• 제목/요약/키워드: hypokinetic dysarthria

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마비성 조음장애의 임상적 양상에 관한 고찰 (Some Clinical Aspects of Dysarthria)

  • 김현기;김완호;서정환;홍기환;신효근;고도흥
    • 음성과학
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    • 제3권
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    • pp.38-49
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    • 1998
  • Dysarthrias are a sort of neuromotor disorders because of the weakness of neuromotor controls. They are classified in six types on the basis of Mayo clinic research: flaccid, spastic, ataxic, hypokinetic, hypekinetic and mixed types. Five dysarthria types are investigated in this study. MRI, EMG, neuropathological tests are essential diagnostic processing. Visi-Pitch and Spectrgraphy, CSL are used for assessing dysarthria speech. Maximum phonation time, diadochokinetic rate, Voice Onset Time and substitution rate are the speech evaluation parameters. Maximum phonation time and diadochokinetic rates are the lowest in case of spastic and ataxic dysarthrias. Spastic dysarthria shows the substituted glottalized consonants. However, flaccid, ataxic and hypokinetic dysarthrias show the substituted aspirated consonants. VOT is the longest for hypokinetic dysarthria and the shortest for ataxic dysarthria. Jitter shows higher percentage in comparison with control group. Speech evaluation using experimental phonetic instruments help create on international standardization of speech evaluation for speech disorders.

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마비성구어장애 화자의 조음밸브 교호운동에 관한 공기역학 및 음향학적 특징 (A Study on the Aerodynamic and Acoustic Characteristics in Dysarthria Speakers' Diadochokinesis by Articulation Valves in Vocal Tract)

  • 박희준;권순복;왕수건;정옥란
    • 음성과학
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    • 제15권2호
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    • pp.177-189
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    • 2008
  • This study was to investigate diadochokinetic (DDK) rate, regularity and mean flow rate of articulation valves in dysarthria. DDK rate, mean airflow rate (MFR) and regularity of DDK syllable repetitions of vocal function /ihi/, tongue function /ta/, velopharyngeal function /bm/, and labial function /pa/ in 24 normal and dysarthric speakers were measured. Aerophone Ⅱ and Motor Speech Profile were used for data recording and analysis. The results of the findings were as follows: First, there were significant differences between the dysarthria and the normal group in DDK rate. DDK rates in ataxic dysarthria were the lowest and spastic, flaccid, and hypokinetic dysarthria followed in sequence. Second, there was a significant difference between the dysarthria and the normal group in DDK regularity. Third, there was a significant difference between dysarthria groups and normal group in DDK MFR. Finally, there was a significant difference between the 4 groups of dysarthria and the normal group in DDK air flow tracking. The results of this study can be guidelines for normal DDK rate, regularity and flow rate in dysarthria groups. In addition, their differential diagnoses and descriptions are important to make a decision on medical and behavioral management of the individuals with disorders according to DDK characteristics.

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파킨슨병 환자의 교대운동속도 과제에서 관찰된 '말 뭉침'의 음향학적 특성 (Acoustic Characteristics of 'Short Rushes of Speech' using Alternate Motion Rates in Patients with Parkinson's Disease)

  • 김선우;윤지혜;이승진
    • 말소리와 음성과학
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    • 제7권2호
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    • pp.55-62
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    • 2015
  • It is widely accepted that Parkinson's disease(PD) is the most common cause of hypokinetic dysarthria, and its characteristics of 'short rushes of speech' have become more evident along with the severity of motor disorders. Speech alternate motion rates (AMRs) are particularly useful for observing not only rate abnormalities but also deviant speech. However, relatively little is known about the characteristics of 'short rushes of speech' in terms of AMRs of PD except for the perceptual characteristics. The purpose of this study was to examine which acoustic features of 'short rushes of speech' in terms of AMRs are a robust indicator of Parkinsonian speech. Numbers of syllabic repetitions (/pə/, /tə/, /kə/) in AMR tasks were analyzed through acoustic methods observing a spectrogram of the Computerized Speech Lab in 9 patients with PD. Acoustically, we found three characteristics of 'short rushes of speech': 1) Vocalized consonants without closure duration(VC) 76.3%; 2) No consonant segmentation(NC) 18.6%; 3) No vowel formant frequency(NV) 5.1%. Based on these results, 'short rushes of speech' may affect the failure to reach and maintain the phonatory targets. In order to best achieve the therapeutic goals, and to make the treatment most efficacious, it is important to incorporate training methods which are based on both phonation and articulation.

