scholarly journals Mowa pacjentki z chorobą Parkinsona w fazie zaawansowanej

Author(s):  
Mateusz Szurek

The purpose of this article is to present speech disorders of 91 years old patient suffering from advanced Parkinson’s disease (it is the last stage of the disease when all symptoms are stronger) and to draw attention to the need of mentioning the impact of speech therapy while describing the disease. In the article an author is introducing the patient and her current condition. Mainly it is focused on the speech therapy diagnosis that was based on particular aspects of speech (such as: general condition of the patient, phonation, comprehension of speech and naming, repea- ting, dialogues and storytelling, reading, counting and writing). In the final part, the effectiveness of speech therapy is presented. This publication might become  a leading example for other speech therapist on how to manage the therapy for people suffering from these types of disorders in speaking and communication.

2009 ◽  
Vol 1 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Lyn R. Tindall ◽  
Ruth A. Huebner

The objective of this research was to assess the effects of an application of telerehabilitation reducing time and financial obligation on caregiver burden among eleven caregivers of elderly persons with Parkinson’s disease. Clients (care receivers) participated in speech therapy delivered via videophones in their homes; the protocol required 16 treatments delivered four times a week for four weeks. At the conclusion of treatment, caregivers completed a structured interview about the impact of telerehabilitation on time and financial aspects of the burden of care. On average, this speech therapy protocol delivered by videophones saved 48 hours of time, more than 92 hours of work time, and $1024 for each caregiver. Savings were significant and previous research demonstrated nearly equal outcomes using the videophone delivery method. Implications for practice and research are discussed. Keywords: Telerehabilitation, Speech Therapy, Parkinson’s Disease.  


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Francesc Valldeoriola ◽  
María José Catalán ◽  
Francisco Escamilla-Sevilla ◽  
Eric Freire ◽  
Jesús Olivares ◽  
...  

AbstractLevodopa-carbidopa intestinal gel (LCIG) has shown to be efficacious in motor and non-motor symptoms (NMS). Nevertheless, studies with patient Quality of Life (QoL) as a primary endpoint are scarce. To assess the effect of LCIG on Advanced Parkinson’s Disease (APD) patients QoL. Secondarily, the impact on motor symptoms and NMS, emotional well-being, treatment satisfaction, and caregiver QoL, stress, disease burden, anxiety, depression, and work impairment were also investigated. In this prospective, 6-month multicenter postmarketing observational study, LCIG was administered to 59 patients with APD. Endpoints were assessed using validated scales and questionnaires. LCIG significantly improved patient QoL (PDQ-39 mean change ± standard deviation from baseline, −12.8 ± 14.6; P < 0.0001), motor symptoms (UPDRS-III in “On,” −6.5 ± 11.8; P = 0.0002), NMS (NMSS, −35.7 ± 31.1; P < 0.0001), mood (Norris/Bond-Lader VAS, −6.6 ± 21.1; P = 0.0297), fatigue (PFS-16, −0.6 ± 1.0; P = 0.0003), depression (BDI-II, −5.1 ± 9.4; P = 0.0002), anxiety (BAI, −6.2 ± 9.6; P < 0.0001), and patient treatment satisfaction (SATMED-Q, 16.1 ± 16.8; P < 0.0001). There were significant correlations between the change from baseline to 6 months between PDQ-39 and UPDRS-IV, NMSS, BAI, BDI-II, AS, and PFS-16 scores, and Norris/Bond-Lader alertness/sedation factor. Caregiver anxiety also improved (Goldberg anxiety scale, −1.1 ± 1.0; P = 0.0234), but the clinical relevance of this finding is questionable. The serious adverse events reported were similar to those previously described for LCIG. In patients with APD, LCIG improves QoL, motor symptoms and NMS, emotional well-being, and satisfaction with the treatment. Improvement in patient QoL is associated with improvements in motor complications, NMS, anxiety, depression, apathy and fatigue. Improvements in patients’ QoL does not correspond with improvements in caregivers’ QoL or burden.


Author(s):  
Stephanie Liangos

Patients with Young Onset Parkinson's Disease may have a long medical journey to receive their diagnosis due to their atypical age. Parkinson's Disease is typically diagnosed in a geriatric population and thus assumed to be a late-onset neurodegenerative disorder. Therefore, when younger people approach clinicians with parkinsonian symptoms, they are typically overlooked as they do not meet the age criteria, and thus the diagnosis may be missed or delayed. In late-onset Parkinson's Disease, a classic primary symptom pertains to voice and speech disorders due to the high prevalence of hypokinetic dysarthria. Thus, a review of speech and voice deficits that are seen prior to or within the time frame of diagnosis can highlight the speech and vocal patterns clinicians may see within a younger population. This could provide an effective tool for clinicians to make a quicker diagnosis for patients and administer medication such as Levodopa without having the patient go through rigorous, time-consuming testing. Furthermore, within neuroscience, little attention is paid to the impact of early speech and vocal changes. Therefore, this study would also like to explore the impact of these changes, highlighting the urge for clinicians not to stigmatise younger patients by age to receive a rapid diagnosis and treatment. This study follows the proceedings of a survey methodology via a formulated questionnaireinserted in a Google Form containing 12 statements, which contained closed-ended questions (Yes/No indicators) and open-ended questions where the participants indicated their answer by filling in a short statement regarding their experience. The statements contained questions about the diagnosis of Parkinson's Disease, the speech and vocal changes experienced, the socio-social effects of the speech and vocal changes on their personal lives and if they found that medication helped their vocal and speech symptoms. The questionnaire yielded a total of 43 participants with young-onset Parkinson's Disease. The results indicated that most of the participants suffered from speech and vocal changes, which resembled the clinical profile of severe hypokinetic dysarthria, typically seen in later stages of Parkinson's Disease in late-onset. In addition, the changes in speech and voice were so impactful that they caused significant distress in the psychosocial domain of their lives. Despite the severity of the speech and vocal changes, most participants struggled to receive a diagnosis, while hardly any received appropriate speech therapy treatment to aid their overall quality of life. Thus, this study concludes that the results of this study are essential to break stigmas and open the conversation in neuroscience and neurology on YOPD. Improvement clinical knowledge of this unique subtype of Parkinson's needs to be stressed amongst clinical practitioners that age of onset does not play a role in managing, treating, and diagnosing Parkinson's Disease.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiying He ◽  
Chun-Feng Liu ◽  
Qinyong Ye ◽  
Zhenguo Liu ◽  
Miao Jin ◽  
...  

