Objective: To investigate the immediate effect and after 15minutes(min) of over articulation technique in individuals with Deep Brain Stimulation(DBS).

Background: Studies evaluating the immediate effects of rehabilitation techniques in patients with DBS are scarce and controversial, are necessary to carry out studies to investigate changes in vocal parameters with the application of speech therapy techniques these patients.

Methods: 29 individuals, mean age 59.4(SD12.5)years, 13.5(SD5.3)years of disease and 2.80(SD0.64)Hoehn&Yahr Scale. Patients underwent stereotactic implantation of bilateral subthalamic nucleus stimulation system with mean 26.6(SD15.5)months. They were evaluated before and after vocal immediate intervention and after 15min. The individuals were filmed speaking the months of the year in three different moments:pre, immediately after and after 15min of performing a sequence of over articulation exercises (normal rate with exaggerated articulation), like:1repeated five times the vowels;2counted twice the numbers 1-20;3spoke weekdays;4repeated once the sequences:PAKATA/BADAGA/FASACHA/VAZAJA. Three videos of each subject were edited and presented in a random order for two speech therapists, which performed the visual and auditory perceptual analysis and had to identify which of the emissions was the best. Besides choosing best emission, the criteria should be:resonance, pitch,loudness,vocal projection,speech rate and articulation.

Results: The technique produced positive results in most patients,69%(N=20) were identified as the best after 15min;20.7(N=6) in the immediately after and 10,3%(N=3) in pre-technique (after 15min x immediately after x pre p=0.001).The parameters that most contributed to identification of the best emission in perceptual assessment were speech articulation(69%) and speech rate(51.7%). The perceptual-visual analysis also showed improvement after 15min 58.6%(N=17), followed by 20.7%(N=6) pre and 20.7%(N=6) immediately after, statistically different from the percentage of other moments(p=0.001). Visual analysis observed a higher movement of eyebrows,eyes and mouth(46.6%), followed by eyebrows and eyes(27.6%).

Conclusions: Over articulation technique produced immediate positive effect on speech and vocal aspects and a greater facial expressiveness.The effects in the long term, using this feature on rehabilitation remain to be studied.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-overexaggerated-articulation-technique-in-voice-and-speech-of-individuals-with-parkinsons-disease-with-deep-brain-stimulation/