Abstract
This study compared orofacial muscle strength between normal and dysarthric speakers and across types of dysarthria, and examined correlations between strength and dysarthria severity. Participants included 79 speakers with flaccid, spastic, mixed spastic–flaccid, ataxic, or hypokinetic dysarthria and 33 healthy controls. Maximum pressure generation (Pmax) by the tongue, lips, and cheeks represented strength. Pmax was lower for speakers with mixed spastic–flaccid dysarthria for all tongue and lip measures, as well as for speakers with flaccid or spastic dysarthria for anterior tongue elevation and lip compression. Anterior tongue elevation and cheek compression tended to be lower than normal for the hypokinetic group. Pmax did not differ significantly between controls and speakers with ataxic dysarthria on any measure. Correlations were generally weak between dysarthria severity and orofacial weakness but were stronger in the dysarthria groups with more prominent orofacial weakness. The results generally support predictions that orofacial weakness accompanies flaccid and/or spastic dysarthria but not ataxic dysarthria. The findings support including type of dysarthria as a variable of interest when examining orofacial weakness in motor speech disorders.
Highlights
The dysarthria classification system proposed by Darley, Aronson, and Brown (DAB) [1]has been maintained and refined by contemporary scholars [2,3]
The current study addresses this gap in the literature by asking three research questions: (1) Do participants with dysarthria (PWD) exhibit orofacial weakness compared to control participants without dysarthria? This broad question is addressed as a partial replication of the study by Solomon et al [22] by examining six tasks involving lingual and facial muscles
This study systematically assessed orofacial strength across dysarthria types to test hypotheses inherent to the DAB dysarthria classification scheme that neuromuscular orofacial weakness is associated with dysarthrias classified as flaccid and/or spastic but not
Summary
Has been maintained and refined by contemporary scholars [2,3] It remains the gold standard for distinguishing types of dysarthria based on perceptual speech features. These authors posited that the dysarthria types, while perceptually distinct, arise from specific neuromuscular deficits and can be localized to unique pathways in the nervous system. A diverse literature has arisen with the goal of better understanding the neuropathophysiology of dysarthria, with several studies confirming that average orofacial strength in speakers with dysarthria is reduced relative to speakers without dysarthria [5–21] These studies have typically focused on speakers with a specific neuropathology (e.g., Parkinson disease (PD), stroke, amyotrophic lateral sclerosis (ALS)), with a smaller number of studies examining groups of speakers with dysarthria regardless of etiology or dysarthria type [7,22]
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