'I can walk briskly and talk at the same time': effects of expiratory muscle strength training on respiration and speech in multiple sclerosis

Keywords: multiple sclerosis, voice, speech, acoustic analysis, respiratory muscle training, single subject study design In this study, a single-subject design (A1-B-A2) was used for five participants (P1-P5) with multiple sclerosis (MS) with Expanded Disability Status Scale (EDSS) scores of 2 to 8 who performed expiratory muscle strength training (EMST). During phase B (6 weeks), all five trained using a positive-expiratory pressure threshold trainer (PEPTT) with a maximum resistance of 20 cm [H.sub.2]O. P4 and P5, with lower EDSS scores (2 and 3), then trained using the 'EMST 150' with a maximum resistance of 150 cm [H.sub.2]O (phase C). After EMST, all five participants increased their expiratory muscle strength and their vocal intensity. P1, P3, and P4 increased their phonation duration. P2, P4, and P5 increased their vocal stability. During phase C, the increase in performance was more marked, particularly for P4, whose performance was stabilized and showed improvement for all speech parameters. It is possible that the forceful exhalations resulted in improved regulation of expiratory airflow and thus better coordination of respiration and phonation. All five participants reported positive effects of the intervention: better respiration, improved voice and speech, and increased communicative participation. The results of this study indicate a need to further investigate the effects of EMST in a larger group of individuals with mild MS and speech dyspnea, dysphonia, or dysarthria.
INTRODUCTION Dysarthria is a frequent symptom of multiple sclerosis (MS), affecting 45% to 52% of individuals with the disease. Several of the most common speech symptoms may be related to [...]