• Archives of Plastic Surgery
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• v.39 no.1
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• pp.25-30
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• 2012

Background : The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. Methods : Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. Results : Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. Conclusions : The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.55 no.8
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• pp.498-507
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• 2012

Background and Objectives We aimed to develop a Korean version of the velopharyngeal insufficiency (VPI) speech corpus system. Subjects and Method After developing a 3-channel simultaneous speech recording device capable of recording nasal/oral and normal compound speech separately, voice data were collected from VPI patients aged more than 10 years with/without the history of operation or prior speech therapy. This was compared to a control group for which VPI was simulated by using a french-3 nelaton tube inserted via both nostril through nasopharynx and pulling the soft palate anteriorly in varying degrees. The study consisted of three transcriptors: a speech therapist transcribed the voice file into text, a second transcriptor graded speech intelligibility and severity and the third tagged the types and onset times of misarticulation. The database were composed of three main tables regarding (1) speaker's demographics, (2) condition of the recording system and (3) transcripts. All of these were interfaced with the Praat voice analysis program, which enables the user to extract exact transcribed phrases for analysis. Results In the simulated VPI group, the higher the severity of VPI, the higher the nasalance score was obtained. In addition, we could verify the vocal energy that characterizes hypernasality and compensation in nasal/oral and compound sounds spoken by VPI patients as opposed to that characgerizes the normal control group. Conclusion With the Korean version of VPI speech corpus system, patients' common difficulties and speech tendencies in articulation can be objectively evaluated. Comparing these data with those of the normal voice, mispronunciation and dysarticulation of patients with VPI can be corrected.

• The Journal of Korean Physical Therapy
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• v.12 no.3
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• pp.293-310
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• 2000

This study was performed to investigate rehabilitation service patterns of stroke patients in metropolis of Korea. Seoul, Taegu. Taejon, Pusan and Kwangju from April-July. 2000. Authors developed questionnair, and distributed it to each physical therapist. Total number of distributed questionnaire was 800, and 622 questionnaire were collected and analysed. 1. The occurrence rate of ischemic stroke$(51.1\%)$ was higher than hemorrage stroke$(48.9\%)$. The highest incidence of the stroke was noted in the group or60 years and ratio of male to female 1.3:1 2. The several warning sign is motor deficit$(50.3\%)$, headache. dizziness. vomitting$(32.6\%)$ and difficulty speaking or understanding$(8.2\%)$. 3. The most important contributing factor of stroke was hypertension both hemorrage stroke$(50.7\%)$ and ischemic stroke$(47.2\%)$. 4. In the painful stroke patients$(53.4\%)$, the major problems were shoulder pain$(55.1\%)$ and shoulder-hand syndrome$(31.9\%)$. There is no clinical method for relieving the pain. 5. The seasonal preference was winter and autumn followed by summer and spring in regardless of diagnosis. 6. In the surgery, hemorrage stroke$(61.2\%)$ was higher than ischemic stroke$(13.5\%)$. 7. The major associated impairment were motor deficit$(99.0\%)$, hearing and speech deficit$(30.9\%)$.perception deficit$(15.9\%)$. psychological deficit$(14.1\%)$ and vision deficit$(10.6\%)$. We need more role of speech pathologist and psychotherapist. 8. The rehabilitation services for stroke patients were given only $15\%$ by onset. 9. Medical doctor did not checking everyday$(41\%)$. 10. Patents said that the physical therapist well understanding$(60.1\%)$ than medical doctor$(36.2\%)$ about their conditions.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.114-117
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• 1996

In this study, remote articulation training system which connects the hearing disabled trainee and the speech therapist via B-ISDN is introduced. The hearing disabled does not have the hearing feedback of his own pronunciation, and the chance of watching his speech organs' movement trajectory will offer him the self-training of articulation. So the system has two purposes of self articulation training and trainer's on-line checking in remote place. We estimate the vocal tract articulatory movements from the speech signal using inverse modelling and display the movement trajectory on the sideview of human face graphically. The trajectories of trainees' articulation is displayed along with the reference trajectories, so the trainee can control his articulating to make the two trajectories overlapped. For on-line communication and ckecking training record, the system has the function of video conferencing and transferring articulatory data.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.2
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• pp.105-117
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• 2013

