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ObjectiveTo investigate the effect of speech imagery therapy combined with traditional dysarthria training on dysarthria in children with cerebral palsy. MethodsFrom August to December, 2022, 21 children with cerebral palsy combined with dysarthria in Wuhu Fifth People's Hospital were randomly divided into three groups A, B and C. Group A was given traditional dysarthria training for 30 minutes everytime, group B was given implantable speech imagery combined with traditional dysarthria training for 40 minutes everytime, and group C was given additional speech imagery combined with traditional dysarthria training for 40 minutes everytime, five days a week, for three weeks. Articulation and Phonology Assessment Scale, Mouth Sensory-Motor Assessment Scale, and mandibular distance, tongue distance and vowel space area (VSA) were evaluated before and after treatment. ResultsThere was no significant difference in all the indexes among three groups before treatment (F < 1.247, P > 0.05). After treatment, the scores of phonological function and sensory-motor assessment scale increased (|t| > 2.575, P < 0.05), and the mandibular distance and VSA increased in groups A and B (|t| > 2.632, P < 0.05). The d-value of phonological function before and after treatment was more in groups B and C than in group A (P < 0.05), and no difference was found in the d-value of other indexes before and after treatment among three groups (P > 0.05). ConclusionBoth speech imagery therapies are effective in improving diction clarity, oral range of motion, and motion control ability in children with cerebral palsy, and are more effective in improving articulatory clarity than traditional speech-language training.
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Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.
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Humans , Idiopathic Pulmonary Fibrosis/diagnosis , Biomarkers , Lung Diseases, Interstitial , Lung , Bronchoalveolar Lavage Fluid , Disease Progression , PrognosisABSTRACT
ObjectiveTo discuss the diagnosis, assessment and rehabilitation for children with cerebral palsy complicated with speech disorder based on the tools of World Health Organization Family of International Classifications (WHO-FICs). MethodsThe diagnosis of speech disorder after cerebral palsy was classified using International Classification of Diseases, 11th Revision (ICD-11). The disorders of speech function were classified using International Classification of Functioning, Disability and Health (ICF). A structured speech function rehabilitation solution was developed based on the International Classification of Health Interventions (ICHIβ-3). ResultsAccording to ICD-11, cerebral palsy was classified as 08 Neurological Disorder, which was further classified as 8D20.0 Spastic Unilateral Cerebral Palsy and 8D20.1 Spastic Bilateral Cerebral Palsy (8D20.10 Spastic Quadriplegic Cerebral Palsy and 8D20.11 Spastic Bilateral Cerebral Palsy), with the speech disorders involving 6A00 Disorders of Intellectual Development, 6A01 Developmental Speech or Language Disorders, MA80 Speech Disturbances, MA81 Speech Dysfluency and MA82 Voice Disturbances. For ICF, the speech disorders mainly involved s1 structures of the nervous system, s3 structures invoved in voice and speech, b3 voice and speech functions, d1 learning and applying knowledge, and environment and individual factors; and could be further classified as b310 voice functions, b320 articulation functions, and b330 fluency and rhythm of speech functions. Based on ICHIβ-3, a rehabilitation solution was developed, involving the areas of body structure and function, activity and participation, and environmental factors. ConclusionBased on ICD-11, ICF and ICHIβ-3, a methodological system of assessment and interventions for speech disorders after cerebral palsy has been systematically constructed, including diagnosis of disease, assessment, intervention and coding of speech disorder.
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ObjectiveTo explore the diagnoses of diseases and functioning of speech fluency disorder, analyze the main assessment content, and construct framework of intervention solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHIβ-3). MethodsThe diagnoses of diseases and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic intervention solution was constructed with ICF and ICHIβ-3. ResultsSpeech fluency disorder is classified as 6A01.1 developmental speech fluency disorder for ICD-11. The related diseases include 6A01.0 developmental speech sound disorder, 6A01.2 developmental language disorder, cerebral palsy, MA80.0 aphasia, MA80.1 dysphasia and MA80.2 dysarthria, etc. For ICF, the categories related to speech fluency disorder might be s3 structures invovled in voice and speech; b3 voice and speech functions, especially b330 fluency and rhythm of speech functions; d1 learning and applying knowledge, d3 communication, especially d330 speaking and d355 discussion, d7 interpersonal interactions and relationships, and d9 community, social and civic life. A holistic intervention solution for speech fluency disorder was developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support, etc. ConclusionA framework of diagnosis, assessment and rehabilitation has been constructed for speech fluency disorder.
