Relationship between Vowel Production and Speech Clarity in Post-stroke Dysarthria Patients / 中国康复理论与实践

Objective:To explore the characteristics of vowel production of dysarthria after stroke, and the relationship between vowel production and speech clarity. Methods:From October, 2019 to January, 2020, 19 patients with post-stroke dysarthria and 18 healthy controls were asked to read a short essay to extract vowels, and measured the jaw distance, tongue distance, F2i/F2u, vowel space area (VSA), vowel articulation index (VAI), F1 and F2 variability, and speech clarity. The correlation between vowel production and speech clarity were analyzed. Results:Tongue distance, F2i/F2u, VSA, VAI, and speech clarity were less in the patients than in the controls (|t| > 2.268, P < 0.05), while F2 variability was more (t = 2.375, P < 0.05). F2i/F2u (r = 0.465), VAI (r = 0.488) and F2 variability (r = -0.504) were correlated to speech clarity (P < 0.05). Conclusion:The vowel production impaired in patients with post-stroke dysarthria, featured as abnormal articulatory movements, concentration of vowels and poor stability of vowels, which impacts the speech clarity.

Research on Rehabilitation Guidelines Using World Health Organization Family International Classifications Framework and Approaches / 中国康复理论与实践

@#Objective To use World Health Organization Family International Classifications (WHO-FICs) to explore the framework and approaches of development and research of guidelines of rehabilitation at levels of policies, community and services.Methods The important documents and tools of rehabilitation at international level, including United Nations Convention on the Rights of Persons with Disabilities, WHO World Report on Disability, Community-based Rehabilitation Guideline, Rehabilitation in Health Service System, and International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHI) of WHO-FICs, had been discussed.Results The framework, classifications, diagnosis and description of diseases and functioning, coding, intervention and functioning evaluation based on ICD-11, ICF and ICHI-β-2 had been established for development and implementation of rehabilitation guidelines and Cochrane rehabilitation.Conclusion The framework and systematic approaches of ontology, classification, terminology, coding, diagnosis and description of diseases and functioning, interventions and evaluations for the development and implementation of rehabilitation guidelines had been developed.

Construction of System of Diagnosis, Assessment and Rehabilitation Interventions for Impairment of Speech and Voice Function Using WHO Family International Classificiations / 中国康复理论与实践

Results and Conclusion:Voice disorders are classified to Voice Disturbance (MA82), within the category of Symptoms or Signs Involving Speech or Voice. Voice disorders may be symptoms or signs of Speech Disturbance (MA80), Malignant Neoplasms of Larynx (2C23), Intracerebral Haemorrhage (8B00), Oedema of Larynx (CA0H.3), and the others. Voice disorder is impairment at body function, and influence activity and participation (d3, d7, d8 and d9), which may involve in environmental and personal factors. The evaluation of voice function involes in production of voice (b3100) and quality of voice (b3101). A structured rehabilitation solution has been developed with the interventions at body structure, body function, activities and participation, environmental factors and personal factors, including assessment (assessment, test, observation), training and treatment (training, assisting), educational counseling (education, advicing, counseling), and support (psychological and social). Objective:To explore diagnosis and assessment of voice function and develop a framework of rehabilitation for it based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHI). Methods:The diagnostic criteria of voice disorders and its complications were discussed with ICD-11 and ICF. The tools of assessment were analysed with ICF. A comprehensive intervention system was developed for the rehabilitation of voice function based on the joint use of ICF and ICHI.

Framework and Approach of Diagnosis and Rehabilitation Intervention for Children with Communication Disorders Using WHO Family International Classifications / 中国康复理论与实践

