ABSTRACT
BACKGROUND: Aphasia, an acquired inability to understand and/or speak language, is a common repercussion of stroke that denigrates the quality of life (QOL) in the affected persons. Several languages in India experience the dearth of instruments to measure the QOL of persons with aphasia. Malayalam, the language spoken by more than 33 million people in Kerala, the southern state of India, is not an exception to this. OBJECTIVE: This study aimed to adapt and validate the widely-used stroke-aphasia quality of life (SAQOL-39) scale to Malayalam. MATERIALS AND METHODS: We required seven Malayalam-speaking Speech Language Pathologists (SLPs), hailing from different regions of Kerala, to examine the socio-cultural suitability of the original items in SAQOL-39 and indicate modifications, wherever necessary. Subsequently, the linguistic adaptation was performed through a forward-backward translation scheme. The socio-culturally and linguistically adapted Malayalam version was then administered on a group of 48 Malayalam-speaking persons with aphasia to examine the test-retest reliability, acceptability, as well as the internal consistency of the instrument. RESULTS: The Malayalam SAQOL-39 scale showed high test-retest reliability (intraclass correlation coefficient, ICC = 0.91) as well as acceptability with minimal missing data (0.52%). Further, it yielded high internal consistency (Chronbach's â = 0.98) as well as item-to-total and inter-domain correlations. CONCLUSIONS: The Malayalam version of SAQOL-39 is the first socio-culturally and linguistically adapted tool to measure the QOL of persons with stroke-aphasia speaking this language. It may serve as a potential tool to measure the QOL of this population in both clinical practice and future research endeavors.
ABSTRACT
OBJECTIVES: Unilateral vocal fold paralysis (UVFP) occurs because of the dysfunction of the vagus nerve innervating the larynx. It causes a characteristic breathy voice often accompanied by swallowing disability, a weak cough, and the sensation of shortness of breath. Clinical evaluation of voice is generally based on perceptive criteria and the acoustic analysis of voice. In the present study, it is hypothesized that there would be an abnormal reduction of the cepstral peak in speakers with UVFP relative to the normal controls, as they are characterized by a breathy voice because of inadequate closure of vocal folds. METHODS: Phonation of sustained vowel /a/ sample was subjected to acoustic analysis using Computerized Speech Lab (CSL model 4150; Kay Pentax, Lincoln Park, NJ) software. The vowels were analyzed acoustically by the measurement of cepstral peak prominence (CPP). RESULTS: The results of 2 × 2 analysis of variance revealed the main effects of the groups (clinical vs control group), indicating reduced cepstral peak value in the clinical group in comparison with controls. The main effect of gender was also significant, indicating a decrease in the CPP value in the female group in comparison with the male group. The results obtained were discussed with respect to the underlying pathophysiology. CONCLUSION: The present study investigated the CPP in subjects with UVFP. Cepstral deviations in the clinical group are explained to be the result of the presence of phonatory gap, leading to the lower values of CPP.
