脑卒中后构音障碍患者构音器官运动功能与言语清晰度的相关性

doi:10.3969/j.issn.1006-9771.2024.07.010

Abstract

Abstract:

Objective To investigate the relationship between motor function of articulation organs and speech intelligibility (SI) in patients with dysarthria after stroke.
Methods A total of 67 patients with dysarthria after stroke in Beijing Bo'ai Hospital from November, 2020 to October, 2023 were collected. They were assessed with SI test and Frenchay Dysarthria Assessment (FDA). The patients were divided into low SI group (SI ≤ 65%) and high SI group (SI > 65%).
Results All the sub-scores of FDA were lower in the high SI group than in the low SI group (Z > 1.543, P < 0.05), except that of the jaw; and the SI was negatively pairwise correlated with FDA sub-scores (r < -0.343, P < 0.001), especially with the lip, tongue and laryngeal (r < -0.6).
Conclusion The motor function of articulation organs may be related to SI in patients with dysarthria after stroke, especially the lip, tongue and laryngeal.

Key words: stroke, dysarthria, articulation organs, motor function, speech intelligibility

CLC Number:

R743.3

LUO Wei, HE Yi, ZHANG Qingsu. Relationship between motor function of articulation organs and speech intelligibility in poststroke dysarthria[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 818-822.

Figures/Tables 4

Table 1

Table 2

Table 3

Table 4

References 25

[1]	陈卓铭. 语言治疗学[M]. 北京: 人民卫生出版社, 2018: 156-157.
	CHEN Z M. Language therapy[M]. Beijing: People's Health Publishing House, 2018: 156-157.
[2]	MITCHELL C, BOWEN A, CONROY P, et al. COS-Speech: protocol to develop a core outcome set for dysarthria after stroke for use in clinical practice and research[J]. Trials, 2023, 24(1): 57. doi: 10.1186/s13063-022-06958-7 pmid: 36698201
[3]	CHIARAMONTE R, VECCHIO M. A systematic review of measures of dysarthria severity in stroke patients[J]. PM R, 2021, 13(3): 314-324.
[4]	CHIARAMONTE R, VECCHIO M. Dysarthria and stroke: the effectiveness of speech rehabilitation: a systematic review and meta-analysis of the studies[J]. Eur J Phys Rehabil Med, 2021, 57(1): 24-43.
[5]	LISS J. Speech intelligibility[M]// ARONOFF M, REES-MILLER J. The handbook of clinical linguistics. 2nd ed. Blackwell Publishing, 2024: 605-613.
[6]	STAIGER A, SCHOELDERLE T, BRENDEL B, et al. Dissociating oral motor capabilities: evidence from patients with movement disorders[J]. Neuropsychologia, 2017, 95: 40-53. doi: S0028-3932(16)30448-1 pmid: 27939368
[7]	杨寅, 郑洁皎, 陈秀恩, 等. 言语治疗结合认知训练对老年脑卒中后构音障碍患者的康复疗效观察[J]. 老年医学与保健, 2023, 29(4): 686-689.
	YANG Y, ZHENG J J, CHEN X E, et al. Observation on rehabilitation effect of speech therapy combined with cognitive training on elderly patients with poststroke dysarthria[J]. Geriatr Health Care, 2023, 29(4): 686-689.
[8]	ZIEGLER W, SCHOLDERLE T, BRENDEL B, et al. Speech and nonspeech parameters in the clinical assessment of dysarthria: a dimensional analysis[J]. Brain Sci, 2023, 13(1): 113.
[9]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9): 710-715.
	Chinese Society of Neurology, Chinese Stroke Society. Chinese diagnostic criteria for cerebral vascular diseases (version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[10]	何维佳, 李胜利. 运动性构音障碍言语声学水平客观评价的研究进展[J]. 中国康复理论与实践, 2010, 16(2): 118-120.
	HE W J, LI S L. Advance in evaluation on speech and phonation in dysarthria (review)[J]. Chin J Rehabil Theory Pract, 2010, 16(2): 118-120
[11]	GUREVICH N, SCAMIHORN S L. Speech-language pathologists' use of intelligibility measures in adults with dysarthria[J]. Am J Speech Lang Pathol, 2017, 26(3): 873-892. doi: 10.1044/2017_AJSLP-16-0112 pmid: 28772293
[12]	ICHT M, BERGERZON‐BITTON O, BEN‐DAVID B M. Validation and cross‐linguistic adaptation of the Frenchay Dysarthria Assessment (FDA‐2) speech intelligibility tests: Hebrew version[J]. Int J Lang Commun Disord, 2022, 57(5): 1023-1049.
[13]	XUE W, VAN HOUT R, CUCCHIARINI C, et al. Assessing speech intelligibility of pathological speech: test types, ratings and transcription measures[J]. Clin Linguistics Phonetics, 2023, 37(1): 52-76.
[14]	CHIARAMONTE R, PAVONE P, VECCHIO M. Speech rehabilitation in dysarthria after stroke: a systematic review of the studies[J]. Eur J Phys Rehabil Med, 2020, 56(5): 547-562.
[15]	YUNUSOVA Y, GREEN J R, LINDSTROM M J, et al. Speech in ALS: Longitudinal changes in lips and jaw movements and vowel acoustics[J]. J Med Speech Lang Pathol, 2013, 21(1): 1-13.
[16]	WEISMER G. Oromotor nonverbal performance and speech motor control: theory and review of empirical evidence[J]. Brain Sci, 2023, 13(5): 768.
[17]	ALHAIDARY A. Treatment of speech sound disorders in children: nonspeech oral exercises[J]. In J Pediatr Adoles Med, 2021, 8(1): 1-4.
[18]	STIPANCIC K L, KUO Y L, MILLER A, et al. The effects of continuous oromotor activity on speech motor learning: speech biomechanics and neurophysiologic correlates[J]. Exp Brain Res, 2021, 239(12): 3487-3505. doi: 10.1007/s00221-021-06206-5 pmid: 34524491
[19]	WEISMER G. Philosophy of research in motor speech disorders[J]. Clin Linguistics Phonetics, 2006, 20(5): 315-349.
[20]	THOMPSON A, HIRSCH M E, LANSFORD K L, et al. Vowel acoustics as predictors of speech intelligibility in dysarthria[J]. J Speech Lang Hear Res, 2023, 66(8S): 3100-3114.
[21]	CARL M, ICHT M. Acoustic vowel analysis and speech intelligibility in young adult Hebrew speakers: developmental dysarthria versus typical development[J]. Int J Lang Commun Disord, 2021, 56(2): 283-298. doi: 10.1111/1460-6984.12598 pmid: 33522087
[22]	葛胜男, 王勇丽, 尹敏敏, 等. 脑卒中构音障碍患者元音产出特征与言语清晰度的相关性[J]. 中国康复理论与实践, 2021, 27(1): 43-47. doi: 10.3969/j.issn.1006-9771.2020.00.023
	GE S N, WANG Y L, YIN M M, et al. Relationship between vowel production and speech clarity in post-stroke dysarthria patients[J]. Chin J Rehabil Theory Pract, 2021, 27(1): 43-47.
[23]	GLOTFELTY A, KATZ W F. The role of visibility in silent speech tongue movements: a kinematic study of consonants[J]. J Speech Lang Hear Res, 2021, 64(6S): 2377-2384.
[24]	RONG P, USLER E, ROWE L M, et al. Speech intelligibility loss due to amyotrophic lateral sclerosis: the effect of tongue movement reduction on vowel and consonant acoustic features[J]. Clin Linguistics Phonetics, 2021, 35(11): 1091-1112.
[25]	RONG P, GREEN J R. Predicting speech intelligibility based on spatial tongue-jaw coupling in persons with amyotrophic lateral sclerosis: the impact of tongue weakness and jaw adaptation[J]. J Speech Lang Hear Res, 2019, 62(8S): 3085-3103.

