计算机辅助训练对脑卒中后构音障碍患者的效果

doi:10.3969/j.issn.1006-9771.2024.05.004

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (5): 520-525.doi: 10.3969/j.issn.1006-9771.2024.05.004

计算机辅助训练对脑卒中后构音障碍患者的效果

韦添元¹^,^2a, 林煜凡¹^,^2a, 何怡¹^,^2b, 宋明洁¹^,^2a, 李晁金子¹^,^2a, 张庆苏¹^,^2b, 杜晓霞¹^,^2a()

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院，a.神经康复科；b.听力语言科，北京市 100068

收稿日期:2024-01-24 修回日期:2024-02-26 出版日期:2024-05-25 发布日期:2024-06-12
通讯作者: 杜晓霞(1975-)，女，汉族，陕西延安市人，博士，主任医师，主要研究方向：神经康复。E-mail： 364906784@qq.com
作者简介:韦添元(2000-)，男，汉族，陕西商洛市人，硕士研究生，主要研究方向：言语康复。
基金资助:
1.国家重点研发计划项目(2020YFC2004105);2.中国残联研究课题(2022CDPFHS-10);3.中国康复研究中心课题(2023ZX-03)

Effect of computer-assisted training on post-stroke dysarthria

WEI Tianyuan¹^,^2a, LIN Yufan¹^,^2a, HE Yi¹^,^2b, SONG Mingjie¹^,^2a, LI Chaojinzi¹^,^2a, ZHANG Qingsu¹^,^2b, DU Xiaoxia¹^,^2a()

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. a. Department of Neurorehabilitation; b. Department of Speech and Hearing Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2024-01-24 Revised:2024-02-26 Published:2024-05-25 Online:2024-06-12
Contact: DU Xiaoxia, E-mail: 364906784@qq.com
Supported by:
National Key Research and Development Program(2020YFC2004105);China Disabled Persons' Federation Scientific Research Project(2022CDPFHS-10);China Rehabilitation Research Center Research Project(2023ZX-03)

摘要/Abstract

摘要：

目的比较常规言语训练与计算机辅助训练方式对脑卒中后构音障碍患者的康复疗效。

方法选取2021年3月至2023年4月北京博爱医院脑卒中后构音障碍患者72例，随机分为对照组(n = 36)和试验组(n = 36)。两组均接受常规康复治疗，对照组接受常规言语训练，试验组进行计算机辅助言语训练，共4周。干预前后采用改良Frenchay构音障碍评定法(m-FDA)和语音清晰度(SI)测试进行评定。

结果对照组脱落8例，试验组脱落1例。治疗后，两组m-FDA和SI评分均较治疗前显著改善(|Z| > 4.183, P < 0.001)，两组m-FDA和SI评分改善程度无显著性差异(|Z| < 1.598, P > 0.05)。试验组m-FDA评分不劣于对照组(|t| > 3.656, P < 0.001)。

结论计算机辅助训练可以改善脑卒中后构音障碍患者的言语功能，疗效与常规言语训练相似。

关键词: 脑卒中, 构音障碍, 计算机辅助训练, 言语康复

Abstract:

Objective To compare the effect of routine speech training and computer-assisted training on post-stroke dysarthria.

Methods From March, 2021 to April, 2023, 72 patients with post-stroke dysarthria in Beijing Bo'ai Hospital were randomly divided into control group (n = 36) and experimental group (n = 36). Both groups received routine rehabilitation, while the control group received routine speech training, and the experimental group received computer-assisted training, for four weeks. They were assessed with modified Frenchay Dysarthria Assessment (m-FDA) and Speech Intelligibility (SI) before and after intervention.

Results Eight cases in the control group and one case in the experimental group dropped down. The scores of m-FDA and SI improved in both groups after treatment (|Z| > 4.183, P < 0.001), and there was no significant difference between two groups (|Z| < 1.598, P > 0.05). Noninferiority of m-FDA was found between two groups (|t| > 3.656, P < 0.001).

Conclusion Computer-assisted training could improve the speech function of patients with post-stroke dysarthria, similar to routine speech training.

Key words: stroke, dysarthria, computer-assisted training, speech rehabilitation

中图分类号:

R743.3

韦添元, 林煜凡, 何怡, 宋明洁, 李晁金子, 张庆苏, 杜晓霞. 计算机辅助训练对脑卒中后构音障碍患者的效果[J]. 《中国康复理论与实践》, 2024, 30(5): 520-525.

WEI Tianyuan, LIN Yufan, HE Yi, SONG Mingjie, LI Chaojinzi, ZHANG Qingsu, DU Xiaoxia. Effect of computer-assisted training on post-stroke dysarthria[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 520-525.

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参考文献 38

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组别	n	性别 (男/女)/n	年龄/岁	利手 (左/右/混合)/n	卒中类型 (出血/缺血)/n	构音障碍严重程度 (极重/重/中/轻)/n
对照组	36	29/7	57.08±13.57	2/33/1	11/25	17/14/5/0
试验组	36	28/8	57.89±13.68	1/35/0	13/23	14/12/6/4
χ²/t值		0.084	0.253		0.250
P值		0.772	0.801	0.614^a	0.617	0.236^a

组别	n	治疗前	治疗后	治疗前后差值	Z值	P值
对照组	28	29.76 (24.71, 32.18)	34.41 (31.05, 37.17)	5.05 (3.27, 6.44)	-4.623	< 0.001
试验组	35	30.75 (27.10, 34.88)	35.00 (33.11, 37.08)	4.05 (2.45, 5.52)	-5.160	< 0.001
Z值		-1.314		-1.598
P值		0.189		0.110

组别	n	治疗前	治疗后	治疗前后差值	Z值	P值
对照组	28	0.65 (0.51, 0.84)	0.78 (0.67, 0.92)	0.08 (0.05, 0.17)	-4.183	< 0.001
试验组	35	0.73 (0.47, 0.93)	0.85 (0.68, 0.96)	0.08 (0.02, 0.21)	-4.677	< 0.001
Z值		-0.844		-0.277
P值		0.399		0.782

项目	对照组(n = 28)	试验组(n = 35)	δ_L	均数差及95%CI	t值	P值
治疗后评分	33.79±3.97	34.64±3.46	-3.5	-0.85 (-2.73, 1.02)	-4.650	< 0.001
治疗前后差值	5.35±2.75	4.26±2.47	-3.5	1.09 (-0.22, 2.41)	-3.656	< 0.001

计算机辅助训练对脑卒中后构音障碍患者的效果

Effect of computer-assisted training on post-stroke dysarthria

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