral intervention: Lee Silverman Voice Treatment Program (LSVT LOUD) in people with Parkinson’s disease. No other treatment approach or population included in this review demonstrated more than limited evidence, reflecting that these approaches/populations require urgent further examination.Conclusion: Suggestions about where future research efforts could be significantly strengthened and how clinicians can apply research findings to their practice are provided.S1: Databases, Keyword and Subject Headings used in Electronic Database SearchesS2: Parkinson’s disease: Study Design Details and Participant Characteristics for Lee Silverman Voice Treatment (LSVT LOUD®)/LSVT® Extended (LSVT-X®)/LSVT® Companion™ as Treatment ModalitiesS2.1: Parkinson’s disease: PEDro Scores for Studies Describing Lee Silverman Voice Treatment LOUD® (LSVT LOUD®)/LSVT® Extended (LSVT-X)/LSVT® Companion™ as Interventions for DysarthriaS2.2: Parkinson’s disease: Findings Summarizing the Benefit of Lee Silverman Voice Treatment LOUD® (LSVT LOUD®)/LSVT® Extended (LSVT-X)/LSVT® Companion™ on Vocal IntensityS3: Parkinson’s disease: Study Design Details and Participant Characteristics for SPEAK OUT!® and The LOUD Crowd as Treatment ModalitiesS3.1: Parkinson’s disease: PEDro Scores for Studies Describing SPEAK OUT!® and The LOUD Crowd as Interventions for DysarthriaS4: Parkinson’s disease: Study Design Details and Participant Characteristics for Loud and Proud as a Treatment ModalityS4.1: Parkinson’s disease: PEDro Scores for Studies Describing Loud and Proud as Interventions for DysarthriaS5: Parkinson’s disease: Study Design Details and Participant Characteristics for Pitch Limiting Voice Treatment (PVLT) as a Treatment ModalityS5.1: Parkinson’s disease: PEDro Scores for the Study Describing Pitch Limiting Voice Treatment (PVLT) as an Intervention for DysarthriaS6: Parkinson’s disease: Study Design Details and Participant Characteristics for Music Therapy/Singing as a Treatment ModalityS6.1: Parkinson’s disease: PEDro Scores for Studies Describing Music Therapy/Singing as an Intervention for DysarthriaS7: Parkinson’s disease: Study Design Details and Participant Characteristics for Verbal Cueing/Articulation Therapy/Speech Therapy as Treatment ModalitiesS7.1: Parkinson’s disease: PEDro Scores for Studies Describing Verbal Cueing/Articulation Therapy/Speech Therapy as Interventions for DysarthriaS8: Parkinson’s disease: Study Design Details and Participant Characteristics for Biofeedback as a Treatment ModalityS8.1: Parkinson’s disease: PEDro Scores for Studies Describing Biofeedback as an Intervention for DysarthriaS9: Parkinson’s disease: Study Design Details and Participant Characteristics for Masking Noise/SpeechVive™ as a