Feasibility of a Telerehabilitation Adaptation of the Be Clear Speech Treatment Program for Non-Progressive Dysarthria.

Brooke-Mai Whelan,Louise Cahill,Atiyeh Vaezipour,Anna Farrell,Deborah Theodoros,Elizabeth Cardell,Adam P. Vogel,Emma Finch

doi:10.3390/brainsci12020197

Abstract

This study evaluated the feasibility and outcomes of a telerehabilitation adaptation of the Be Clear speech treatment program for adults with non-progressive dysarthria to determine clinical delivery viability and future research directions. Treatment effects on speech clarity, intelligibility, communication effectiveness, and participation, as well as psychosocial outcomes in 15 participants with non-progressive dysarthria, were explored. Intervention involved daily 1-h online sessions (4 days per week for 4 weeks, totalling 16 sessions) and daily home practice. Outcome measures were obtained at baseline (PRE), post-treatment (POST), and 12 weeks following treatment (FUP). Feasibility measures targeting participant satisfaction, treatment adherence and fidelity, and technical viability were also employed. The programme was feasible concerning technical viability and implementation, treatment adherence and fidelity. High levels of participant satisfaction were reported. Increases in overall ratings of communication participation and effectiveness were identified at POST and FUP. Reductions in speech rate were identified at FUP. Improvements in aspects of lingual and laryngeal function were also noted after treatment. Over time, improvements relating to the negative impact of dysarthria were identified. Naïve listeners perceived negligible changes in speech clarity following treatment. Online delivery of the Be Clear speech treatment program was feasible, and some positive speech benefits were observed. Due to the small sample size included in this research, statistically significant findings related to speech outcomes must be interpreted with caution. An adequately powered randomised controlled trial of Be Clear online is warranted to evaluate treatment efficacy.

Highlights

Dysarthria is an acquired speech disorder causing reduced speech intelligibility due to weakened, imprecise, slow, and/or inco-ordinated movement of the muscles of speech motor control [1]
The findings of this review indicated that high-quality evidence for non-progressive dysarthria treatments that target motor speech subsystems other than laryngeal-respiratory systems is lacking and that further research is needed
The quality of speech sample recordings for playback was poor, and on many occasions the audio recording function failed to record successfully. These issues necessitated a change of the telerehabilitation platform for the remaining participants

Summary

Introduction

Dysarthria is an acquired speech disorder causing reduced speech intelligibility due to weakened, imprecise, slow, and/or inco-ordinated movement of the muscles of speech motor control [1]. This motor speech disorder may present as a result of progressive (e.g., Parkinson’s Disease) or non-progressive (e.g., traumatic brain injury) neurological conditions [2]. It is a common and persistent sequela of acquired brain injury (ABI) in adulthood, with reported incidence rates as high as 60% [3]. Interventions are influenced by the type and severity of the presenting speech deficit [1] and, the primary motor speech subsystem impairments contributing to reduced speech intelligibility

Results

Discussion

Conclusion