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Objective:To analyze the factors related to rehabilitation outcome of dysphagia for patients with cricopharyngeal dysfunction. Methods:From October, 2017 to December, 2020, 16 inpatients with cricopharyngeal dysfunction in Beijing Bo'ai Hospital accepted swallowing training and balloon dilatation. They also finished Shaker exercise out of treatment rooms, and the compliance was recorded. They were assessed with Ichiro Fujishima's Ingestion-Swallowing Function Rating Scale, and divided into effective and ineffective groups according to the result of assessment. The factors such as ages, education levels, courses of disease, time of treatment, compliance, balloon dilation modes, balloon dilation times and maximum water capacity of the balloon were recorded. Results:The score of swallowing improved after treatment (Z = -3.550, P < 0.001). There were significant differences between groups in age (Z = 0.833, P = 0.031) and compliance (P = 0.003). Age negatively correlated with effect (r = -0.533, P = 0.033), and compliance positively correlated (r = 0.856, P < 0.001). Conclusion:Age and compliance to rehabilitation relate to the outcome of dysphagia for patients with cricopharyngeal dysfunction. It is more effective in patients with good compliance and younger age.
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Objective:To study the influence of age-related functional hearing loss on memory ability. Methods:From January to October, 2018, 30 patients aged 52 to 76 years visiting otolaryngology were screened hearing using a computer aided platform, and then were divided into two groups according to the results. Those with good speech recognition in noise (SIN < -2.63 dB) were in L group (n = 15) and those with poor speech recognition in noise (SIN > -2.63 db) were in H group (n = 15). They were assessed with Paired Associates Learning (PAL) and Spatial Working Memory (SWM) of Cambridge Neuropsychological Test Automated Battery in loading of four, six and eight models. Results:The amount of errors of both PAL and SWM increased with the loading in both groups (χ2 > 28.182, P < 0.001). The amount of errors of PAL was less in L group than in H group under any loading (U < 53.5, P < 0.05), while the amount of errors of SWM only less under loading of six models (U = 55.0, P < 0.05). There was no significant interaction between hearing and loading (F < 1.680, P > 0.05). Conclusion:Age-related functional hearing loss tend to impair episodic memory rather than working memory, whatever the impacts of memory load.
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Objective:To observe the effect of oral reading training on acquired alexia after stroke. Methods:From September, 2018 to August, 2019, 41 stroke patients with alexia were randomly divided into control group (n = 20) and experimental group (n = 21). Both groups accepted Schuell stimulation approach, while the experimental group accepted oral reading training in addition, for four weeks. They were assessed with Western Aphasia Battery (WAB) before and after treatment. Results:Aphasia quotient (AQ) increased in both groups after treatment, as well as reading score and oral reading accuracy. The Cohen's d coefficients of all the indexes were more in the experimental group (0.45, 0.68, 0.85) than in the control group (0.29, 0.39, 0.51). There was not significant correlation between the subjective scores of the therapists and the indexes improvement (P > 0.05). Conclusions:Oral reading training may improve the reading ability in stroke patients with alexia. There is no clear correlation between the subjective and objective scores for alexia.
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Objective:To observe the effect of melodic intonation therapy combined with speech training on nonfluent aphasia after stroke, and the changes of brain function. Methods:From March, 2017 to August, 2019, 40 patients with nonfluent aphasia after stroke were randomly divided into control group (n = 20) and intensive group (n = 20). Both groups accepted routine speech training, and the intensive group accepted melodic intonation therapy in addition. They were assessed with China Rehabilitation Research Center Chinese Standard Aphasia Examination before and four weeks after treatment. Three patients from each group were examined with resting-state functional magnetic resonance imaging to observe the changes of regional homogeneity (ReHo) of cerebral hemisphere. Results:The scores of comprehension (noun, verb and sentence), repetition (noun and verb), read (noun) and naming (verb) increased in the control group (t > 2.221, P < 0.05), while it increased in comprehension (noun, verb and sentence), repetition (noun, verb and sentence), reading (noun and verb) and naming (noun and verb) in the intensive group (t > 2.179, P < 0.05). The scores of repetition (noun and verb) increased more in the intensive group than in the control group (t > 2.299, P < 0.05)， and the scores of reading (sentence) increased somehow. The ReHo in left cerebellum and temporal occipital area increased and the ReHo in bilateral frontal and temporal cortex decreased after treatment. Conclusion:Melodic intonation therapy based on speech therapy can promote the recovery of speech function for patients with nonfluent aphasia after stroke, especially in sentence reading and words repetition. The changes of the ReHo in resting state may associate with the neurological repairment after brain injury.
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Objective:To explore the relationship between age-related hearing loss, cognitive level and speech perception in noise in Putonghua. Methods:From January to October 2018, 31 outpatients who visited the department of otolaryngology (aged 52-75) were divided into hearing normal (HN) group and hearing loss (HL) group according to the results of the average threshold measured with pure-tone audiometry. They were assessed with the computer-aided Chinese Speech Test Platform and the Cambridge Neuropsychological Test Automated Battery, which respectively evaluated the speech perception ability in noise, and the episodic memory, working memory and executive ability under non-verbal stimulation. Results:There were significant differences in speech perception ability, episodic memory and executive ability between the two groups (U < 68, P < 0.05). The hearing level correlated to the speech perception in noise, whatever the speech and noise were separated, as well as the episodic memory, working memory and executive ability (r > 0.360, P < 0.05). The more difficult the speech perception task was, the more significant the correlation between signal-noise ratio and cognitive ability was. Conclusion:Under the condition of Putonghua, age-related hearing loss is one of the main reasons for the decline of speech perception in noise in the old adults. Hearing loss leads to the decline of episodic memory and executive ability, which in turn affects speech perception in noise. The more difficulty it is to recognize speech in noise, the greater the dependence on cognitive level.
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@#ObjectiveTo explore the characteristics and rehabilitation of dysarthria patients who speak mandarin. Methods18 patients were rehabilitated with physiologic approach for 40 d. Before and after rehabilitation, maximum phonation time (MPT), frequency, tone and expiratory rate were tested with phonolaryngeal graph, while forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR) were tested with Microspiro; Articulation and intelligibility were tested with mandarin words table and rate of sentence and paragraph. ResultsCompared with that before intervention, MPT of the patients were longer after intervention (P<0.05). The FVC was lower than normal rate before intervention and it was remarkable higher after intervention(P<0.01).Correct rate of sentence and paragraph was remarkable higher(P<0.01). ConclusionTests of Phono-laryngograph, Microspiro and correct rate of sentence are good comprehensive evaluation methods to speech and phonation of dysarthria. Physiologic approach to rehabilitation can remarkably improve patient's communication ability.
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@#ObjectiveTo explore the characteristics and rehabilitation of dysarthria patients who speak mandarin. Methods18 patients were rehabilitated with physiologic approach for 40 d. Before and after rehabilitation, maximum phonation time (MPT), frequency, tone and expiratory rate were tested with phonolaryngeal graph, while forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR) were tested with Microspiro; Articulation and intelligibility were tested with mandarin words table and rate of sentence and paragraph. ResultsCompared with that before intervention, MPT of the patients were longer after intervention (P<0.05). The FVC was lower than normal rate before intervention and it was remarkable higher after intervention(P<0.01).Correct rate of sentence and paragraph was remarkable higher(P<0.01). ConclusionTests of Phono-laryngograph, Microspiro and correct rate of sentence are good comprehensive evaluation methods to speech and phonation of dysarthria. Physiologic approach to rehabilitation can remarkably improve patient's communication ability.