Treatment ModalityS9.1: Parkinson’s disease: PEDro Scores for Studies Describing Masking Noise/SpeechVive™ as an Intervention for DysarthriaS10: Parkinson’s disease: Study Design Details and Participant Characteristics for Voice Therapy as a Treatment ModalityS10.1: Parkinson’s disease: PEDro Scores for Studies Describing Voice Therapy as an Intervention for DysarthriaS11: Parkinson’s disease: Study Design Details and Participant Characteristics for Delayed Auditory Feedback/Frequency-Shifted Feedback as Treatment ModalitiesS11.1: Parkinson’s disease: PEDro Scores for the Study Describing Delayed Auditory Feedback/Frequency-Shifted Feedback as Interventions for DysarthriaS12: Parkinson’s disease: Study Design Details and Participant Characteristics for Expiratory Muscle Strength Training as a Treatment ModalityS12.1: Parkinson’s disease: PEDro Scores for the Study Describing Expiratory Muscle Strength Training as an Intervention for DysarthriaS13: Parkinson’s disease: Study Design Details and Participant Characteristics for Group Dynamics/Coaching Strategies as a Treatment ModalityS13.1: Parkinson’s disease: PEDro Scores for the Study Describing Group Dynamics/Coaching Strategies as an Intervention for DysarthriaS14: Progressive Supranuclear Palsy: Study Design Details and Participant Characteristics for LSVT LOUD® as a Treatment ModalityS14.1: Progressive Supranuclear Palsy: PEDro Scores for the Study Describing LSVT LOUD® as an Intervention for DysarthriaS15: Progressive Supranuclear Palsy: Study Design Details and Participant Characteristics for Verbal Cueing as a Treatment ModalityS15.1: Progressive Supranuclear Palsy: PEDro Scores for the Study Describing Verbal Cueing as an Intervention for DysarthriaS16: Progressive Supranuclear Palsy: Study Design Details and Participant Characteristics for Singing as a Treatment ModalityS16.1: Progressive Supranuclear Palsy: PEDro Scores for Studies Describing Singing as an Intervention for DysarthriaS17: Multiple System Atrophy: Study Design Details and Participant Characteristics for Verbal Cueing as a Treatment ModalityS17.1: Multiple System Atrophy: PEDro Scores for the Study Describing Verbal Cueing as an Intervention for DysarthriaS18: Multiple System Atrophy: Study Design Details and Participant Characteristics for Singing as a Treatment ModalityS18.1: Multiple System Atrophy: PEDro Scores for Studies Describing Singing as an Intervention for DysarthriaS19: Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay: Study Design Details and Participant Characteristics for Melbourne Ataxia Speech Treatment as a Treatment ModalityS19.1: Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay: PEDro Scores for the Study Describing Melbourne Ataxia Speech