[The curative effect of task-oriented approach in combination with articulation approach on spastic dysarthria].

OBJECTIVE: To assess the effectiveness of task-oriented approach in treating patients with spastic dysarthria. METHODS: A randomized control trial was undertaken in 44 inpatients diagnosed with spastic dysarthria at the Department of Rehabilitation Medicine in West China Hospital. All of the participants received basic medical therapy, occupational therapy, physical therapy, and an articulation approach for speech therapy by a professional speech therapist over a one month period. A task-oriented approach was added to the speech therapy regime of the test group of participants by another professional speech therapist over the same period of time. The outcomes of speech therapy were measured by the Frenchay dysarthria assessment (FDA). RESULTS: Significant improvements were found in the test group in relation to 15 FDA items, such as dribbling, lips spread, and palate maintenance (P<0. 05). The performance of the participants in the test group on the rest of FDA items also demonstrated an improvement trend compared with that of the controls (P>0. 05) except for the three items in relation to cough, lips at rest and jaw in speech. CONCLUSION: Task-oriented approach for speech therapy is effective in treating patients with spastic dysarthria. A task-oriented approach in combination with an articulation approach can produce better patient outcomes compared with the articulation approach alone. Further studies are warranted.

Bladder management of patients with spinal cord injuries sustained in the 2008 Wenchuan earthquake.

This study's aim is provide an overview of the patients who suffered spinal cord injury (SCI) after the magnitude 8.0 Wenchuan earthquake, including each patient's demographic and epidemiological characteristics, bladder management status, and quality of life (QOL). We also assessed the relationships between bladder management methods, symptomatic urinary tract infection (SUTI), and QOL. Two years after the 2008 Wenchuan earthquake, a cross-sectional face-to-face survey was conducted on 180 patients with SCI. A self-administered questionnaire and the WHOQOL-BREF assessment were used to assess injury-related information, bladder management methods, and SUTI. Statistical analysis was performed using the Chi-square test and analysis of variance. A p value <0.05 was considered statistically significant. This study found that a male-to-female ratio of approximately 1.2:1, including 98 (54.4%) male patients and 82 (45.6%) female patients. Thoracic-level injuries were seen in 82 patients (45.56%), 60 (33.33%) patients had lumbar-level injuries, 18 (8.33%) patients had thoracolumbar-level injuries, and a small number of patients had cervical- or sacral-level injuries. Sixty-two patients (34.44%) demonstrated normal voiding, 65 (36.11%) required manually assisted voiding, 29 (16.11%) required catheterization, and 24 (13.33%) used aurine-collecting apparatus. The prevalence of SUTI was 43.89%. Patients who emptied their bladder via manually assisted voiding, catheterization, or with the use of a urine-collecting apparatus demonstrated higher rates of SUTI compared with patients who voided normally (p < 0.05); the patients who required catheterization had higher rates of SUTI compared with patients who required manually assisted voiding (p < 0.05). When manually assisted voiding and catheterization were compared with the use a urine-collecting apparatus, no statistically significant differences were observed in terms of the risk of developing SUTI. The patients in this study demonstrated low scores on the WHOQOL-BREF physical domain (11.61 ± 3.80), psychological domain (10.11 ± 3.63), social domain (11.46 ± 2.84), and environmental domain (11.86 ± 2.51). The patients who reported normal voiding also demonstrated the best QOL in terms of physical, psychological, and social component scores (p < 0.05). In conclusion, the percentage of women in this study is higher than that reported in other studies on traumatic causes of SCI. Patients who suffered SCI following the Wenchuan earthquake demonstrate poor bladder management status and are unable to take advantage of urodynamic testing that is used to monitor the functional state of the bladder. This study's findings indicate that bladder management methods influence the rate of SUTI and the QOL of patients with SCI. Caring for SCI patients following a disaster requires comprehensive long-term planning. Bladder management of patients with SCI is essential for improving the QOL of these patients.