Effect of speech therapy on quality of life in patients with spinocerebelar ataxia type 3

• Published in: Arquivos de neuro-psiquiatria Vol. 80; no. 10; pp. 1017 - 1025
• Main Authors: Diaféria, Giovana, Bommarito, Silvana, Braga Neto, Pedro, Park, Sung Woo, Padovani, Marina, Haddad, Fernanda, Haddad, Leonardo, Voos, Mariana Callil, Chien, Hsin Fen, Pedroso, José Luiz, Barsottini, Orlando
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-10-2022; Arquivos de Neuro-Psiquiatria; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Adult; Ataxia; Cerebellar Ataxia; deglutition disorders; Deglutition Disorders - etiology; Dysarthria; Humans; Machado-Joseph Disease; Middle Aged; NEUROSCIENCES; Original; Original Article; Pharynx; PSYCHIATRY; Quality of Life; Rehabilitation; Speech; Speech Therapy; Swallowing; Deglutition Disorders; Fonoterapia; Speech Therapy; Qualidade de Vida; Quality of Life; Transtornos de Deglutição; Machado-Joseph Disease; Dysarthria; Disartria; Doença de Machado-Joseph
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1055/s-0042-1755203

Abstract
Background
 Individuals with spinocerebellar ataxia type 3 (SCA3) present communication and swallowing disorders, and consequent deterioration in quality of life (QOL).
Objective
 To evaluate the impact of a speech therapy rehabilitation program on the QOL of patients with SCA3.
Methods
 All participants were randomly assigned to two groups, an intervention group receiving speech therapy (STG) and a control group (CG). The International Cooperative Ataxia Rating Scale scores were 32.4 ± 20.2, and the Scale for the Assessment and Rating of Ataxia scores were 11.8 ± 8.0. The intervention consisted of a 12-session speech therapy rehabilitation program with oral, pharyngeal, and laryngeal strengthening exercises—the so-called ATAXIA–Myofunctional Orofacial and Vocal Therapy (A-MOVT). They all were submitted to pre- and postintervention evaluations using the World Health Organization's Quality of Life (WHOQOL-BREF) assessment, as well as the Living with Dysarthria (LwD), Quality of Life in Swallowing Disorders (SWAL-QOL), and Food Assessment Tool (EAT-10).
Results
 The study sample consisted of 48 patients with SCA3 (STG = 25; CG = 23), mean age was 47.1 ± 11.4 years; mean age at symptom onset was 36.9 ± 11.3 years; disease duration was 11.9 ± 13.3 years. After the 3-month intervention, there were significant changes in the QOL in the STG compared with the CG, when assessed by the LwD (179.12 ± 62.55 vs. 129.88 ± 51.42,
p
 < 0.001), SWAL-QOL (869.43 ± 153.63 vs. 911.60 ± 130.90,
p
 = 0.010), and EAT-10 (5.16 ± 7.55 vs. 2.08 ± 3.85,
p
 = 0.018).
Conclusions
 Patients with SCA3 should receive continuous speech therapy as part of the A-MOVT program, because therapy helps to improve difficulty swallowing and dysarthria.