마비성조음장애, 편도 비대, 비폐쇄 및 구개열 환자의 실험 임상 음성학적 연구 (An Experimental Clinical Phonetic Study on Patients of Dysarthria, Tonsilhypertrophy, Nasal Obstruction, and Cleft Palate)

  • 김현기;고도홍;신효근;홍기환;서정환
    • 음성과학
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    • 제2권
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    • pp.67-88
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    • 1997
  • The aim of this study is to develop an assessment program of speech rehabilitation for children having some language and speech disorders. Patients of dysarthria, tonsillectomy, tonsilhypertrophy, and nasal obstruction were selected for this experimental clinical phonetic study. Formant variations ($F_1\;&\;F_2$) show pre- and post-operation differences in tonsillectomy and cleft palate patients. Nasal formants ($NF_1\;&\;NF_2$) show pre- and post-operation differences in nasal obstruction. The articulation reaction time (ART) as a parameter was used to assess Voice Onset Time(VOT). It was shown longer duration for hypokinetic dysarthria and shorter for atoxic dysarthria.. The diadochokinetic rate was measured by Visi-pitch. Lower diadochokinetic rate appeared to spastic and dysarthria in comparison with the control group. It was shown that the nasalance of tonsilhypertrophy, nasal obstruction, and cleft palate patients was seen to increase after operation. In addition, the assessment of nasality can be measured only by simple vowels such as /a/ and /i/.

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다계통위축증 환자를 대상으로 한 마비말장애 집중 치료의 효과 (Efficacy of intensive treatment of dysarthria for people with multiple system atrophy)

  • 박영미
    • 말소리와 음성과학
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    • 제10권4호
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    • pp.163-171
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    • 2018
  • A mixed dysarthria with combinations of hypokinetic, ataxic, and spastic components is a common clinical feature of multiple system atrophy (MSA). Due to the rapid progress of dysarthria after diagnosis, people with MSA experience difficulty with verbal communication, which eventually affects their quality of life negatively. In this study, SPEAK $OUT!^{(R)}$, an intensive 1:1 treatment of dysarthria for improving functional communicative ability, was provided to twelve people with MSA. To evaluate the efficacy of SPEAK $OUT!^{(R)}$ in people with MSA, aerodynamic, acoustic, and perceptual analyses were conducted. Pre-and post-therapy data included maximum phonation time, vocal intensity, and fundamental frequency during /a/ sustained phonation and passage reading; frequency range between high /a/ and low /a/ phonation; jitter, shimmer, and HNR for vocal quality; speech rate during passage reading; and perceptual evaluation scores for articulation precision and intonation. The participants achieved statistically significant improvement in vocal intensity, pitch range, vocal quality, speech rate, and speech intelligibility. In conclusion, SPEAK $OUT!^{(R)}$ is a feasible treatment for people with MSA to efficaciously improve their speech ability.

특발성 파킨슨병의 시상밑부핵 심부뇌자극술 관련 말 평가 과제에 대한 문헌연구 (Speech Evaluation Tasks Related to Subthalamic Nucleus Deep Brain Stimulation in Idiopathic Parkinson's Disease: A Review)

  • 김선우;김향희
    • 재활복지
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    • 제18권4호
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    • pp.237-255
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    • 2014
  • 특발성 파킨슨병(idiopathic Parkinson disease, IPD)은 알 수 없는 원인으로 인해 중뇌의 흑질신경세포가 손실되는 대표적인 퇴행성 신경계 질환이다. IPD 환자는 신체 운동 이상을 주로 호소하지만 이들 중 70~90%가 운동저하형 마비말장애(hypokinetic dysarthria)를 동반하는 것으로 알려져 있다. 진행된 심도의 IPD 환자의 운동 증상 호전에 가장 효과적인 치료 방법으로 알려진 시상밑부핵 심부뇌자극술(subthalamic nucleus deep brain stimulation, STN-DBS)은 말 산출에서는 그 효과가 일관되지 않게 보고된다. 이에 본 연구에서는 STN-DBS가 말 산출에 미치는 영향을 살펴보고, 연구에서 어떠한 말 평가 과제가 사용되었는지를 조사하기 위하여 medline을 통해 2012까지 이루어진 연구 논문을 수집하였다. 총 32편 중, 연구대상자들에서 술 후 말 상태의'호전'이 관찰된 논문은 42%,'악화'는 29%,'엇갈리는 결과'는 26%,'변화 없음'은 3%로 확인되었다. 말 효과 간에는 문맥발화(contextual speech)가 연구에 사용된 비중이 높을수록 술 후 말 상태는 부정적인 결과로 보고되었으며, 말 산출 단계 중 일부 단계(예: 호흡 및 발성만, 혹은 조음만)만이 반영된 평가 과제가 연구마다 선택적으로 사용되었음을 확인하였다. 이에 본 연구는 STN-DBS를 받은 IPD 환자의 말 평가는 말 산출 하부 단계를 모두 반영하는 문맥발화 과제를 통일적으로 사용할 것을 제안한다.

