Logopedski tretman kod osoba sa progresivnom dizartrijom

Abstract

Progresivna dizartrija predstavlja neurogeni poremećaj govora koji je čest simptom različitih degenerativnih bolesti centralnog i perifernog nerv- nog sistema, kao što su Parkinsonova bolest, multipla skleroza, amiotro- fična lateralna skleroza, i Hantingtonova bolest. Ove progresivne neuro- loške bolesti imaju različit uticaj na govornu produkciju. Međutim, njihova zajednička karakteristika je da se promene u kliničkoj slici manifestuju povećanjem težine dizartrije, što može da dovede do značajnog oštećenja ili gubitka govornih sposobnosti. Logopedski tretman predstavlja sastav- ni deo lečenja osoba sa progresivnom dizartrijom i njegov cilj je poboljšanje razumljivosti govorne produkcije, kao i motoričke kontrole govora. Cilj ovog rada je bio da se pregledom dostupne literature analiziraju i prika- žu mogućnosti primene logopedskog tretmana u populaciji osoba sa progresiv- nom dizartrijom. Takođe, da se međusobno uporedi njihova efikasnost i doprinos ublažavanju simptoma motoričkog poremećaja govora. Rezultati istraživanja pokazuju da logopedi primenjuju različite metode tretmana u radu sa osobama sa progresivnom dizartrijom koje, između ostalog, obuhvataju bihevioralne i metode koje su usmerene na uspostavljanje funkcionalne komunikacije, upotrebu biofidbeka, oromotornih vežbi, kao i mnoge druge. Na odabir vrste tretmana i postavljanje ciljeva utiču mnogobrojni faktori, kao što su vrsta i stepen težine dizartrije, etiologija, osnovna neuropatologija, postojanje komorbi- diteta, brzina progresije, jezičke i kognitivne sposobnosti osobe, kao i socio- demografski faktori.

Progressive dysarthria is a neurogenic speech disorder that is a common symptom of various degenerative diseases of the central and peripheral nervous system, such as Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and Huntington’s disease. These progressive neurological diseases have different effects on speech production. However, their common feature is that changes in the clinical picture are manifested by an increase in the severity of dysarthria, which can lead to significant impairment or loss of speech abilities. Speech and language therapy is an integral part of the treatment of the persons with progressive dysarthria and its goal is to improve the intelligibility of speech production, as well as motor control of speech. The aim of this paper was to review the available literature that present the possibilities of applying speech and language therapy of the persons with progressive dysarthria. Also, to compare their effectiveness and contribution to alleviating the symptoms of motor speech disorder. The results show that speech and language therapists apply different treatment techniques in working with people with progressive dysarthria, which, among other things, include behavioral and techniques aimed at establishing functional communication, the use of biofeedback, oromotor exercises, as well as many others. Choosing the type of treatment and setting goals is influenced by many factors, such as the type, degree of severity of dysarthria, etiology, basic neuropathology, existence of comorbidities, rate of progression, language and cognitive abilities of the person, as well as sociodemographic factors.