• Speech Sciences
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• v.15 no.4
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• pp.159-170
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• 2008

The purpose of this study was to find out the ability of coordination of the articulatory motor and the ability of control of the respiration and laryngeal for spastic dysarthria by acoustic analysis. The sustained of vowel /a/ and repetition of syllable /pa/ in 15 normal and 10 spastic dysarthria were measured. Multi-Speech, MDVP, and MSP were used for data recording and analysis. As a result, the mean DDK rate in the spastic group was significantly slower than in the normal. The maximum phonation time in the spastic group ($4.80{\pm}1.94$) was shorter than in the normal ($11.20{\pm}3.72$). The DDKjit in the spastic group was significantly higher than in the normal. The DDKsla was reduced in the spastic group. The mean syllable duration in the spastic group (146.2ms) was significantly longer than in the normal (75.8ms). The mean energy was reduced in the spastic group. The range of Fo was greater than in the normal. The frequency perturbation (jitter, vFo) and amplitude perturbation (shimmer, vAm) were higher than in the normal group. The NHR was higher than in the normal group. The parameters of this were significantly difference between the spastic dysarthria and the normal (p<0.05). Finally, the spastic dysarthria has short respiration, slow speech rate, and voice quality problem. The these results will help to establish a plan and the intervention of treatment.

• MALSORI
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• no.48
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• pp.1-17
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• 2003

Among the types of dysarthria, spastic and flaccid types are the most prominent manifestations. The objectives of the present research are (1) to discover the phonetic contrasts that differentiate spastic dysarthria from flaccid dysarthria, (2) to analyze the degrees of predictability of each phonetic contrast for intelligibility in spastic and flaccid dysarthrias and to compare them. The 'phonemic contrast word intelligibility pairs' for dysarthric speakers were tested and proved to be useful for clinical assessment of and research on dysarthria. In the group of spastic type, it showed that initial fricative vs. affricate and front vs. back vowel contrasts are transmitted relatively less effectively than flaccid type. In the group of flaccid type, initial glottal vs null contrast is transmitted less effectively than spastic type. The overall intelligibility of spastic dysarthria was predicted by multiple regression analysis with 88% accuracy by three phonetic contrasts(initial fricative vs. affricate; front vs. back vowels; initial consonant correlates). And the intelligibility of flaccid dysarthria was predicted by two phonetic contrasts(initial nasal vs. stop, front vs. back vowels) with 60% accuracy.

• Physical Therapy Korea
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• v.8 no.1
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• pp.51-58
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• 2001

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was $-1.812{\pm}.962$, $-1.519{\pm}.935$, respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.111-113
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• 2004

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.129-136
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• 2017

This study investigates the effect of voice quality on speech intelligibility and the relationship between voice quality and intelligibility for children with spastic CP. We recruited 36 children with spastic CP (mean age 10.43 year, 17 girls, 19 boys, spastic type 34, mixed 2) from a special school and a rehabilitation hospital. Voice samples for the perceptual analysis of voice quality were extracted from a sustained vowel /a/ and were rated on the GRBAS scales by two experienced speech language pathologists. Ten adult subjects with no hearing problems evaluated speech intelligibility for the 37 words listed in the Assessment of Phonology and Articulation for Children on a 7-point interval scale. The children with spastic CP were divided into three groups according to the rated G scores on the GRBAS scales (G1(n)=10, G2(n)=13, G3(n)=13). Analyses of ANCOVA and Pearson correlation showed that there was a significant difference in speech intelligibility among three groups. There was also a significant correlation in G scale (grade), A scale (asthenia), B scale (breathy) score, and speech intelligibility. These findings suggest that poor speech intelligibility of spastic CP might be related to asthenia and breathiness. Vocal intensity should be increased and vocal functioning should be improved for speech therapy to improve speech intelligibility of the children with spastic CP.

• The Journal of Korean Physical Therapy
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• v.25 no.3
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• pp.155-159
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• 2013

Purpose: Circumference of the chest and waist can be one of clinical indicator to reflect respiratory function in children with cerebral palsy. In this study, we compared to differences in the chest/waist circumference and maximal phonation time between children with spastic diplegia and hemiplegia. Methods: Seventeen children with spastic diplegic and hemiplegic cerebral palsy were recruited, who were matched to gender, age, height, weight, and body mass index for control of the known factors affected to respiratory function. The chest/waist circumference and were measured in each group, when children took a breath at rest and at maximal voluntary inspiration/expiration. Results: No significant differences were found in the chest and waist circumference and expansion between the two groups. However, only in the waist expansion, children with diplegic CP were significantly lower extensibility of lung, compared to the other group. In comparison of the maximal phonation time, a significant lower score was shown in children with spastic diplegic CP, compared to children with hemiplegic CP. Conclusion: Our results indicated that children with spastic diplegic CP had smaller chest wall and waist, compared to children with spastic hemiplegic CP. In addition, they showed a shorter time for sustaining phonation than spastic hemiplegic CP did. Therefore, spastic diplegic CP will be required for careful monitor regarding respiratory function in rehabilitation settings.