Results and Conclusion:The core diagnostical terms of communication disorder for children include Primary Pragmatic Language Impairment of Developmental Language Disorder, Communication, Communicating-Receiving, and Communicating-Production, etc. Communication disorder is a typical disorder of limited social interaction and a typical manifestation of developmental retardation for children, named Developmental Language Disorder Main Companion Pragmatic Language Impairment (6A01.22), subclass of Developmental Language Disorder (6A01). Communication disorders involve in speech-related body structures and functions, activity and participation, environmental factors and personal factors; such as communication (d3), including communicating-receiving (d310-d329), communicating-production (d330-d349), conversation and use of communication devices and techniques (d350-d369), and health-related behaviors. The structured framework of rehabilitation intervention involves in body function and structure, activity and participation, environmental factors and personal factors; includes assessment, training and treatment, educational counseling, and psychological and social support. Objective:To explore the definition and core terminology of communication disorders for children, establish the diagnostic criteria and functional assessment criteria of communication disorder, and develop a holistic rehabilitation solution for it based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (Children and Youth version) (ICF-CY) and International Classification of Health Interventions (ICHI). Methods:Core definition and terminology of communication disorder were analysed with ICD-11, American Speech-Language-Hearing Association (ASHA) and Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V). The diagnostical criteria of communication disorders for children were analyzed using the ICD-11. The functioning diagnostical criteria of communication disorders for children were explored using ICF-CY. A holistic rehabilitation solution was developed based on ICF-CY and ICHI.

Suprapubic puncture: preferable to transurethral catheterization for pressure-flow determination in BPH patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare suprapubic puncture and transurethral catheterization for pressure-flow determination during voiding in BPH patients.</p><p><b>METHODS</b>Both suprapubic puncture and transurethral catheterization were used for pressure-flow determinations during voiding in 23 BPH patients at the mean age of 69.3 years (range 57-77 years) and the related parameters were compared by t-test.</p><p><b>RESULTS</b>Compared with transurethral catheterization, suprapubic puncture increased Qmax by 1.19 mn/s (P <0.05) and MMC by 66.61 ml (P <0.01) , and reduced the pressure of detrusor at Qmax (Pdet, Qmax) by 10.57 cmH2O (P < 0.05), URA by 11.39 cmH2O (P < 0.01) and AG by 12.94 (P < 0.01). Either according to the Schäfer diagram or with AG > 40 as the diagnostic standard, there were 16 (69.6%) cases of bladder outlet obstruction (BOO) in the suprapubic puncture group and 20 (87.0%) in the transurethral catheterization group.</p><p><b>CONCLUSION</b>In pressure-flow determination during voiding, suprapubic puncture and transurethral catheterization each have its own advantages and disadvantages, but the former is preferred for BPH patients. As for other patients, it all depends on specific conditions.</p>

Effects of transurethral catheterization on uroflow rate in the pressure-flow study of patients with benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of transurethral catheterization on the uroflow rate in the pressure-flow study of patients with benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Thirty-nine men with BPH underwent free uroflowmetry and pressure-flow analysis respectively. With an 8 F urethral catheter, the standard pressure-flow variables such as the maximum flow rate, detrusor pressure at the maximum flow rate and so on were recorded. The free maximum flow rate and the maximum flow rate with transurethral catheterization were statistically analyzed.</p><p><b>RESULTS</b>The maximum voided volumes of the free uroflowmetry group and the pressure-flow study group were (209.23 +/- 56. 56) ml and (210.33 +/- 62.02) ml respectively (P > 0.05). The free maximum flow rate was (8.61 +/- 2.80) ml/s, and the maximum flow rate with transurethral catheterization-was (7.39 +/- 3.01) ml/s (P < 0.05). When the patients were divided into seven grades of bladder outlet obstruction (BOO) according to the Schäfer nomogram, the free maximum flow rate and the maximum flow rate with transurethral catheterization with Grade 0-I of BOO were (12.56 +/- 1.57) ml/s and (10.95 +/- 2.51) ml/s, and those of Grade II were (9.35 +/- 0.76) ml/s and (8.41 +/- 1.23) ml/s respectively. For Grades III, IV and V-VI , the two maximum flow rates were (7.88 +/- 1.21) ml/s and (6.37 +/- 0.59) ml/s, (6.54 +/- 1.93) ml/s and (5.55 +/- 2.48) ml/s, and (6.01 +/- 2.10) ml/s and (4.84 +/- 2.89) ml/s, respectively, all with significant difference in between (P < 0.05).</p><p><b>CONCLUSION</b>The 8 F urethral catheter has a significant effect on the maximum uroflow rate in the pressure-flow study and this effect is correlated with the grade of BOO.</p>