文章摘要
庞子建,何怡,贾革红,等.励-协夫曼言语治疗在脑卒中后构音障碍患者中的应用[J].中华物理医学与康复杂志,2024,46(12):1096-1101
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励-协夫曼言语治疗在脑卒中后构音障碍患者中的应用
  
DOI:10.3760/cma.j.cn421666-20240308-00172
中文关键词: 励-协夫曼言语治疗  脑卒中; 构音障碍; 声学分析
英文关键词: Lee-Silverman voice treatment  Stroke  Dysarthria  Acoustic analysis  Speech rehabilitation
基金项目:
作者单位
庞子建 国家康复辅具研究中心附属康复医院康复治疗科 北京 102600 
何怡 中国康复研究中心北京博爱医院听力语言科 北京 100068
首都医科大学康复医学院 北京 100068 
贾革红 中国康复研究中心北京博爱医院听力语言科 北京 100068
首都医科大学康复医学院 北京 100068 
张庆苏 中国康复研究中心北京博爱医院听力语言科 北京 100068
首都医科大学康复医学院 北京 100068 
王博 中国康复研究中心北京博爱医院听力语言科 北京 100068
首都医科大学康复医学院 北京 100068 
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中文摘要:
      目的 观察励-协夫曼言语治疗(LSVT)对脑卒中后构音障碍患者的临床疗效。 方法 选取脑卒中后构音障碍患者49例,按随机数字表法随机分为对照组25例和观察组24例。对照组采用常规构音障碍治疗,观察组则采用LSVT进行治疗,2组均每日治疗1次,每次治疗1 h,每周治疗4 d,连续治疗4周。于治疗前和治疗4周后(治疗后)对2组患者进行言语清晰度测试(SI)、Frenchay构音障碍评定(FDA)、嗓音障碍指数(VHI)、最长发声时间(MPT)和声学分析,其中声学分析包括音量、音调、三角声学空间面积(tVSA)、元音构音指数(VAI)和共振峰集中率(FCR)。 结果 治疗后,观察组的SI、FDA、VHI、MPT、tVSA、VAI、 FCR与组内治疗前比较,差异均有统计学意义(P<0.05);对照组的FDA、MPT、VAI、FCR与组内治疗前比较,差异均有统计学意义(P<0.05)。治疗后,2组患者的SI、FDA、VHI、MPT、音量、音调、tVSA、VAI、FCR组间比较,差异均无统计学意义(P>0.05)。 结论 LSVT可显著改善脑卒中后构音障碍患者的言语清晰度、嗓音障碍程度、构音器官运动功能和构音准确性,其疗效与常规构音障碍训练相近,临床可尝试将LSVT用于脑卒中后构音障碍的治疗。
英文摘要:
      Objective To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria. Methods Forty-nine stroke survivors with dysarthria were randomly divided into a control group (n=25) and a treatment group (n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores. Conclusions LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.
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