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Oral speech mechanism exercises in dysarthria following stroke: speech and language therapists' practice and influences on it

Mackenzie, Catherine and Muir, Margaret and Allen, Carolyn (2009) Oral speech mechanism exercises in dysarthria following stroke: speech and language therapists' practice and influences on it. In: 4th UK stroke forum conference, 2009-12-01 - 2009-12-03. (Unpublished)

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Abstract

Dysarthria, a motor speech disorder, affecting intelligibility, naturalness and efficiency of speech, is a common sequel to stroke. In speech and language therapy intervention there is a long tradition of including exercises for the oral speech muscles, although there is no robust evidence that such exercises are beneficial to speech, in stroke or in other neurological disorders. Method: Postal questionnaires were distributed to all speech and language therapists working with adult dysarthria in Scotland, Wales and Northern Ireland, to gather data on use of oral speech mechanism exercises, with reference to dysarthria populations, exercise regimes and influences on practice. Results: The return was 56% (n=191). 76% of respondents (n=145) used speech mechanism exercises in stroke dysarthria. This was twice as many as the respondent number for Parkinson's disease. Exercises were used with all dysarthria severities, especially moderate and severe, at acute and chronic stages, and all diagnostic categories, especially flaccid. Exercises were sourced largely from therapy resource manuals and materials produced by respondents' departments. Exercise regimes were very variable. Respondents' opinions that they had evidence from their own practice that speech mechanism exercises were effective, discussion with colleagues, expectations of patients, and university teaching were main influences on the decision to use exercises. Conclusion: Speech mechanism exercises are widely used in dysarthria resulting from stroke. The study provides a justification and foundation for clinical research comparing outcomes for people with stroke whose dysarthria management includes and does not include speech mechanism exercises.