20/02/2012 - Oropharyngolaryngeal Disorders in Scleroderma: Development and Validation of the SLS Scale

Abstract Systemic sclerosis (SSc) is a multisystemic
disorder characterized by functional and structural abnormalities
of small blood vessels and fibrosis of the skin and
internal organs. Eighty percent of subjects with SSc have
orofacial manifestations. No tests for oral manifestations
have been validated for this pathology, and in the literature
there are few studies of speech therapy for subjects with
SSc. These facts suggested the need for an exhaustive
assessment of mouth mobility and muscle strength, and
also of swallowing and voice, in order to plan a targeted
and effective speech therapy. The Scleroderma Logopedic
Scale (SLS) has been developed to assess disorders in five
domains: Impairment, Swallow, Voice, Multifield, and
Quality of Life. Perception of these disorders was assessed
in 84 subjects with SSc and in 40 healthy subjects. After
the first draft, a shorter form (39 items) was obtained after
statistical analysis. This scale showed good discriminant
and concurrent validity. Internal consistency was good:
three of five subscales had a Cronbach a coefficient higher
than 0.8. The test/retest coefficient for the total score was
0.94. Thirty-six percent of examined subjects showed
moderate to severe oropharyngolaryngeal disorders. Swallowing
disorders and impairment of mouth (e.g., decrease
in mobility and strength) were the most commonly reported
problems. Conversely, the change of voice due to the
pathology was not perceived as a problem. Fifty-five percent
of subjects reported a decreased level of quality of life.