Speech Therapist Intervention in the Diagnosis of Amyotrophic Lateral Sclerosis: A Case Report

Yıl 2024, Cilt: 11 Sayı: 2, 339 - 349, 02.08.2024

Feyza Deniz Saman

https://doi.org/10.21020/husbfd.1243670

Öz

Objective: The purpose of this case report is to examine the effectiveness of a speech therapist's comprehensive evaluation and therapy program on speech and swallowing skills in patients who may have swallowing disorders in addition to motor speech disorder in the diagnosis of Amyotrophic Lateral Sclerosis.
Materials and Methods: A 58-year-old female patient was included in the study. In the 2-stage therapy program, after a 3-week preservative program, a 12-session intensified therapy program was applied for 2 weeks. Oral motor examination, Toronto Bedside Swallowing Assessment, Clinical Swallowing Assessment, YFTT/EAT-10, Mini Mental State Test, ALSFDS, SET and Praat were used in the assessment. The therapy program aimed to develop oral motor skills, improve voice quality and speech intelligibility.
Results: After the intervention, an increase in oral motor skills, improvement in bolus control and swallowing ability, decrease in YFTT score, approach to norm values in acoustic properties of voice and increase in speech intelligibility were observed.
Conclusion:It was observed that speech therapy had positive effects on swallowing and speaking skills in a patient with ALS. Longitudinal studies involving larger numbers of cases are thought to prove the effectiveness of speech therapy intervention in ALS.

Anahtar Kelimeler

speech therapy, Amyotrophic Lateral Sclerosis, ALS

Amyotrofik Lateral Sklerozis Tanısında Konuşma Terapisti Müdahalesi: Olgu Sunumu

Öz

Amaç: Bu olgu sunumunun amacı, Amyotrofik Lateral Sklerozis tanısında motor konuşma bozukluğuna ek olarak yutma bozukluğu yaşayabilecek olan hastalara konuşma terapistinin uygulayacağı kapsamlı değerlendirme ve terapi programının konuşma ve yutma becerileri üzerindeki etkililiğini incelemektir.
Gereç ve Yöntem: Çalışmaya 58 yaşında bir kadın hasta dahil edilmiştir. 2 Aşamalı şekilde uygulanan terapi programında olguya 3 haftalık koruyucu programın ardından 2 hafta süresince 12 seanslık yoğunlaştırılmış terapi programı uygulanmıştır. Değerlendirmede oral motor muayene, Toronto Yatakbaşı Yutma Değerlendirmesi, Klinik Yutma Değerlendirmesi, YFTT/EAT-10, Mini Mental Durum Testi, ALSFDS, SET ve Praat kullanılmıştır. Terapi programı oral motor becerileri geliştirmeyi, ses kalitesini ve konuşma anlaşılırlığını arttırmayı amaçlamıştır.
Bulgular: Müdahale sonrası oral motor becerilerde artış, bolus kontrolünde ve yutma becerisinde iyileşme, YFTT puanında düşüş, sesin akustik özelliklerinde norm değerlere yaklaşma ve konuşma anlaşılırlığında artış gözlenmiştir.
Sonuç: ALS tanılı hastada konuşma terapisinin yutma ve konuşma becerileri üzerindeki olumlu etkileri olduğu görülmüştür. Daha fazla sayıda olguyu içeren uzun süreli çalışmaların ALS’de konuşma terapisi müdahalesinin etkililiğini kanıtlayacağı düşünülmektedir.