Treatment as an Intervention for DysarthriaS20: Cerebellar Ataxia: Study Design Details and Participant Characteristics for Lee Silverman Voice Treatment® – Extended Version as a Treatment ModalityS20.1: Cerebellar Ataxia: PEDro Scores for the Study Describing Lee Silverman Voice Treatment® – Extended Version as an Intervention for DysarthriaS21: Huntington’s disease: Study Design Details and Participant Characteristics for Speech Therapy as a Treatment ModalityS21.1: Huntington’s disease: PEDro Scores for the Study Describing Speech Therapy as an Intervention for DysarthriaS22: Lewy Body Dementia: Study Design Details and Participant Characteristics for Singing as a Treatment ModalityS22.1: Lewy Body Dementia: PEDro Scores for the Study Describing Singing as an Intervention for DysarthriaS23: Multiple Sclerosis: Study Design Details and Participant Characteristics for Verbal Cueing as a Treatment ModalityS23.1: Multiple Sclerosis: PEDro Scores for Studies Describing Verbal Cueing as an Intervention for DysarthriaS24: Multiple Sclerosis: Study Design Details and Participant Characteristics for Expiratory Muscle Strength Training as a Treatment ModalityS24.1: Multiple Sclerosis: PEDro Scores for the Study Describing Expiratory Muscle Strength Training as an Intervention for DysarthriaS25: Multiple Sclerosis: Study Design Details and Participant Characteristics for Lee Silverman Voice Treatment® as a Treatment ModalityS25.1: Multiple Sclerosis: PEDro Scores for the Study Describing Lee Silverman Voice Treatment® as an Intervention for DysarthriaS26: Myotonic Dystrophy: Study Design Details and Participant Characteristics for Speech Warming Up Exercises as a Treatment ModalityS26.1: Myotonic Dystrophy: PEDro Scores for the Study Describing Speech Warming Up Exercises as an Intervention for DysarthriaPerry, S. E., Troche, M., Huber, J. E., Curtis, J., Kiefer, B., Sevitz, J., Dennard, Q., Borders, J., Browy, J. R., Dakin, A., Gonzalez, V., Chapman, J., Wu, T., Katz, L., & Britton, D. (2024). Behavioral management of respiratory/phonatory dysfunction for dysarthria associated with neurodegenerative disease: A systematic review. American Journal of Speech-Language Pathology, 33(2), 1069–1097. https://doi.org/10.1044/2023_AJSLP-23-00274

目的：本系统综述旨在更新先前关于神经退行性疾病所致构音障碍个体呼吸/发音功能障碍行为管理的文献综述。方法：根据系统评价和荟萃分析优先报告项目标准，进行了多次电子数据库搜索和主要言语病理学期刊的手工检索。结果：检索产生了1,525篇文章，其中88篇符合纳入标准，并由两位盲法共同调查员进行审查。自上次综述以来，已添加了大量治疗方法的证据基础，包括呼气肌力量训练、歌唱以及计算机和设备驱动的程序，以及多种治疗方式，包括远程治疗。关于治疗多个不同人群的证据（包括小脑性共济失调、肌强直性营养不良、Charlevoix-Saguenay常染色体隐性痉挛性共济失调、亨廷顿病、多系统萎缩和路易体痴呆）被纳入本次综述。证据质量综合分析为仅一种行为干预提供了强有力的证据支持：针对帕金森病患者的李·西尔弗曼声音治疗计划（LSVT LOUD）。本综述中包含的其他治疗方法和人群均未显示出超过有限证据，反映出这些方法和人群迫切需要进一步的深入研究。结论：提供了关于未来研究努力如何得以显著加强以及临床医生如何将研究结果应用于实践的建议。