Journal of Medical Speech-Language Pathology
Volume 14, Number 3, pp. 207–217
Copyright © 2006 by Delmar Learning, a division of Thomson Learning, Inc.
Expiratory Muscle Strength Training in
the Treatment of Mixed Dysarthria in a
Patient with Lance-Adams Syndrome
Harrison N. Jones, M.A.
VA RR&D Brain Rehabilitation Research Center, Gainesville, Florida
Department of Communicative Disorders, University of Florida, Gainesville
Neila J. Donovan, Ph.D.
VA RR&D Brain Rehabilitation Research Center, Gainesville, Florida
Department of Communicative Disorders, University of Florida, Gainesville
VA HSR&D/RR&D Rehabilitation Outcomes Research Center, Gainesville, Florida
Christine M. Sapienza, Ph.D.
VA RR&D Brain Rehabilitation Research Center, Gainesville, Florida
Department of Communication Sciences and Disorders, University of Florida
Rahul Shrivastav, Ph.D.
VA RR&D Brain Rehabilitation Research Center, Gainesville, Florida
Department of Communication Sciences and Disorders, University of Florida, Gainesville
Hubert H. Fernandez, M.D.
Department of Neurology, University of Florida, Gainesville
John C. Rosenbek, Ph.D.
VA RR&D Brain Rehabilitation Research Center, Gainesville, Florida
Department of Communicative Disorders, University of Florida, Gainesville
The results of an expiratory muscle strength training (EMST) program is described in
the rehabilitation of mixed dysarthria in a patient with Lance-Adams syndrome sec-
ondary to a motor vehicle accident (MVA) with associated traumatic brain injury (TBI).
A pretest-posttest design was employed. Following EMST, maximum phonation dura-
tion, intelligibility scores of 14-word sentences, and Communicative Effectiveness Sur-
vey (CES) scores increased. Three months after the discontinuation of EMST, maximum
phonation duration had decreased but remained increased in comparison to pretreat-
ment performance, while intelligibility scores dropped below baseline level. CES scores
continued to increase following the discontinuation of treatment. These data suggest
that EMST was associated with a therapeutic effect for this patient, as evidenced by
improved performance measured pre- and posttreatment.