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Objective To study the validity of a new material, to verify the influence of gender and age differences on normal school children, and give advice to establishing the norms of mean nasalance for normal school children.Methods The mean nasalance of 190 school children in Shanghai was obtained by reading the new, old material and the vowel /a/,/o/,/e/,/i/,/u/, and /ü/, the mean nasalance was analyzed for the standard deviations.The gender and age score differences were compared.Results The new material was more stable than the old.In the test of /i/ and/ü/and the nasal material, the girls'' MNS was higher than the boys''.In testing the vowels /a/,/o/,/e/,/i/,/u/, and /ü/and the new material, there were differences in different ages.Conclusion The validity of new material is more stable than the old.The MNS of the normal children in Shanghai show that it is higher for the girls than the boys, and also higher for the older children than for the younger.
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Objective To investigate the difference and the correlation of the vowel's phonation threshold pressure and nasalance in normal subjects .Methods The Aeroview (GLOTTAL Enterprises)with the materials /pa/,/pi/,/pu/ was used to obtain phonation threshold pressure values and The NasalviewTM (Tiger Electronics Inc .,Seattle ,Shanghai) with the materials /a/,/i/,/u/was used to obtain nasalance values .A total of 30 subjects (15 males ,15 females ,and aged 19~30) years old received the tests .The results of the vowel's phonation threshold pressure and nasalance gender score difference were compared .Results The PTP gender scores of /a/,/i/,/u/in maleswere4.53±0.70cm,5.21±0.80cm,5.87±1.45cm,andinfemaleswere4.09±0.30cm,4.47±0.30cm, and 4 .77 ± 0 .32 cm ,respectively .There were significant differences between males and females in PTP values (P 0 .05) .The na‐salance gender score differences showed that females were greater than males .There were significant differences in different vowels(P<0 .05) .This study found a weak correlation between PTP and nasalance .Conclusion The relationship between oral pressure and nasal flow cannot be accurately measured by measuring PTP ,and /pa/is a relatively suit‐able material for testing oral pressure .
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Objective To study the characteristics and difference of speech rate in monologue and reading in normal adults .Methods Through the acquisition of spontaneous speech and reading from 30 normal adults ,the syl‐lables per minute (SPM ) and the words per minute (WPM )were separately calculated .The monologue materials in‐clude ten topics :self introduction hobby ,hometown and so on;the reading material was the stars in the sky written by Ba Jin .We also analyzed whether there was a significant difference in genders and types of expression for speech rates .Results With the expression of monologue :SPM (male)=226 .13 ± 25 .97 ,SPM (female)=198 .73 ± 40 .With the expression of reading :SPM (male)= 208 .93 .13 ± 29 .35 ,SPM (female)= 220 .53 .± 26 .52 ,WPM (male)=104 .67 ± 13 .43 ,WPM (female)=111 .80 ± 12 .73 .Pearson correlation coefficient of SPM and WPM had reached 0 .926(r=0 .926) in the spontaneous speech and 0 .969 (r=0 .969) in reading .There were no significant differences in both genders (P=0 .42) and types of expression(P=0 .72) .The interaction effect of genders and types of ex‐pression was significant (P=0 .006) .For females ,the rate of reading was significantly higher than monologue (P=0 .025);for monologue ,there was a significant difference between males and females(P=0 .035) .The male was higher than the female in the speed of monologue .Conclusion The statistics revealed a high correlation between SPM and WPM .Genders and types of expression did not play an important role on the speech rate .The interactioneffect of gender and type of expression was significantly high (P=0 .006) .