• Genomics & Informatics
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• v.20 no.3
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• pp.30.1-30.9
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• 2022

Hereditary spastic paraplegia is a not common inherited neurological disorder with heterogeneous clinical expressions. ALDH18A1 (located on 10q24.1) gene-related spastic paraplegias (SPG9A and SPG9B) are rare metabolic disorders caused by dominant and recessive mutations that have been found recently. Autosomal recessive hereditary spastic paraplegia is a common and clinical type of familial spastic paraplegia linked to the SPG11 locus (locates on 15q21.1). There are different symptoms of spastic paraplegia, such as muscle atrophy, moderate mental retardation, short stature, balance problem, and lower limb weakness. Our first proband involves a 45 years old man and our second proband involves a 20 years old woman both are affected by spastic paraplegia disease. Genomic DNA was extracted from the peripheral blood of the patients, their parents, and their siblings using a filter-based methodology and quantified and used for molecular analysis and sequencing. Sequencing libraries were generated using Agilent SureSelect Human All ExonV7 kit, and the qualified libraries are fed into NovaSeq 6000 Illumina sequencers. Sanger sequencing was performed by an ABI prism 3730 sequencer. Here, for the first time, we report two cases, the first one which contains likely pathogenic NM_002860: c.475C>T: p.R159X mutation of the ALDH18A1 and the second one has likely pathogenic NM_001160227.2: c.5454dupA: p.Glu1819Argfs Ter11 mutation of the SPG11 gene and also was identified by the whole-exome sequencing and confirmed by Sanger sequencing. Our aim with this study was to confirm that these two novel variants are direct causes of spastic paraplegia.

• MALSORI
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• no.58
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• pp.1-18
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• 2006

The purpose of this study was to investigate diadochokinetic (DDK) characteristics in the subjects with spastic cerebral palsy (CP) by severity. DDK characteristics were measured through rate, regularity, accuracy and consistency in Alternate Motion rate (AMR) and Sequential Motion rate (SMR) tasks. The subjects participated in this study included 27 subjects with spastic CP (mild- 9, moderate- 9, severe- 9) and 9 normal persons who are around 11-20 years old. On the result of this study, rate in AMR was significant difference between all spastic groups and normal group, and rate in SMR was significant difference between normal and mild groups and moderate and severe groups. In regularity of the DDK tasks, severe group had significant difference the other groups. Finally, accuracy and consistency of the DDK tasks exhibited significant difference between all spastic groups and normal group. In conclusion, the subjects with spastic CP have a tendency to produce slow and irregular syllable repetition as severity increases, but to produce inaccurate and inconsistent syllable repetition regardless of severity in the DDK tasks.

• Proceedings of the KSPS conference
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• 2006.05a
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• pp.105-108
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• 2006

The purpose of this study was to investigate the diadochokinetic characters in the patients with spastic cerebral palsy(CP) in severity. The diadochokinetic characters were measured through rate, regularity, accuracy and consistency. The subjects participated in this study included 27 persons with spastic CP(mild- 9, moderate- 9, severe- 9) and 9 normal persons who is around 11-20 years old. On the result of this study, rate in AMR was significant difference between all spastic groups and normal group, and rate in SMR was significant difference between normal and mild groups and moderate and severe groups. In regularity of diadochokinetic task, severe group had significant difference the other groups. Finally, accuracy and consistency of diadochokinetic task exhibited significant difference between all spastic groups and normal group.

• Speech Sciences
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• v.11 no.4
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• pp.185-195
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• 2004

Spastic dysarthria is a motor speech disorder produced by a damage to the direct (pyramidal) and indirect (extrapyramidal) pathways of the central nervous system. This study attempted to determine the influences of the severity of spastic dysarthria on the stability of voice. A sustained /a/, /a/ produced at the beginning of a sentence and at the end of the sentence were analyzed. The Praat 4.0.51 was used for analysis. The results showed a significant difference between the severe spastic dysarthric group and normal group matched by age and sex at the beginning and the end of the sentence. In addition, the severe group showed a significant difference between the first /a/ and the second /a/ at the end of sentence.