组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(梗死/出血)/n
高SI组	34	26/8	54(45.75, 69.25)	46.5(27, 65.75)	11/23
低SI组	33	28/5	61(55, 66)	60(37, 96)	8/25
χ²/Z值		0.752	1.306	1.020	0.542
P值		0.386	0.066	0.248	0.462

变量	组别	n	最小值	最大值	均值	标准差	偏度	峰度
反射	低SI组	33	3	10	7.12	1.88	-0.604	-0.083
反射	高SI组	34	3	13	5.26	2.42	1.629	3.205
呼吸	低SI组	33	2	8	4.97	1.47	0.055	-0.404
呼吸	高SI组	34	2	8	3.44	1.56	1.285	1.266
唇运动	低SI组	33	6	19	13.40	3.06	-0.315	0.003
唇运动	高SI组	34	5	16	8.97	2.99	0.645	-0.549
颌位置	低SI组	33	2	8	3.40	1.68	1.065	0.257
颌位置	高SI组	34	2	6	2.59	1.16	2.013	3.177
软腭运动	低SI组	33	3	11	6.27	2.11	0.530	-0.016
软腭运动	高SI组	34	3	9	4.62	1.67	0.860	-0.031
喉控制	低SI组	33	7	20	13.36	2.97	0.172	-0.425
喉控制	高SI组	34	4	16	9.38	3.30	0.054	-0.701
舌运动	低SI组	33	10	23	16.58	3.40	-0.099	-0.03
舌运动	高SI组	34	6	22	11.91	4.20	0.495	-0.111
言语	低SI组	33	5	20	13.82	3.71	-0.265	-0.592
言语	高SI组	34	4	14	7.62	2.77	0.622	-0.161
a级项目数	低SI组	33	0	15	4.94	3.00	1.031	2.563
a级项目数	高SI组	34	1	28	12.44	7.75	0.271	-0.921

