Oropharyngolaryngeal Disorders in Scleroderma: Development and Validation of the SLS Scale
- 436 Downloads
Systemic sclerosis (SSc) is a multisystemic disorder characterized by functional and structural abnormalities of small blood vessels and fibrosis of the skin and internal organs. Eighty percent of subjects with SSc have orofacial manifestations. No tests for oral manifestations have been validated for this pathology, and in the literature there are few studies of speech therapy for subjects with SSc. These facts suggested the need for an exhaustive assessment of mouth mobility and muscle strength, and also of swallowing and voice, in order to plan a targeted and effective speech therapy. The Scleroderma Logopedic Scale (SLS) has been developed to assess disorders in five domains: Impairment, Swallow, Voice, Multifield, and Quality of Life. Perception of these disorders was assessed in 84 subjects with SSc and in 40 healthy subjects. After the first draft, a shorter form (39 items) was obtained after statistical analysis. This scale showed good discriminant and concurrent validity. Internal consistency was good: three of five subscales had a Cronbach α coefficient higher than 0.8. The test/retest coefficient for the total score was 0.94. Thirty-six percent of examined subjects showed moderate to severe oropharyngolaryngeal disorders. Swallowing disorders and impairment of mouth (e.g., decrease in mobility and strength) were the most commonly reported problems. Conversely, the change of voice due to the pathology was not perceived as a problem. Fifty-five percent of subjects reported a decreased level of quality of life.
KeywordsScleroderma Oral disorders Swallow Voice Assessment Scale Deglutition Deglutition disorders
This work was supported by the GILS (Gruppo Italiano Lotta alla Sclerodermia).
- 3.Ferri C, Valentini G, Cozzi F, Sebastiani M, Michelassi C, La Montagna G, et al. Systemic Sclerosis Study Group of the Italian Society of Rheumatology, (SIR-GSSSc): systemic sclerosis: demographic, clinical, and serologic features and survival in 1,012 Italian patients. Medicine. 2002;81:139–53. doi: 10.1097/00005792-200203000-00004.CrossRefPubMedGoogle Scholar
- 6.Menditti D, Palomba F, Rullo R, Minervini G. Progressive systemic sclerosis (scleroderma): oral manifestations. Arch Stomatol. 1990;31:537–48.Google Scholar
- 12.Biotto C (2006) Sclerosi Sistemica: elaborazione e somministrazione di un protocollo di valutazione logopedica. Analisi e sintesi dei dati raccolti. Bachelor’s Thesis, University of Milan, November 2006Google Scholar
- 13.Enderby P, John A, Petherham B. Therapy Outcome Measures manual: physiotherapy, occupational therapy, rehabilitation nursing. San Diego, CA: Singular; 1998.Google Scholar
- 14.Yorkston KM, Bombardier C, Hammer V. Dysarthria from the view point of individuals with dysarthria. In: Till JA, Yorkston KM, Beukelman DR, editors. Motor speech disorders. Advances in assessment and treatment. Toronto: Brooks Publishing; 1994.Google Scholar
- 17.Haynes BF, Soderberg KA, Fauci AS. Disorders of the immune system, connective tissue, and joints. In: Harrison, editor. Principi di medicina interna. 14th ed. Milan: McGraw-Hill; 1999. p. 2153–62.Google Scholar
- 19.No authors listed, Appendix. Manual of signs, symptoms, methods and procedures for the assessment of the patient with SSc. Clin Exp Rheumatol 2003; 21:S49–S56Google Scholar
- 25.Deary IJ, Webb A, Mackenzie K, Wilson JA, Carding PN. Short, self-report voice symptom scales: psychometric characteristics of the voice handicap index-10 and the vocal performance questionnaire. Otolaryngol Head Neck Surg. 2004;131:232–5. doi: 10.1016/j.otohns.2004.02.048.CrossRefPubMedGoogle Scholar
- 26.LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1998;15:202–5.Google Scholar
- 28.Streiner DL, Norman GR. Health measurement scales. A practical guide to their development and use. 2nd ed. New York: Oxford University Press; 1996.Google Scholar
- 34.Portney LG, Watkins MP. Foundations of clinical research; application to practice. Upper Saddle River, NJ: Prentice Hall Health; 1999. p. 560–8.Google Scholar