言语表象疗法改善脑瘫患儿构音障碍的效果

Effect of speech imagery therapy on dysarthria in children with cerebral palsy

目的探讨言语表象疗法结合传统构音训练改善脑瘫患儿构音障碍的疗效。方法2022年8月至12月,选取芜湖市第五人民医院并发构音障碍的脑瘫患儿21例,随机分为A、B、C 3组,每组各7例。A组给予传统构音训练,每次30 min;B组给予植入型言语表象结合传统构音训练,每次40 min;C组给予附加型言语表象结合传统构音训练,每次40 min。每周5 d,共3周。训练前后采用构音功能评估量表、口部感觉-运动评估表以及声学指标下颌距、舌距、元音空间面积(VSA)进行评价。结果治疗前,3组各项指标比较均无显著性差异(F<1.247,P>0.05)。治疗后,3组构音功能评估量表评分、口部感觉-运动评估表评分均提高(|t|>2.575,P<0.05);A组、B组下颌距、VSA均较治疗前提高(|t|>2.632,P<0.05)。B组、C组构音功能评分差值高于A组(P<0.05),其他指标治疗前后差值组间均无显著性差异(P>0.05)。结论两种言语表象疗法均可改善脑瘫患儿构音清晰度、口部运动范围和运动控制能力,在改善构音清晰度方面的效果优于传统构音训练。

Objective To investigate the effect of speech imagery therapy combined with traditional dysarthria training on dysarthria in children with cerebral palsy.Methods From August to December,2022,21 children with cerebral palsy combined with dysarthria in Wuhu Fifth People's Hospital were randomly divided into three groups A,B and C.Group A was given traditional dysarthria training for 30 minutes everytime,group B was given implantable speech imagery combined with traditional dysarthria training for 40 minutes everytime,and group C was given additional speech imagery combined with traditional dysarthria training for 40 minutes everytime,five days a week,for three weeks.Articulation and Phonology Assessment Scale,Mouth Sensory-Motor Assessment Scale,and mandibular distance,tongue distance and vowel space area(VSA)were evaluated before and after treatment.Results There was no significant difference in all the indexes among three groups before treatment(F<1.247,P>0.05).After treatment,the scores of phonological function and sensory-motor assessment scale increased(|t|>2.575,P<0.05),and the mandibular distance and VSA increased in groups A and B(|t|>2.632,P<0.05).The d-value of phonological function before and after treatment was more in groups B and C than in group A(P<0.05),and no difference was found in the d-value of other indexes before and after treatment among three groups(P>0.05).Conclusion Both speech imagery therapies are effective in improving diction clarity,oral range of motion,and motion control ability in children with cerebral palsy,and are more effective in improving articulatory clarity than traditional speech-language training.