S1：电子数据库搜索中使用的数据库、关键词和主题词S2：帕金森病：Lee Silverman声音治疗（LSVT LOUD®）/LSVT®扩展（LSVT-X®）/LSVT®伴侣™作为治疗方式的研究设计细节和参与者特征S2.1：帕金森病：描述Lee Silverman声音治疗LOUD®（LSVT LOUD®）/LSVT®扩展（LSVT-X®）/LSVT®伴侣™作为构音障碍干预措施的PEDro评分S2.2：帕金森病：总结Lee Silverman声音治疗LOUD®（LSVT LOUD®）/LSVT®扩展（LSVT-X®）/LSVT®伴侣™对音量益处的发现S3：帕金森病：SPEAK OUT!®和LOUD Crowd作为治疗方式的研究设计细节和参与者特征S3.1：帕金森病：描述SPEAK OUT!®和LOUD Crowd作为构音障碍干预措施的PEDro评分S4：帕金森病：Loud and Proud作为治疗方式的研究设计细节和参与者特征S4.1：帕金森病：描述Loud and Proud作为构音障碍干预措施的PEDro评分S5：帕金森病：Pitch Limiting Voice Treatment（PVLT）作为治疗方式的研究设计细节和参与者特征S5.1：帕金森病：描述PVLT作为构音障碍干预措施的PEDro评分S6：帕金森病：音乐治疗/歌唱作为治疗方式的研究设计细节和参与者特征S6.1：帕金森病：描述音乐治疗/歌唱作为构音障碍干预措施的PEDro评分S7：帕金森病：言语提示/构音治疗/言语治疗作为治疗方式的研究设计细节和参与者特征S7.1：帕金森病：描述言语提示/构音治疗/言语治疗作为构音障碍干预措施的PEDro评分S8：帕金森病：生物反馈作为治疗方式的研究设计细节和参与者特征S8.1：帕金森病：描述生物反馈作为构音障碍干预措施的PEDro评分S9：帕金森病：Masking Noise/SpeechVive™作为治疗方式的研究设计细节和参与者特征S9.1：帕金森病：描述Masking Noise/SpeechVive™作为构音障碍干预措施的PEDro评分S10：帕金森病：声音治疗作为治疗方式的研究设计细节和参与者特征S10.1：帕金森病：描述声音治疗作为构音障碍干预措施的PEDro评分S11：帕金森病：Delayed Auditory Feedback/Frequency-Shifted Feedback作为治疗方式的研究设计细节和参与者特征S11.1：帕金森病：描述Delayed Auditory Feedback/Frequency-Shifted Feedback作为构音障碍干预措施的PEDro评分S12：帕金森病：呼气肌力量训练作为治疗方式的研究设计细节和参与者特征S12.1：帕金森病：描述呼气肌力量训练作为构音障碍干预措施的PEDro评分S13：帕金森病：群体动力学/辅导策略作为治疗方式的研究设计细节和参与者特征S13.1：帕金森病：描述群体动力学/辅导策略作为构音障碍干预措施的PEDro评分S14：进行性核上性麻痹：LSVT LOUD®作为治疗方式的研究设计细节和参与者特征S14.1：进行性核上性麻痹：描述LSVT LOUD®作为构音障碍干预措施的PEDro评分S15：进行性核上性麻痹：言语提示作为治疗方式的研究设计细节和参与者特征S15.1：进行性核上性麻痹：描述言语提示作为构音障碍干预措施的PEDro评分S16：进行性核上性麻痹：歌唱作为治疗方式的研究设计细节和参与者特征S16.1：进行性核上性麻痹：描述歌唱作为构音障碍干预措施的PEDro评分S17：多系统萎缩：言语提示作为治疗方式的研究设计细节和参与者特征S17.1：多系统萎缩：描述言语提示作为构音障碍干预措施的PEDro评分S18：多系统萎缩：歌唱作为治疗方式的研究设计细节和参与者特征S18.1：多系统萎缩：描述歌唱作为构音障碍干预措施的PEDro评分S19：Charlevoix-Saguenay常染色体隐性痉挛性共济失调：Melbourne Ataxia Speech Treatment作为治疗方式的研究设计细节和参与者特征S19.1：Charlevoix-Saguenay常染色体隐性痉挛性共济失调：描述Melbourne Ataxia Speech Treatment作为构音障碍干预措施的PEDro评分S20：小脑性共济失调：Lee Silverman Voice Treatment® – Extended Version作为治疗方式的研究设计细节和参与者特征S20.1：小脑性共济失调：描述Lee Silverman Voice Treatment® – Extended Version作为构音障碍干预措施的PEDro评分S21：亨廷顿病：言语治疗作为治疗方式的研究设计细节和参与者特征S21.1：亨廷顿病：描述言语治疗作为构音障碍干预措施的PEDro评分S22：路易体痴呆：歌唱作为治疗方式的研究设计细节和参与者特征S22.1：路易体痴呆：描述歌唱作为构音障碍干预措施的PEDro评分S23：多发性硬化症：言语提示作为治疗方式的研究设计细节和参与者特征S23.1：多发性硬化症：描述言语提示作为构音障碍干预措施的PEDro评分S24：多发性硬化症：呼气肌力量训练作为治疗方式的研究设计细节和参与者特征S24.1：多发性硬化症：描述呼气肌力量训练作为构音障碍干预措施的PEDro评分S25：多发性硬化症：Lee Silverman Voice Treatment®作为治疗方式的研究设计细节和参与者特征S25.1：多发性硬化症：描述Lee Silverman Voice Treatment®作为构音障碍干预措施的PEDro评分S26：肌强直性营养不良：言语预热练习作为治疗方式的研究设计细节和参与者特征S26.1：肌强直性营养不良：描述言语预热练习作为构音障碍干预措施的PEDro评分Perry, S. E., Troche, M., Huber, J. E., Curtis, J., Kiefer, B., Sevitz, J., Dennard, Q., Borders, J., Browy, J. R., Dakin, A., Gonzalez, V., Chapman, J., Wu, T., Katz, L., & Britton, D. (2024). 神经退行性疾病所致构音障碍呼吸/发音功能障碍的行为管理：系统综述。美国言语-语言病理学杂志，33(2)，1069–1097。https://doi.org/10.1044/2023_AJSLP-23-00274