Effects of SPEAK OUT! & LOUD Crowd on Functional Speech Measures in Parkinson's Disease.

PURPOSE This study investigated the effects of the SPEAK OUT! & LOUD Crowd therapy program on speaking rate, percent pause time, intelligibility, naturalness, and communicative participation in individuals with Parkinson's disease (PD). METHOD Six adults with PD completed 12 individual SPEAK OUT! sessions across four consecutive weeks followed by group-based LOUD Crowd sessions for five consecutive weeks. Most therapy sessions were conducted via telehealth, with two participants completing the SPEAK OUT! portion in person. Speech samples were recorded at six time points: three baseline time points prior to SPEAK OUT!, two post-SPEAK OUT! time points, and one post-LOUD Crowd time point. Acoustic measures of speaking rate and percent pause time and listener ratings of speech intelligibility and naturalness were obtained for each time point. Participant self-ratings of communicative participation were also collected at pre- and posttreatment time points. RESULTS Results showed significant improvement in communicative participation scores at a group level following completion of the SPEAK OUT! & LOUD Crowd treatment program. Two participants showed a significant decrease in speaking rate and increase in percent pause time following treatment. Changes in intelligibility and naturalness were not statistically significant. CONCLUSIONS These findings provide preliminary support for the effectiveness of the SPEAK OUT! & LOUD Crowd treatment program in improving communicative participation for people with mild-to-moderate hypokinetic dysarthria secondary to PD. This study is also the first to demonstrate positive effects of this treatment program for people receiving the therapy via telehealth.

目的 本研究调查了“大声说出来！”和“大声人群”治疗方案对帕金森病（PD）患者的语速、停顿时间百分比、可懂度、自然度以及交流参与度的影响。 方法 6名帕金森病成年患者在连续4周内完成了12次个体的“大声说出来！”课程，随后连续5周参加基于小组的“大声人群”课程。大多数治疗课程通过远程医疗进行，有2名参与者亲自完成“大声说出来！”部分。在6个时间点录制语音样本：“大声说出来！”之前的3个基线时间点、“大声说出来！”之后的2个时间点以及“大声人群”之后的1个时间点。获取每个时间点的语速和停顿时间百分比的声学测量值以及语音可懂度和自然度的听者评分。在治疗前和治疗后的时间点也收集了参与者对交流参与度的自我评分。 结果 结果显示，在完成“大声说出来！”和“大声人群”治疗方案后，小组层面的交流参与度得分有显著提高。2名参与者在治疗后语速显著降低，停顿时间百分比显著增加。可懂度和自然度的变化没有统计学意义。 结论 这些发现为“大声说出来！”和“大声人群”治疗方案在改善帕金森病继发的轻至中度运动减少型构音障碍患者的交流参与度方面的有效性提供了初步支持。本研究也是首次证明该治疗方案对通过远程医疗接受治疗的患者具有积极效果。