杨美芳，赵健，且亚玲，王剑雄，鞠梅.励-协夫曼言语治疗对帕金森病患者言语功能及生活质量的影响[J].中华物理医学与康复杂志,2017,39(1):43-47
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| 励-协夫曼言语治疗对帕金森病患者言语功能及生活质量的影响 |
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| DOI： |
| 中文关键词: 励-协夫曼 言语治疗 帕金森病 生活质量 |
| 英文关键词: Lee Silverman Voice treatment Parkinson′s disease Quality of life |
| 基金项目:四川省科技厅-泸州市政府-医学院联合专项资金科技计划项目（14RKX0023） |
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| 中文摘要: |
| 目的探讨励-协夫曼（Lee Silverman）言语治疗技术对帕金森病患者言语功能及生活质量的影响。 方法选取伴有不同程度言语障碍且Hoehn-Yahr临床分期1～3期的帕金森病患者98例，按随机数字表法分为干预组和对照组，每组49例。2组患者均进行言语康复训练治疗，每次治疗1h，每周4d，共训练12周，其中对照组接受常规言语康复治疗，包括舌唇运动、韵律、发声、音量、语速和呼吸控制等，干预组接受励-协夫曼言语治疗，主要针对嗓音异常问题，注重发音训练，包括训练持续元音发音最大时长、训练患者发音的最大基频范围、阶梯式的声强训练等，治疗期间，要求患者遵从以上治疗方法，在家自主进行家庭训练，治疗日每天完成1次家庭训练，治疗间歇日每天2次家庭训练以维持疗效。分别于干预前（治疗前）和干预12周末（治疗后），采用嗓音障碍指数量表（VHI）、西方失语症成套检查（WAB）、统一帕金森病综合评价量表（UPDRS-Ⅲ）运动部分的言语表达评分项和言语清晰度评分，对2组患者言语功能的治疗效果进行评估。 结果治疗前，2组患者的VHI、WAB、UPDRS-Ⅲ运动部分的言语表达评分和言语清晰度评定得分比较，差异均无统计学意义（P>0.05）；治疗后，2组患者的上述指标均较组内治疗前有明显改善，干预组患者的VHI总体评价得分［（60.39±9.84）分］、WAB各项评分［自发言语（14.64±1.98）、听语理解（112.67±19.43）、复述（65.31±7.98）和命名（39.89±9.84）分］及AQ得分［（69.19±10.78）分］、UPDRS-Ⅲ评分［（1.39±0.61）分］均较对照组治疗后上述各项指标［（71.03±11.01）、（13.67±1.06）、（111.53±29.61）、（63.75±7.41）、（37.89±9.29）、（62.14±10.21）和（1.82±0.82）分］改善更为明显,且组间差异均有统计学意义（P<0.05）。治疗后，干预组和对照组患者的言语清晰度评分分别为（77.61±11.72）和（59.67±10.04）分，均较组内治疗前［（54.36±10.71）和（53.98±9.92）分］明显提高(P<0.05)，且干预组得分提高较对照组更为明显(P<0.05)。 结论励-协夫曼言语治疗能有效改善帕金森病患者的言语功能及生活质量。 |
| 英文摘要: |
| Objective To explore the effect of Lee Silverman voice treatment on the speech and life quality of Parkinson′s disease patients. Methods A total of 98 patients with Parkinson′s disease anddifferent degrees of speech disorder (Hoehn-Yahr clinical stages 1 to 3) were randomly divided into an intervention group and a control group,each of 49, according to a random number table. The control group was given routine speech therapy covering tongue and lip movement, rhythm, sound, volume, speed and respiratory control.The intervention group was provided with 12 weeks of Lee Silverman voice treatment aimed at abnormal voice and emphasizing pronunciation, 4 times a week and 1 hour each time. During the treatment, all patients were required to practice once at home on treatment days and twice on days without treatment. The voice handicap index (VHI), the western aphasia battery (WAB), the speech function portion of UPDRS-Ⅲand the speech articulation assessment were used to evaluate the 2 groups before and after the 12 weeks ofintervention. ResultsBeforethe intervention there was no significant differencebetween the two groups in any of the measurements.After the interventionsignificant improvement was observed in all of these indicesin bothgroups. After treatment the average total VHI score of the intervention group(60.39±9.84) had improved significantly more than that of the control group, as did the WAB score for spontaneous speech (14.64±1.98), listening comprehension (112.67±19.43), repeating (65.31±7.98), Name (39.89±9.84) and the average AQ scores (69.19±10.78) and UPDRS- scores ［(1.39±0.61)］［of the intervention group than the control group ［(71.03±11.01), (13.67±1.06), (111.53±29.61), (63.75±7.41), (37.89±9.29), (62.14±10.21) and (1.82±0.82)］. After the intervention, the average speech articulation scores of the intervention and control group were (77.61±11.72) and (59.67±10.04), significantly higher than those before the intervention ［(54.36±10.71) and (53.98±9.92)］, with the improvement of the intervention group significantly higher than the control group. ConclusionLee Silverman voice treatment can effectively improve the speech and life quality of patients with Parkinson′s disease. |
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