Bulbar dysfunction is a common presentation of amyotrophic lateral sclerosis (ALS) and significantly impacts quality of life of people with ALS (PALS). The current paper reviews measurements of dysarthria and dysphagia specific to ALS to identify efficient and valid assessment measures. Using such assessment measures will lead to improved management of bulbar dysfunction in ALS. Measures reviewed for dysarthria in PALS are organized into three categories: acoustic, kinematic, and strength. A set of criteria are used to evaluate the effectiveness of the measures' identification of speech impairments, measurement of functional verbal communication, and clinical applicability. Assessments reviewed for dysphagia in PALS are organized into six categories: patient reported outcomes, dietary intake, pulmonary function and airway defense capacity, bulbar function, dysphagia/aspiration screens, and instrumental evaluations. Measurements that have good potential for clinical use are highlighted in both topic areas. Additionally, areas of improvement for clinical practice and research are identified and discussed. In general, no single speech measure fulfilled all the criteria, although a few measures were identified as potential diagnostic tools. Similarly, few objective measures that were validated and replicated with large sample sizes were found for diagnosis of dysphagia in PALS. Importantly, clinical applicability was found to be limited; thus, a collaborative team focused on implementation science would be helpful to improve the clinical uptake of assessments. Overall, the review highlights the need for further development of clinically viable and efficient measurements that use a multidisciplinary approach.

中文翻译：

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肌萎缩侧索硬化症患者构音障碍和吞咽困难的评估：现有证据的回顾

延髓功能障碍是肌萎缩侧索硬化症 (ALS) 的常见表现，显着影响 ALS (PALS) 患者的生活质量。目前的论文回顾了 ALS 特有的构音障碍和吞咽困难的测量，以确定有效和有效的评估措施。使用此类评估措施将改善 ALS 延髓功能障碍的管理。PALS 构音障碍的评估措施分为三类：声学、运动学和强度。一套标准用于评估这些措施识别语言障碍、功能性语言交流的测量和临床适用性的有效性。对 PALS 吞咽困难的评估分为六类：患者报告的结果、饮食摄入、肺功能和气道防御能力、延髓功能、吞咽困难/吸入筛查和仪器评估。两个主题领域都强调了具有良好临床应用潜力的测量方法。此外，还确定并讨论了临床实践和研究的改进领域。一般来说，没有任何一项语音测量符合所有标准，尽管一些测量被确定为潜在的诊断工具。同样，在 PALS 吞咽困难的诊断中，很少有经过大样本验证和重复的客观测量。重要的是，发现临床适用性有限。因此，一个专注于实施科学的协作团队将有助于提高评估的临床接受度。全面的，