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Objective By analyzing the graph features of fundamental frequency at different rates of/i/with continuously variable pitch and loundness made by normal adults,we could explore that the rate and gender have some impact on the graph to lay the foundation of regulating the clinical maximum counting ability.Methods Nor-mal adults of 51 (25 males,26 females were included).After each deep breathing,the subjects respectively took sustained speech/i/ with continuously variable pitch and lounolness twice at different rates of fast,medium and slow speed.Some parameters were measured byDoctor Speechat different rates of the tone/i/:Total time(T), Mean time standard deviation (MTSD),Mean wave crest (MWC),Mean wave trough (MWT),Mean frequency range (MFR),Mean frequency range standard deviation (MFRSD),comparing the speed having some effect on those above parameters with gender.ResuIts ①With the increasing rate of speech,the tone/i/of T (P0.05 ).②The tone /i/ of T (P>0.05 )were not effected by gender,female's MWT (P<0.001),MWC (P<0.001),MFR (P<0.001),MFRSD (P<0.01)were obviously higher than male's,while female's MTSD were significantly larger than male's (P<0.01).ConcIusion We should consider the impact of rate of speech and gender in clinical tests and values of MCA.The maximum counting capacity can be respectively tested at three different rates of speech for each subject,but only are the tone/i/of fun-damental frequency graphs with MWT,MWC,MFR,and MFRSD in normal range with corresponding speed and gender,can we get the value or can the value be valid.
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Objective This study aimed to develop reading material for nasalance evaluation ,and find out na-salance scores associated with genders .Methods The NasalView ? (Tiger Electronics Inc .,Seattle ,USA) was used to obtain nasalance values in the new and old material .A total of 102 subjects (51 males ,51 females) who have lived in Beijing for 18 years or longer at the time of the experiment received the tests ,the results from two pieces of material and the mean nasalance gender score differences were compared .Results The mean nasalance scores of sen-tences were 56 .58% ± 3 .43% for'Nasal sentence',33 .86% ± 5 .24% for'Oral sentence',and 49 .49% ± 4 .13% for'Oro -nasal sentence'respectively in the new material .The mean nasalance scores of sentences were 54 .31% ± 4 .43% for'Nasal sentence',35 .64% ± 5 .90% for'Oral sentence',and 47 .12% ± 4 .96% for'Oro-nasal sentence're-spectively in the old material .There were significant differences between males and females through materials .The nasalance gender score differences showed that females were bigger than males (P<0 .01) .This study found a cor-relation between the new and old materials :'Nasal sentence'(r=0 .899 ,P< 0 .01) ,'Oral sentence'(r= 0 .850 ,P<0 .01) ,and'Oro -nasal sentence'(r=0 .851 ,P<0 .01) .The standard error difference showed that the new was smaller than the old (P<0 .01) .Conclusion The new material for nasalance evaluation has a better test validity ,and there is a high correlation between the old materials .The usage of the new material for nasalance evaluation will produce more accurate results with higher credibility .Normal female's nasalance scores were higher than males .
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Objective To investigate how the tones impact the perceptual result of hypernasality for designing subjective evaluation ma-terial for hypernasality. Methods 20 normal children and 20 children with cleft palate were asked to read the material with different tones. The degree of hypernasality and nasality was recorded. Results There was no significant difference in the degree of perceived hypernasality and nasality rate among all the children in all the tones (P>0.05). Conclusion The impact of tones on perceived hypernasality can be ignored when designing the subjective evaluation material for hypernasality.
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@#Objective To investigate how the tones impact the perceptual result of hypernasality for designing subjective evaluation material for hypernasality. Methods 20 normal children and 20 children with cleft palate were asked to read the material with different tones.The degree of hypernasality and nasality was recorded. Results There was no significant difference in the degree of perceived hypernasality and nasality rate among all the children in all the tones (P>0.05). Conclusion The impact of tones on perceived hypernasality can be ignored when designing the subjective evaluation material for hypernasality.
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Objective To compare the resonance acoustic characteristics between 7~16 years old Down syn-drome children and normal children .Methods A total of 29 cases of 7~16 years old Down syndrome children and 90 cases of 7~16 years old normal children pronuanced /a/,/u/,/i/,each sound for 3 times ,every time 1 to 2 sec-onds .The oral resonance acoustic parameters ,including F1 (a) ,F2 (a) ,F1 (i) ,F2 (i) ,F1 (u) ,F2 (u) ,the distance of tongue and the distance of jaw ,were recorded by real analysis .Analysis of variance was used for the voice acous-tic .Results With age ,there was a significant decrease tendency of the value of F2 (a) and a very significant growth tendency of the values of F2 (i) and the distance of tongue in normal children .The value of F2 (i) inrcreased signifi-cantly in Down syndrome children .The values of every oral resonance acoustic parameters were not different signifi-cantly on sex in normal children .The values of F1 (i) and F1 (u) in Down syndrome boys were significantly less than those of in the Down syndrome girls ,but the the distance of jaw in Down syndrome boys were significantly greater than those of in the Down syndrome girls .The values of F2 (u) and F1 (i) in Down syndrome children were signifi-cantly greater than those of in normal children ,but the distance of tongue was significantly less than those of in nor-mal children .Conclusion With age ,in normal children ,the amplitude of the tongue forward movement and the range of tongue back and forward movement were increased significantly ,the oral focus moved forward gradually .In Down syndrome children ,the amplitude of the tongue back movement ,and the range of tongue back and forward movement ,were poor than those of in normal children .The Down syndrome children were easier to suffer from oral resonance disorder than normal children .
