The use of biofeedback in the treatment of ataxic dysarthria in patients with multiple sclerosis

By K. Maddava, E. Wang, D. Stefoski, and G. Katsamakis

Dysarthria is present in approximately 40% of patients with multiple sclerosis (MS). This pilot project examines the role of biofeedback in treating ataxic dysarthria in MS patients, and, in particular, in maintenance of treatment effects. Two main questions are posed: 1) Can biofeedback more effectively treat ataxic dysarthria in MS patients than verbal feedback only therapy? and 2) Does biofeedback promote better maintenance of treatment effects? Six MS patients with predominantly cerebellar impairment participated in the study. Two received verbal feedback only, two received real-time visual biofeedback, and two were controls. Therapy targeted increased control of respiratory and articulatory speech subsystems. Acoustic and perceptual assessments were made at baseline, between the treatment of the two subsystems, immediately after, and one-month post treatment. Only results for respiratory measures are being presented here. Preliminary results for the respiratory subsystem reveal that while biofeedback may be more effective than verbal feedback only therapy in increasing control, treatment order may have an even greater significance. Also, maintenance of treatment was significant for treatment order but not for group in MSVP. This suggests when treating dysarthria in patients with MS, it may be more effective to address the respiratory subsystem first.