Efficacy of cognitive behavioral therapy combined with oral motor training for dysarthria in patients with Parkinson's disease.

OBJECTIVE

This study aimed to evaluate the multidimensional effects of an intervention integrating cognitive behavioral therapy (CBT) with orofacial muscle training on dysarthria in patients with Parkinson's disease (PD), with particular emphasis on articulatory performance, speech-related psychosocial burden, and acoustic speech characteristics.

METHODS

A prospective, stratified, randomized controlled trial was conducted. Eligible patients with PD-related dysarthria were stratified based on baseline characteristics and randomly assigned, using SPSS 26.0, to either a control group that received routine care or an experimental group that received cognitive-behavioral therapy (CBT) combined with orofacial muscle training. Articulatory performance was assessed using the Frenchay Dysarthria Assessment (FDA), while speech-associated psychosocial burden was evaluated using the Speech Handicap Index (SHI). Objective acoustic parameters, including fundamental frequency, sound pressure level, jitter, shimmer, harmonics-to-noise ratio (HNR), and speech rate, were systematically analyzed.

RESULTS

After 8 weeks of intervention, the experimental group demonstrated significantly greater improvements than the control group across all FDA subdomains, as well as the SHI emotional, functional, and physiological dimensions, and key acoustic speech parameters (P < 0.05). Multivariate analyses revealed a significant group × time interaction effect (P < 0.05), indicating a sustained and intervention-specific benefit. Notably, the therapeutic effects exhibited a coordinated enhancement across psychological, behavioral, and physiological domains.

CONCLUSIONS

An intervention integrating CBT with orofacial muscle training produces systematic, multidimensional improvements in dysarthria among patients with Parkinson's disease. The findings highlight the cross-domain therapeutic potential of this nursing approach, spanning emotional regulation, behavioral adaptation, and neuromuscular functional remodeling.