Incorporating the Principles of Self-Management into Treatment of Dysarthria Associated with Parkinson's Disease

Although understanding patient perspectives on treatment is a major component of patient-centered care, little is known about patient perspectives related to dysarthria treatment in Parkinson's disease (PD). This article attempts to explore the perspective of patients with dysarthria associated with PD by interviewing them before and after treatment. Treatment expectations and experiences are summarized along with a discussion of how patients are using the tools they learned once treatment was completed. Comments about treatment were generally positive and suggested increased awareness and improved speech loudness. However, areas for improvement were also identified including: (1) treatment was not addressing some communication problems that were of concern to patients; (2) therapy programs were not enjoyable; and (3) it was difficult to maintain gains after therapy ended. Principles of self-management are reviewed to address some of the shortcomings of current treatment approaches.

Subjective Reports of Trouble Tolerating Sound in Daily Life versus Loudness Discomfort Levels

Purpose A retrospective analysis of tonal and speech loudness discomfort levels (LDLs) relative to a subjective report of sound tolerance (SRST) was performed to explore the relation between the 2 commonly used clinical measures. Method Tonal LDLs and SRST were measured for 139 U.S. military veterans who were recruited into a study providing intervention for tinnitus. Spearman's rank correlation coefficients were computed to assess the relation between the tonal and speech LDLs and the SRST. Results Only weak correlations were found between tonal LDLs and SRST and between speech LDLs and SRST. Conclusion If LDLs ratings of SRST measured the same phenomenon, the measures would be strongly negatively correlated. The weak correlations found between the measures suggest that LDLs do not accurately represent a patient's ability to tolerate sound in daily life.

An Improved Frequency-Shift Compression Method Based on Auto Energy Gain Compensation for Digital Hearing Aids

Sensorineural hearing impaired individuals have narrow hearing range, especially in high frequency. Due to acoustic diffusion masking, just amplifying speech can’t meet patients’ demands. Traditional methods restore the signal of high frequency in low frequency, which has two weaknesses. On the one hand high frequency covers low frequency, on the other hand the methods change the energy of speech. These two aspects severely decrease speech loudness, perception and recognition. To solve the above problems, we have proposed an improved frequency shifting compression method based on Auto Energy Gain Compensation (AEGC) which is used for hearing aids. Fully investigating the relationship of speech frequency with energy and recognition, the scheme selectively keeps the information of vital frequency band. Meanwhile, it compensates the speech loudness with AEGC module. With the proposed scheme, it has obviously improved the speech perception and recognition. Both the theoretical simulation result and subjective test in APP on android platform show the energy is compensated and the speech recognition ratios are enhanced 20%-30% in different environments, especially efficient in quiet, noisy and normal environment.

Perception of Speech by Individuals with Parkinson's Disease: A Review

A few clinical reports and empirical studies have suggested a possible deficit in the perception of speech in individuals with Parkinson's disease. In this paper, these studies are reviewed in an attempt to support clinical anecdotal observations by relevant empirical research findings. The combined evidence suggests a possible deficit in patients' perception of their own speech loudness. Other research studies on the perception of speech in this population were reviewed, in a broader scope of the perception of emotional prosody. These studies confirm that Parkinson's disease specifically impairs patients' perception of verbal emotions. However, explanations of the nature and causes of this perceptual deficit are still limited. Future research directions are suggested.