言语表象疗法改善脑瘫患儿构音障碍的效果

doi:10.3969/j.issn.1006-9771.2023.05.017

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (5): 601-607.doi: 10.3969/j.issn.1006-9771.2023.05.017

言语表象疗法改善脑瘫患儿构音障碍的效果

王勇丽¹^,², 余新春¹^,², 金昕玥¹^,², 毕思雨¹^,², 王曦¹^,², 倪天皓¹^,², 万勤¹^,²(), 黄昭鸣¹^,²

1.华东师范大学教育学部康复科学系，上海市 200062
2.华东师范大学中国言语听觉康复科学与ICF应用研究院，上海市 200062

收稿日期:2023-03-07 修回日期:2023-05-30 出版日期:2023-05-25 发布日期:2023-06-19
通讯作者: 万勤(1982-)，女，汉族，江西南昌市人，博士，副教授，主要研究方向：言语语言康复。E-mail：ada.wan@hotmail.com
作者简介:王勇丽(1985-)，女，汉族，河南漯河市人，博士，副教授，主要研究方向：言语语言康复。
基金资助:
国家社会科学基金重点项目(20AZD125)

Effect of speech imagery therapy on dysarthria in children with cerebral palsy

WANG Yongli¹^,², YU Xinchun¹^,², JIN Xinyue¹^,², BI Siyu¹^,², WANG Xi¹^,², NI Tianhao¹^,², WAN Qin¹^,²(), HUANG Zhaoming¹^,²

1. Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai 200062, China
2. Institute of Chinese Speech and Hearing Rehabilitation Science and ICF Application, East China Normal University, Shanghai 200062, China

Received:2023-03-07 Revised:2023-05-30 Published:2023-05-25 Online:2023-06-19
Contact: WAN Qin, E-mail: ada.wan@hotmail.com
Supported by:
National Social Science Foundation (Key)(20AZD125)

摘要/Abstract

摘要：

目的探讨言语表象疗法结合传统构音训练改善脑瘫患儿构音障碍的疗效。

方法 2022年8月至12月，选取芜湖市第五人民医院并发构音障碍的脑瘫患儿21例，随机分为A、B、C 3组，每组各7例。A组给予传统构音训练，每次30 min；B组给予植入型言语表象结合传统构音训练，每次40 min；C组给予附加型言语表象结合传统构音训练，每次40 min。每周5 d，共3周。训练前后采用构音功能评估量表、口部感觉-运动评估表以及声学指标下颌距、舌距、元音空间面积(VSA)进行评价。

结果治疗前，3组各项指标比较均无显著性差异(F < 1.247, P > 0.05)。治疗后，3组构音功能评估量表评分、口部感觉-运动评估表评分均提高(|t| > 2.575, P < 0.05)；A组、B组下颌距、VSA均较治疗前提高(|t| > 2.632, P < 0.05)。B组、C组构音功能评分差值高于A组(P < 0.05)，其他指标治疗前后差值组间均无显著性差异(P > 0.05)。

结论两种言语表象疗法均可改善脑瘫患儿构音清晰度、口部运动范围和运动控制能力，在改善构音清晰度方面的效果优于传统构音训练。

关键词: 脑性瘫痪, 构音障碍, 言语表象

Abstract:

Objective To investigate the effect of speech imagery therapy combined with traditional dysarthria training on dysarthria in children with cerebral palsy.

Methods From 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.

Results There 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).

Conclusion Both 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.

Key words: cerebral palsy, dysarthria, speech imagery

中图分类号:

R742.3

王勇丽, 余新春, 金昕玥, 毕思雨, 王曦, 倪天皓, 万勤, 黄昭鸣. 言语表象疗法改善脑瘫患儿构音障碍的效果[J]. 《中国康复理论与实践》, 2023, 29(5): 601-607.

WANG Yongli, YU Xinchun, JIN Xinyue, BI Siyu, WANG Xi, NI Tianhao, WAN Qin, HUANG Zhaoming. Effect of speech imagery therapy on dysarthria in children with cerebral palsy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 601-607.

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组别	n	性别(男/女)/n	年龄/岁	GMFCS/(Ⅰ/Ⅱ/Ⅲ级)/n
A组	7	4/3	7.10±2.18	4/3/3
B组	7	5/2	9.91±2.90	1/3/2
C组	7	5/2	9.61±2.45	2/1/2
F/χ²值		0.431	2.614	1.603
P值		0.814	0.100	0.812

组别	n	治疗前	治疗后	差值	t值	P值
A组	7	0.44±0.25	0.52±0.27	0.08±0.01	-5.195	0.002
B组	7	0.42±0.27	0.62±0.23	0.20±0.08^a	-6.377	0.001
C组	7	0.36±0.18	0.55±0.22	0.19±0.06^b,c	-8.420	< 0.001
F值		0.214	0.358	8.010
P值		0.809	0.704	0.003

组别	n	治疗前	治疗后	差值	t值	P值
A组	7	0.82±0.11	0.86±0.01	0.04±0.01	-6.087	0.001
B组	7	0.81±0.13	0.88±0.07	0.08±0.08	-2.575	0.042
C组	7	0.82±0.07	0.85±0.07	0.04±0.03	-3.577	0.012
F值		0.047	0.358	1.676
P值		0.955	0.716	0.215

组别	n	治疗前	治疗后	治疗前后差值	t值	P值
A组	7	113.08±28.65	351.50±239.88	213.43±258.65	-2.632	0.046
B组	7	111.33±58.09	515.65±325.33	390.33±275.83	-3.261	0.022
C组	7	165.58±162.53	339.89±330.20	168.52±258.62	-1.594	0.172
F值		0.481	0.663	1.179
P值		0.627	0.530	0.334

组别	n	治疗前	治疗后	治疗前后差值	t值	P值
A组	7	1579.00±325.02	2093.43±395.81	370.00±837.19	-2.233	0.076
B组	7	1796.33±519.17	1885.17±397.71	107.81±656.04	-0.784	0.469
C组	7	1573.85±477.26	1652.75±569.68	78.90±979.10	-0.197	0.851
F值		0.314	2.268	0.438
P值		0.735	0.138	0.653

言语表象疗法改善脑瘫患儿构音障碍的效果

Effect of speech imagery therapy on dysarthria in children with cerebral palsy

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组别	n	治疗前	治疗后	治疗前后差值	t值	P值
A组	7	-34748.46±116529.19	-284513.40±251182.15	-249764.93±190954.69	3.204	0.024
B组	7	-110392.13±84832.76	-486901.35±353523.65	-364786.13±270933.70	3.103	0.027
C组	7	-121594.57±105112.16	-246086.21±244502.26	-195089.25±331716.13	1.497	0.195
F值		1.247	1.216	1.920
P值		0.315	0.324	0.175

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