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Objective To explore the speech respiratory characteristics of 7-15 years old children with spastic cerebral palsy and the differences between ordinary children and children with cerebral palsy.Methods The maximum phonation time (MPT) and maximum counting ability (MCA) of 90 ordinary children and 58 children with cerebral palsy aged 7-15 years were measured and a comparison between the 2 groups were conducted.Results (1) Age has significant effects on MPT and MCA of the ordinary children (P ＜0.05).The MPT and MCA of the ordinary children at the age of 7 ～9 years and 10 ～ 12 years are lower than the ones at the age of 13 ～ 15 years.Age has almost no effects on MPT and MCA of children with cerebral palsy(P ＞0.05) ; (2)Sex has no significant effects on MPT and MCA of ordinary children and children with cerebral palsy (P ＞0.05) ; (3) The MPT and MCA of children with cerebral palsy are significantly lower than those of ordinary children (P ＜0.05).Conclusions The MPT and MCA of ordinary children are increased with the growth of age,especially after the age of 13 years,but the children with spastic cerebral palsy do not show that kind of trend and demonstrate a state of retardation of speech respiratory function.Compared with ordinary children,the children with spastic cerebral palsy are easier to suffer from insufficient respiratory support and poor respiratory-phonatory coordination.
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Objective To investigate the acoustic characteristics of the voice of 3~6 years old children with hearing-impairment. Meth-ods The voice samples were collected from 148 hearing-impaired children and 122 normal children, all aged 3~6 years. The acoustic param-eters including F0, F0SD, jitter, shimmer, NNE, OQ, SQ, AQ, STF were compared. Results The F0, SQ, STF, F0SD, jitter were more in the children with hearing-impairment than in the normal children (P0.05). There was no significant difference of all the acoustic parameters among chil-dren with different ages (P>0.05), except the NNE was less in 3~4 years old children than 5~6 years old children (P0.05). Conclusion The vibration of vocal cords is instable and ir-regular, saying overquick and close intensely in hearing-impaired children. The age and sex do not influence the acoustic parameters, except NNE is less in younger children.
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@#Objective To explore whether there is significant difference in the oral-pharyngeal resonance function between children with spastic and athetoid cerebral palsy. Methods The acoustic parameters (F1、F2) of /ɑ/、/i/、/u/ were compared between these two kinds of children. Results The incidence of oral-pharyngeal resonance disorder were 71% and 95% in the children with spastic cerebral palsy and athetoid cerebral palsy respectively. There was no significant difference in F1 and F2 of /ɑ/、/i/、/u/ between these two kinds of children. Conclusion The incidence of oral-pharyngeal resonance disorder is high in both two kinds of children, and there is no significant difference in the oral-pharyngeal resonance function between them.
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OBJECTIVE@#To study the relationship between the first formant (F1) and jaw, the second formant (F2) and tongue and the third formant (F3) and lip. Fine articulation of jaw, lips, tongue by measured formant of different single-vowel, in order to explore clinical implications of F1, F2 and F3.@*METHOD@#Measure 30 hearing normal men's F1, F2, F3 of /a/, /i/, /e/, /u/ and /ü/. The study compared F1 of /a/, /i/, /e/ to find the relation ship between F1 and jaw movement by one-way anova, compared F2 of /a/, /i/, /e/, /u/ to find the relationship between F2 and four tongue movements, and compared F2 and F3 of /i/, /ü/ to find the relationship between F2, F3 and lip movement by paired-samples t test.@*RESULT@#There was significant difference among F1 of /a/, /i/, /e/. F2 and F3 of /i/, /ü/ were also significantly different (P<0.01); F2 of /a/, /i/, /u/ that expresses tongue articulation movement exists significant difference (P<0.01), but both F2(a) and F2(e) did not differ significantly by multiple compare means. There were extremely significant differences (P<0.01) among other three positions of tongue.@*CONCLUSION@#F1 can reflect different positions of jaw. F2 and F3 can reflect the position of lip and tongue. F2 can reflect different locations of tongue.
