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"I can walk briskly and talk at the same time" - effects of Expiratory Muscle Strength Training (EMST) on respiration and speech in multiple sclerosis

Artikel i vetenskaplig tidskrift
Författare Kerstin Johansson
Lena Hartelius
Liselotte Kjellmer
Sten Fredriksson
Ellika Schalling
Publicerad i Journal of Medical Speech-Language Pathology
Volym 20
Nummer/häfte 4
Sidor 70-76
ISSN 1065-1438
Publiceringsår 2012
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Sidor 70-76
Språk en
Ämnesord multiple sclerosis; voice; speech; acoustic analysis; respiratory muscle training; single subject study design
Ämneskategorier Logopedi och foniatrik

Sammanfattning

In this study, a single-subject design (A1-B-A2) was used for five participants (P1-P5) with multiple sclerosis (MS) with Expanded Disability Status Scale (EDSS) scores of 2 to 8 who performed expiratory muscle strength training (EMST). During phase B (6 weeks), all five trained using a positive-expiratory pressure threshold trainer (PEPTT) with a maximum resistance of 20 cm H2O. P4 and P5, with lower EDSS scores (2 and 3), then trained using the "EMST 150" with a maximum resistance of 150 cm H2O (phase C). After EMST, all five participants increased their expiratory muscle strength and their vocal intensity. Pl, P3, and P4 increased their phonation duration. P2, P4, and P5 increased their vocal stability. During phase C, the increase in performance was more marked, particularly for P4, whose performance was stabilized and showed improvement for all speech parameters. It is possible that the forceful exhalations resulted in improved regulation of expiratory airflow and thus better coordination of respiration and phonation. All five participants reported positive effects of the intervention: better respiration, improved voice and speech, and increased communicative participation. The results of this study indicate a need to further investigate the effects of EMST in a larger group of individuals with mild MS and speech dyspnea, dysphonia, or dysarthria.

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