Purpose : This study was to investigate the awareness on occupational therapy by the people involved in rehabilitation of persons with disabilities Methods : The survey on the awareness of occupational therapy was conducted on 9 organizations and 111 employees associated with rehabilitation, of which the collected data was calculated in percentage using the results Result : 89.2% answered with "I know the subject of occupational therapy," 66.6% with "I know the meaning of it," 81.1% with "I know the purpose of it," being awared that it has been conducted in medical institutions and other places. However those answers might need more precise information for each occasion. In addition, for the distinction between occupational therapy and other kinds(physical therapy, speech therapy, art therapy, play therapy, music therapy), 40.5% answered with "yes in some degree," but 19% with "no." Regarding the eligibility requirement for occupational therapist, 55% answered with "qualified with a licence." Conclusion : Active promotion will be required more focusing on the subject of occupational therapy, the meaning of occupation, the purpose and working places of occupational therapy, the difference from other therapies, and the qualification of occupational therapist.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.123-131
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• 1999

The purpose of is study deals with the physical therapy and the delivery system of public health center, as a center, in community based rehabilitation and delivery system. We hope that the system of physical therapy of public health center in community based rehabilitation spreads all over the country and contributes to the promotion of national health and social welfare. There are many public health center in the country because it can serve inhabitants with the medical benefits in the Erst line. public health center continuously provides poor inhabitants who cant pay medical expenses care of health. It has the public health center branches that take care of inhabitants who live a remote village and hiterland. Additionally, many people want to receive physical therapy. Therefore, the physical therapy of public health center becomes the central paint in community based rehabilitation so that we supply the inhabitants with superior rehabilitation service. We can approach them as a team that be constituted with physical therapist speech therapist, psychologist, nurse, social work. Also the role of physical therapist is divided into two parts, which are home visiting part that individually takes can of patients nod public health part that takes care of patient, family, home, community. We connect with both self-governing body and the government so that we may receive government subsidies. Also, we must prepare regular school education for community based rehabilitation

• Speech Sciences
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• v.8 no.1
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• pp.135-142
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• 2001

The present study was performed to investigate adequate levels of utterances which can give essential as well as useful information about the patients' voice, by examining the degrees of correlation between the levels of utterances (vowels, words, and phrase paragraph reading) and the entire utterance including all of the levels. For this purpose, a total of 10 individual utterance samples (5 vowels, 3 words, 1 phrase, 1 paragraph reading) were collected from each of the 30 subjects with voice disorder patients, and four experienced voice therapists evaluated them using GRBAS. The results showed that four therapists highly agreed upon on 'G' parameter. The coefficient of the correlation between each level of utterance and entire utterance tended to be above 0.70. Judgements of the vowel /$\varepsilon$/ as well as /o/ highly correlated with the judgement of the entire utterance. Regardless of severity, the judgement of the entire utterance highly correlated with the judgements of the vowel /u/ and the paragraph reading. These results suggest that experienced voice therapists can precisely evaluate patients' voice quality with only one sustained vowel in the clinic field, as is done with the entire utterance evaluation.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.6 no.6
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• pp.923-930
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• 2002

This study aims at developing dialog system to improve the quality of life of the elderly with a dementia. The proposed system mainly consists of three modules including speech recognition, automatic search of the time-sorted dialog database, and agreeable responses with the recorded voices of caregivers. For the first step, the dialog that dementia patients often utter at a nursing home is first investigated. Next, the system is organized to recognize the utterances in order to meet their requests or demands. The system is then responded with recorded voices of professional caregivers. For evaluation of the system, the comparison study was carried out when the system was introduced or not, respectively. The occupational therapists then evaluated a male subjects reaction to the system by photographing his behaviors. The evaluation results showed that the dialog system was more responsive in catering to the needs of dementia patient than professional caregivers. Moreover, the proposed system led the patient to talk more than caregivers did in mutual communication.

• Journal of Biomedical Engineering Research
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• v.23 no.6
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• pp.459-465
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• 2002

The goat of the present research is to improve the quality of life of both the elderly patients with dementia and their caregivers. For this Purpose, we developed a communication aid system that is consisted of three modules such as speech recognition engine, graphical agent. and database classified by a nursing schedule. The system was evaluated in an actual environment of nursing facility by introducing the system to an older mail patient with dementia. The comparison study was then carried out with and without system, respectively. The occupational therapists then evaluated subject"s reaction to the system by photographing his behaviors. The evaluation results revealed that the proposed system was more responsive in catering to needs of subject than professional caregivers. Moreover we could see that the frequency of causing the utterances of subject increased by introducing the system.

• Journal of Korean Physical Therapy Science
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• v.18 no.1
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• pp.33-49
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• 2011

The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.