Date of Degree

2-2017

Document Type

Dissertation

Degree Name

Ph.D.

Program

Speech-Language-Hearing Sciences

Advisor(s)

Herbert Karpatkin

Committee Members

Douglas H. Whalen

Martin Gitterman

Subject Categories

Physical Therapy | Speech and Hearing Science | Speech Pathology and Audiology

Keywords

Anomia, Word-finding, Expressive Language, Multiple Sclerosis, Fatigue, Exercise

Abstract

To date, little research has been conducted on the relationship between fatigue and expressive language among Multiple Sclerosis patients (MS). This study was a response to this knowledge gap. A nonrandom, matched- subject, mixed-factor design model was used with a purposive sample of 17 individuals with MS (five had primary-progressive (PP) MS, and 12 had relapsing-remitting (RR) MS). The research design was subjected to pretesting to ensure validity. Participants were assessed on a range of language tasks after undergoing one bout of cardiovascular exercise (NuStep T5 Recumbent Cross Trainer) and asked to provide a subjective fatigue score. The expressive language tests included confrontation naming, assessment of expressive-language skills, verbal fluency, and assessment of a picture description. The tasks were replicated after a fatigue-equivalent rest period. Statistical analyses involved the testing of assumptions for one-way MANOVA/MANCOVA. Gender and subtypes of MS were subject to chi distribution.

Analysis of the intervention and control groups for differences in gender, ethnicity and years of education revealed no significant difference. The mean number of years with a MS diagnosis was 12.82 with a median EDSS score of 5.50. The Intervention Fatigue Group had a significantly higher confrontation naming errors score in comparison to the Control Fatigue Group, the Control Rest Group and the Intervention Rest Group. Analysis of verbal fluency revealed that the Intervention Fatigue Group generated significantly fewer words when given a letter of the alphabet or asked to generate words within an abstract category compared to the Control Fatigue Group, the Control Rest Group and the Intervention Rest Group. Analysis of narrative production skills revealed the Intervention Fatigue Group and the Intervention Rest Group illustrated a similar reduced performance compared to the Control Fatigue Group and Control Rest Group. For tasks concerning confrontation naming, the Intervention Fatigue Group took significantly longer time to verbally name colors and objects compared to the Control Fatigue Group and the Control Rest Group; however, the Intervention Fatigue Group was not statistically different from the Rest Group. The Intervention Fatigue Group had a significantly higher fatigue change score in comparison to the Intervention Rest Group and the Control Rest Group. However, the Intervention Fatigue Group did not significantly differ from the Control Fatigue Group.

Overall, the results indicate that when working with language skills in persons with MS, clinicians should account for the presence of fatigue on performance measures and consider testing skills in conditions.

 
 

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