De novo 특발성 파킨슨병 환자의 문단 읽기 과제에서의 호흡 특성 (Characteristics of Speech Breathing in de novo Idiopathic Parkinson's Disease during Passage Reading Tasks)

  • 김병미;손영호;백승재;이필휴;남정모;이지은;최예린
    • 말소리와 음성과학
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    • 제3권1호
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    • pp.103-110
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    • 2011
  • Idiopathic Parkinson's Disease patients' speech is hypokinetic dysarthria and their speech is possibly the consequence of impaired respiratory support. The purpose of this study was focused on the respiratory characteristics of speech breathing in de novo IPD who were not given prior vocal or anti-Parkinson treatment. A total of 40 subjects participated in the study: 20 de novo IPD patients between the ages of 50 and 80, and 20 normal subjects with similar age, height, and weight matches. Forced Expiratory Vital Capacity (FVC), Forced Expiratory Volume in 1 sec (FEV1) and $FEV_1$ as a percentage of FVC (FEV1/FVC) was measured with a PC-based spirometer (Cosmed). In addition, Maximum Phonation Time (MPT), Mean Airflow Rate (MFR), Subglottal Pressure (Psub) and the number of syllables produced per breath were measured with a Phonatory Aerodynamic System (Kay PENTAX). All subjects were asked to read a standardized Korean paragraph and the following measurements were obtained from the task. Results indicated no statistically significant differences in respiratory function (FEV1/FVC%) and aerodynamic function between the two groups, but the number of syllables per breath was significantly lower in the IPD patient group than in the normal group and it could be predicted by FVC and MFR. Therefore, the study shows that the MFR from the lungs during speech in de novo IPD patients is used inefficiently.

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파킨슨병 환자의 말 속도와 쉼 특성 (Speech Rate and Pause Characteristics in Patients with Parkinson's Disease)

  • 고열매;김덕용;최예린;김향희
    • 말소리와 음성과학
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    • 제2권4호
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    • pp.173-184
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    • 2010
  • The purpose of this study is to investigate the speech rate characteristics (whole speech rate, articulation speech rate, and articulation percentage) and the pause characteristics (pause duration, pause frequency, and pause percentage) of Korean-speaking patients with idiopathic Parkinson's disease (referred to as IPD hereafter). The study aims first to examine the differences between the patient group with IPD and the other group without IPD concerning those measurements, and secondly to investigate the relevant measurements of the two groups following the sentence length changes. There were two groups of subjects in this study. The first group consisted of 7 subjects between the ages of 50 and 60 who were diagnosed as IPD with mild severity, and the second group consisted of 13 subjects without IPD who matched the age and gender of those in the first group. Those two groups were asked to read 8 different sentences in length at habitual speed. Speech rate and pause characteristics of the two groups were measured and compared each other. The followings results were observed. First, in a study of speech rate characteristics, the whole speech rate and the articulation speech rate of the patient group scored within the normal range, which is same as the group without IPD. On the other hand, with regard to the pause characteristics, differences between two groups were shown; the patient group had shorter pause duration, lower pause frequency, lower pause percentage, and higher articulation percentage. Secondly, in a study of relevant measurements following the sentence length, both groups showed a tendency for whole speech rate and articulation rate to increase as the length of the sentence increased, but the result of pause characteristics showed a difference between two groups. While the group without IPD showed a longer pause duration, higher pause frequency, and higher pause percentage as the length of sentences increases, no differences were shown among the patient group concerning the length of sentences. This study suggests a result that the patients with IPD of mild severity retained a normal speech rate and examined pause characteristics of the patient group which showed a different result from the group without IPD in terms of quality. Future studies on the speech rate and pause characteristics of Korean-speaking patients with IPD in various severities.

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