Parkinson’sand Lou Gehrig disorders
Parkinson`sand Lou Gehrig Disorders
Speechand swallowing problems frequently occur in both Parkinson’s andLou Gehrig`s (ALS) disease. Speech problems in Parkinson’s diseaseare characterized by short phrases, mono pitch, reduced overallloudness, mono loudness, and short rushes of speech, variable rate,inappropriate silences, imprecise consonants, reduced stress, andrepeated phonemes. It is also characterized by breathiness andphonatory harshness, with patients producing less efficient chestwall movements for speech. In ALS, the patient loses the ability toarticulate, control sound quality, and maintain prosody as well as areduction in the volume of speech (Clinic, 2010).
Swallowingabnormalities in Parkinson’s disease are characterized by tonguepumping, which is the forward and backward rocking of the tongue thatprevents the exit of material from the oral canal. Drooling isanother characteristic, which is not always as a result of excesssaliva production, but rather the reduction in spontaneous swallowsas well as an anteriorly flexed position of the neck. Patients alsoreport xerostomia and delayed triggering of the pharyngeal swallow.This problem is caused by the limited mandible excursion whichincreases the oral preparation time. It is also caused by a poorpharyngeal wall and tongue base motion and decreased elevation of thelaryngeal (Kowal,Dall, Chakrabarti, Storm, & Jain, 2013).Swallowing problems in ALS are as a result of the weakening of thetongue, lips, pharynx, soft palate, and the larynx. It can also becaused by the lack of coordination in swallowing and breathing by therespiratory muscles.
Swallowingproblems can, however, be corrected through swallowing and medicationto maximize the drug effect, drooling and feeding modifications. Thisis done through adaptive utensils as well as therapeutic andcompensatory swallowing techniques to control food flow or through avariety of techniques as suggested by the SLP. The therapeuticprocedures usually alter the swallow physiology to help reduce theswallowing problem.
Clinic, A. M. (2010). Speech and Swallowing Issues with ALS. Retrieved November 6, 2016, from Massachusetts General Hospital: http://www.massgeneral.org/als/patienteducation/speechandswallowingissues_ALS.aspx
Kowal, S. L., Dall, T. M., Chakrabarti, R., Storm, M. V., & Jain, A. (2013). The current and projected economic burden of Parkinson`s disease in the United States. Movement Disorders, 28(3), 311-318.