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Adolescent , Adult , Humans , Male , Young Adult , Sound Spectrography , Speech Acoustics , Speech Production Measurement , Vocal Cords , PhysiologyABSTRACT
@#Objective To explore oropharyngeal swallowing disorders with videofluoroscopic swallowing study (VFSS). Methods 16 patients with dysphagia accepted VFSS with 10 ml of thin barium meal (50% w/v), thick barium meal (270% w/v), biscuit coated with thick barium meal in single swallow. Their swallowing function was observed on the lateral and anterior/posterior planes, including: symmetry of pyriform sinuses, oral transit time, presence of pharyngeal delay, pharyngeal transit time, oral and pharyngeal residue, and presence of aspiration.Results 5 patients demonstrated oral swallowing disorder. 3 patients demonstrated pharyngeal swallowing disorders, that was pharyngeal delay which caused in aspiration after swallowing. 8 patients demonstrated oropharyngeal swallowing disorders, and 3 of them presented aspiration,2 patients were silent aspirators, 1 was aspiration before and 1 after swallowing. The aspiration time could not be judged from the videofluoroscopy in the other one. For 4 patients with aspiration, 3 were severe, with more than 25% of the bolus aspirated, and 1 aspirated less than 5%. Conclusion VFSS can be helpful to plan individual rehabilitation.
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OBJECTIVE@#To explore the developing rule of formants of core vowels with age, and difference with gender.@*METHOD@#2492 normal people were randomly selected with 1318 males and 93 females,and divided to 4 groups according to age. /a/,/i/,/u/ of each child was recorded. Using D1200 to record normatively, reading data of formants in Real Analysis. Datawere analysis by SPSS13.0.@*RESULT@#Formants of Core vowels had significant difference with age (P < 0.05), generally having a decreasing trend mainly with F1,F2 and deltaA (A1-A2) were different significantly as to gender; There were also significant difference between the formants of the core vowels (P < 0.05).@*CONCLUSION@#(1) There are significant effect of age,gender and core vowels(a,i,u)on F1, F2; (2) There are parallel correlation between developing trend of F1, F2 and that of F0.
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Young Adult , Acoustics , Age Factors , Asian People , Sampling Studies , Sex Factors , Speech Acoustics , Voice , Voice QualityABSTRACT
OBJECTIVE@#To testify the effect of voice therapy methods for the glottal dysraphism patient with functional voice disorder.@*METHOD@#The subject was a 62 year old man, who had been diagnosed as functional voice disorder of glottal dysraphism. The main therapy was voice training, with normalized noise energy (NNE) as the assessment and monitoring parameter of the voice function. The datum of the baseline period and the treatment period were collected, and were analyzed with A-B Single-Subject Design in statistics.@*RESULT@#NNE had been significantly decreased (P < 0.01) through the systematical voice training.@*CONCLUSION@#Voice training had been the effective therapy for the glottal dysraphism patient with functional voice disorder.
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Humans , Male , Middle Aged , Glottis , Treatment Outcome , Voice Disorders , Therapeutics , Voice Quality , Voice TrainingABSTRACT
OBJECTIVE@#To discuss the effect of cochlear implant and hearing aid to voice quality.@*METHOD@#Four groups of randomly selected 73 subjects were compared. The groups comprised: cochlear implant children, children using hearing aids, normal hearing children and deaf children with no hearing instrumentation. The latter two groups were control groups. Each subject was required to phonate /ae/ about 3 s using 'voice assessment' to record the sound, and following voice acoustic variables were analysed: F0, SDF0, Jitter, Shimmer, NNE, HNR, SNR.@*RESULT@#Voice F0 of children with cochlear implant was significantly lower that the other three groups (P0. 05); SDF0 of cochlear implant group and hearing aids group were significantly larger than the normal hearing group and deaf children group with no intervention (P0.05), which means that cochlear implant and hearing aid could have affected the SDF0 of female children more than those of male children. There were no significant difference among all the four groups about voice quality variables: Jitter, Shimmer, NNE, HNR, SNR.@*CONCLUSION@#Cochlear implant and hearing aid mainly change the voice F0 and/or SDF0, and have no effect on the voice quality variables.