组别	n	反射	呼吸	唇运动	颌位置	软腭运动	喉控制	舌运动	言语	a级项目数
高SI组	34	5(3, 6)	3(2, 4)	8.5(6, 11)	2(2, 3)	4(3, 6)	9.5(6.75, 12)	12(8, 14.25)	7.5(5.75, 9.25)	12.5(5, 17.5)
低SI组	33	7(6, 8)	5(4, 6)	14(11.5, 15)	3(2, 4)	6(5, 7.5)	13(11, 15.5)	17(15, 18.5)	14(10.5, 16.5)	5(3, 7)
Z值		2.130	1.904	2.258	1.149	1.543	1.798	2.261	2.757	2.393
P值		< 0.001	0.001	< 0.001	0.143	0.017	0.003	< 0.001	< 0.001	< 0.001

FDA领域	r值	P值
反射	-0.464	< 0.001
呼吸	-0.526	< 0.001
唇运动	-0.649	< 0.001
颌位置	-0.343	< 0.001
软腭运动	-0.566	< 0.001
喉控制	-0.668	< 0.001
舌运动	-0.664	< 0.001
言语	-0.829	< 0.001

Relationship between motor function of articulation organs and speech intelligibility in poststroke dysarthria

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 25

Related Articles 15

Metrics

Comments

Recommended 0

[1]	DUAN Linru, ZHENG Jiejiao, CHEN Xi, LI Yan. Analysis of relevant factors for fall risk in stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 811-817.
[2]	HE Aiqun, LI Jingbo, HE Maoli, YE Simei, SONG Qiushuang, LIU Haiou, XIE Youshu. Effect of occupational skills relearning on hemiplegic arm function after stroke: a randomized controlled trial [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 823-830.
[3]	CHEN Chen, MENG Zhaoxiang, YANG Kang, ZHANG Minjie, ZUO Ya'nan, WANG Kui, ZHANG Xibin, QUAN Yifeng, JIN Xing. Effect of intelligent mirror glove task-oriented training combined with low-frequency repetitive transcranial magnetic stimulation on hand function in patients with stroke: a randomized controlled trial [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 831-838.
[4]	REN Xiaomin, WEI Hui, YUE Shouwei, YIN Sen. Risk factors of stroke in nine hospitals of six cities in Shandong, China: a case-control study [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 839-847.
[5]	YANG Bin, LIU Mingyue, GAO Dan, LI Zhe. Application of transcranial direct current stimulation in stroke rehabilitation: a bibliometrics analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 675-685.
[6]	LI Yanli, LIU Lanqun, XU Jimin, WANG Haifang. Post-stroke foot drop research： a bibliometrics analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 686-692.
[7]	YANG Shining, MA Jiang, LI Hong, GUO Liying, LIU Xianying, ZHANG Lifang. Correlation of upper extremity somatosensory evoked potentials with sensory and motor functions in stroke patients in different stages [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 701-708.
[8]	WANG Xue, WANG Liping, SONG Ning, LIU Lanqun, ZHOU Jie, WU Jun. Effect of behavioral vision training on post-stroke ocular motility disorders [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 726-730.
[9]	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.
[10]	XU Dongyan, WANG Weining, PAN Li, LIU Gang, LIU Jiapeng, WU Yi, ZHU Yulian. Effect of enriched environment theory-based multisensory feedback gait training on walking function in stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 526-534.
[11]	XIONG Xingxiu, ZHANG Zhenghui, DENG Chunyan, LI Yunbo, CHEN Zhenpeng, LI Yuanjie, SONG Jing. Effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function after stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 554-559.
[12]	HUANG Songhua, LING Junqi, GAO Tianhao, HUANG Yijia, BAI Yulong. Effect of wrist-hand orthosis combined with modified constraint-induced movement therapy on upper limb and hand function in patients with stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 606-612.
[13]	ZHENG Jianling, LIU Huilin, ZHU Lin, GU Bin, YAN Ruxiu, ZHAO Qi, SONG Luping. Effect of early intelligent assisted walking under suspension protection on motor and walking function for stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 431-436.
[14]	CUI Tiantian, YANG Yulin, CUI Tengteng, MA Lihong. Effect of different intensive training on upper limb motor function in children with cerebral palsy: a network meta-analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 437-448.
[15]	SU Zhaoyin, KANG Weihan, LIU Yatao, LÜ Yuan, Michael NERLICH. Relationship between physical activity levels and stroke risk among middle-aged and older adults in China based on CHARLS data [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 449-453.