Anahtar Kelimeler

konuşma terapisi, Amyotrofik Lateral Sklerozis, ALS

Kaynakça

• Ahmed, R. M., Newcombe, R. E., Piper, A. J., Lewis, S. J., Yee, B. J., Kiernan, M. C., & Grunstein, R. R. (2016). Sleep disorders and respiratory function in amyotrophic lateral sclerosis. Sleep Medicine Reviews, 26, 33–42. https://doi.org/10.1016/j.smrv.2015.05.007
• Akbaş, D. & Karadakovan, A. (2021). Amyotrofik Lateral Sklerozda Semptom Yönetimine Genel Bakış . Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 5(2), 354-360. https://doi.org/10.46237/amusbfd.757630
• Aktekin, M.R., Uysal, H., (2020). Epidemiology of Amyotrophic Lateral Sclerosis, Turkish Journal of Neurology, 26(3), 187-196. DOI: 10.4274/tnd.2020.45549
• Aronson, A.E., Winholtz, W.S., Ramig, L.O., Silber, S.R.,(1992). Rapid Voice Tremor, or ‘flutter,’’ in Amyotrophic Lateral Sclerosis. Annals of Otology, Rhinology & Laryngology, 101(6), 511-518. https://doi.org/10.1177/000348949210100612
• Carpenter, R.J., McDonald., T.J., Howard, F.M., (1978) The Otolaryngologic Presentation of Amyotrophic Lateral Sclerosis. Otolaryngology. 86(3), 479-484. https://doi.org/10.1177/019459987808600319
• Chen, A., & Garrett, C. G. (2005). Otolaryngologic presentations of amyotrophic lateralsclerosis. Otolaryngology-Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 132(3), 500–504. https://doi.org/10.1016/j.otohns.2004.09.092
• Delpont, B., Beauvais, K., Jacquin-Piques, A., Alavoine, V., Rault, P., Blanc-Labarre, C., Osseby, G. V., Hervieu-Bègue, M., Giroud, M., & Béjot, Y. (2019). Clinical features of pain in amyotrophic lateral sclerosis: A clinical challenge. Revue Neurologique, 175(1-2), 11–15. https://doi.org/10.1016/j.neurol.2017.11.009.
• Hulisz, D. (2018), Amyotrophic lateral sclerosis: disease state overview. The American Journal Managed Care. 24(15), 320-326.
• Kühnlein, P., Gdynia, H. J., Sperfeld, A. D., Lindner-Pfleghar, B., Ludolph, A. C., Prosiegel, M., & Riecker, A. (2008). Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nature Clinical Practice. Neurology, 4(7), 366–374. https://doi.org/10.1038/ncpneuro0853
• Makkonen, T., Ruottinen, H., Puhto, R., Helminen, M., Palmio, J. (2018). Speech deterioration in amyotrophic lateral sclerosis (ALS) after manifestation of bulbar symptoms. International Journal of Language & Communication Disorders,53(2), 385-392. https://doi.org/10.1111/1460-6984.12357
• Masrori, P., & Van Damme, P. (2020). Amyotrophic lateral sclerosis: a clinical review. European Journal of Neurology, 27(10), 1918–1929. https://doi.org/10.1111/ene.14393
• McGuirt, W. F., & Blalock, D. (1980). The otolaryngologist's role in the diagnosis and treatment of amyotrophic lateral sclerosis. The Laryngoscope, 90(9), 1496–1501.
• Mehta, P., Horton, D. K., Kasarskis, E. J., Tessaro, E., Eisenberg, M. S., Laird, S., & Iskander, J. (2017). CDC Grand Rounds: National Amyotrophic Lateral Sclerosis (ALS) Registry Impact, Challenges, and Future Directions. MMWR. Morbidity and Mortality Weekly Report, 66(50), 1379–1382. https://doi.org/10.15585/mmwr.mm6650a3
• Pinto, S., & Carvalho, M.d (2014). Breathing new life into treatment advances for respiratory failure in amyotrophic lateral sclerosis patients. Neurodegenerative Disease Management, 4(1), 83–102. https://doi.org/10.2217/nmt.13.74
• Plowman, E.K. (2015). Is There a Role for Exercise in the Management of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis?. Journal of Speech, Language, and Hearing Research, 58, 1151-1166. https://doi.org/10.1044/2015_JSLHR-S-14-0270
• Üstüner, E. , Erden, İ. , Erden, A. , Aydın, N. & Tuncel, D. (2002). Olgu Sunumu: Amyotrofik Lateral Sklerozda Kranial MRG Bulguları . Ankara Üniversitesi Tıp Fakültesi Mecmuası , 55 (3), 231-236 . DOI: 10.1501/Tipfak_0000000030
• Wang, M. D., Little, J., Gomes, J., Cashman, N. R., & Krewski, D. (2017). Identification of risk factors associated with onset and progression of amyotrophic lateral sclerosis using systematic review and meta-analysis. Neurotoxicology, 61, 101–130. https://doi.org/10.1016/j.neuro.2016.06.015
• Zarei, S., Carr, K., Reiley, L., Diaz, K., Guerra, O., Altamirano, P. F., Pagani, W., Lodin, D., Orozco, G., & Chinea, A. (2015). A comprehensive review of amyotrophic lateral sclerosis. Surgical Neurology İnternational, 6, 171. https://doi.org/10.4103/2152-7806.169561