PD Check-In: The Development and Trial of a Supported Self-Management Program for People with Parkinson's Disease Following Intensive Speech Intervention

• Published in: International journal of language & communication disorders Vol. 57; no. 1; pp. 138 - 151
• Main Authors: Finnimore, Ann, Theodoros, Deborah, Rumbach, Anna F
• Format: Journal Article
• Language: English
• Published: United States Wiley 2022
• Subjects: Allied Health Personnel; Diseases; Dysarthria - complications; Dysarthria - therapy; Humans; Neurological Impairments; Parkinson Disease - complications; Parkinson Disease - therapy; Program Development; Program Evaluation; Program Implementation; Quality of Life; Self Management; Speech; Speech Disorders - therapy; Speech Language Pathology; Speech Therapy; Parkinson's disease; LSVT LOUD; speech; maintenance; self-management
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12682

Background: Debilitating speech and communication changes in Parkinson's disease (PD) lead to diminished quality of life for people with PD and their communication partners. Maintenance of the long-term effects of treatment such as LSVT LOUD® remains equivocal. Development of supported long-term maintenance programs is warranted. Aims: This article describes the development and preliminary outcome data for PD Check-In, a supported self-management intervention for the maintenance of speech and social communication for people with PD following LSVT LOUD. Methods & Procedures: A narrative literature review of the principles of self-management and social cognitive theory of self-regulation was conducted to develop the core elements of PD Check-In. PD Check-In was conducted in person by a speech and language therapist (SLT) for three participants at 6 and 12 weeks, and at 6, 12 and 24 months following LSVT LOUD. Outcome measures included vocal intensity (SPL) during monologue and the dysarthria impact profile (DIP). PD Check-In utilized semi-structured discussion to develop, evaluate, and support the self-efficacy and skill of the person with PD in maintaining speech and social communication. Outcomes & Results: Six conceptual elements of PD Check-In were identified in the development phase--partnerships, self-reflection, maintenance issues, revision, goal-setting and maintenance strategies. Preliminary intervention data revealed monologue vocal intensity at 24 months post-LSVT LOUD was maintained above pre-treatment level, but below levels achieved post-treatment. The psychosocial impact of speech changes from pre-LSVT LOUD to 24 months post-treatment as measured by the DIP was variable. Qualitative statements reflected participant experiences underlying the clinical data. Conclusions & Implications: The theoretical and practical underpinnings of PD Check-In were defined. The impact of PD Check-In on three persons with PD was variable but positive. Further evaluation of the model is warranted.