Abstract Background The impact of nocturnal disturbance (ND) in Parkinson’s disease on quality of life of patients in Western Countries is increasingly understood. Our study aimed to investigate ND prevalence and its quality of life impact in patients with advanced Parkinson’s disease in China. Methods In a multicenter, tertiary-care hospital, outpatient-based, cross-sectional study, patients with advanced Parkinson’s disease (Modified Hoehn & Yahr [H&Y] Stage II–IV with ≥3 h awake “off” time/day) from 10 tertiary hospitals throughout China completed the Parkinson’s Disease Sleep Scale-2 (PDSS-2) and Parkinson’s Disease Questionnaire-39 (PDQ-39). The primary endpoint was the percentage of patients with significant ND (PDSS-2 total score ≥ 15). Additional endpoints were demographic and clinical characteristics, PDSS-2 and PDQ-39 total and subscale scores, correlation between PDSS-2 and PDQ-39, and risk factors for ND and higher PDSS-2 or PDQ-39 scores. Results Of 448 patients analyzed (mean age 63.5 years, 47.3% female), 70.92% (95% confidence interval: 66.71, 75.13) had significant ND. Presence of ND and higher PDSS-2 scores were associated with longer disease duration and higher H&Y stage. Presence of ND was also associated with more awake “off” time/day and female sex. PDQ-39 scores were significantly worse for patients with ND versus those without ND; worse scores were associated with more awake “off” time/day, female sex, and higher H&Y stage. PDSS-2 and PDQ-39 total scores were associated: Pearson correlation coefficient 0.62 (p < 0.001). Conclusions In China, ND was highly prevalent in patients with advanced Parkinson’s disease and adversely impacted quality of life. This study highlights the importance of early diagnosis and optimized management of ND in patients with Parkinson’s disease in China.


2011 ◽  
Vol 259 (6) ◽  
pp. 1081-1086 ◽  
Author(s):  
Lynn Rochester ◽  
Sebastien Francois Martin Chastin ◽  
Sue Lord ◽  
Katherine Baker ◽  
David John Burn

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Sara Varanese ◽  
Zoe Birnbaum ◽  
Roger Rossi ◽  
Alessandro Di Rocco

Patients at late stage Parkinson's disease (PD) develop several motor and nonmotor complications, which dramatically impair their quality of life. These complications include motor fluctuations, dyskinesia, unpredictable or absent response to medications, falls, dysautonomia, dementia, hallucinations, sleep disorders, depression, and psychosis. The therapeutic management should be driven by the attempt to create a balance between benefit and side effects of the pharmacological treatments available. Supportive care, including physical and rehabilitative interventions, speech therapy, occupational therapy, and nursing care, has a key role in the late stage of disease. In this review we discuss the several complications experienced by advance PD patients and their management. The importance of an integrative approach, including both pharmacological and supportive interventions, is emphasized.


2004 ◽  
Vol 24 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Ruediger Hilker ◽  
Juergen Voges ◽  
Simon Weisenbach ◽  
Elke Kalbe ◽  
Lothar Burghaus ◽  
...  

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a highly effective surgical treatment in patients with advanced Parkinson's disease (PD). Because the STN has been shown to represent an important relay station not only in motor basal ganglia circuits, the modification of brain areas also involved in nonmotor functioning can be expected by this intervention. To determine the impact of STN-DBS upon the regional cerebral metabolic rate of glucose (rCMRGlc), we performed positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) in eight patients with advanced PD before surgery as well as in the DBS on- and off-conditions 4 months after electrode implantation and in ten age-matched healthy controls. Before surgery, PD patients showed widespread bilateral reductions of cortical rCMRGlc versus controls but a hypermetabolic state in the left rostral cerebellum. In the STN-DBS on-condition, clusters of significantly increased rCMRGlc were found in both lower thalami reaching down to the midbrain area and remote from the stimulation site in the right frontal cortex, temporal cortex, and parietal cortex, whereas rCMRGlc significantly decreased in the left rostral cerebellum. Therefore, STN-DBS was found to suppress cerebellar hypermetabolism and to partly restore physiologic glucose consumption in limbic and associative projection territories of the basal ganglia. These data suggest an activating effect of DBS upon its target structures and confirm a central role of the STN in motor as well as associative, limbic, and cerebellar basal ganglia circuits.


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