文章摘要
郝世杰,庄贺,刘西花,卫晨,王丽敏,邹建鹏.综合呼吸训练对脑卒中患者运动性构音障碍的影响[J].中国康复,2022,37(5):263-266
综合呼吸训练对脑卒中患者运动性构音障碍的影响
Effect of comprehensive respiratory training on motor dysarthria in stroke patients
  
DOI:
中文关键词: 呼吸控制  缩唇-腹式呼吸  阈值压力负荷吸气肌训练  脑卒中  运动性构音障碍
英文关键词: respiratory control  lip contraction-abdominal breathing  threshold training of inspiratory muscle  stroke  motor dysarthria
基金项目:国家自然青年科学基金项目(81802239);山东省中医药科技项目(2021Q081)
作者单位
郝世杰 山东中医药大学济南 250355 
庄贺 山东中医药大学济南 250355 
刘西花 山东中医药大学附属医院济南 250014 
卫晨 山东中医药大学附属医院济南 250014 
王丽敏 山东中医药大学济南 250355 
邹建鹏 山东中医药大学附属医院济南 250014 
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中文摘要:
  目的:探讨综合呼吸训练对脑卒中患者运动性构音障碍的影响。方法:将纳入的58例伴有运动性构音障碍的脑卒中患者随机分为观察组(30例)和对照组(28例)。对照组采取基础构音训练,观察组在此基础上进行综合呼吸训练,包括呼吸控制训练、缩唇-腹式呼吸训练和阈值压力负荷吸气肌训练,2组患者均训练6周。训练前后分别采用Frenchay构音障碍评定(FDA)、最长声时(MPT)测定、最大数数能力(MCA)测定和肺功能测试对2组患者进行疗效评定。结果: 训练6周后,观察组患者的FDA评分(8个项目)较训练前均显著降低(P<0.01),对照组中除呼吸项目其余7个项目评分较训练前也均显著降低(P<0.01),且观察组FDA评分中呼吸、唇的运动、软腭运动、喉的运动、舌的运动和言语6个项目评分显著低于对照组(P<0.01, 0.05);2组患者MPT和MCA值较训练前均有显著升高(P<0.01),且观察组MPT和MCA值与对照组相比有显著升高(P<0.01)。治疗后,观察组FVC、PEF和MIP值较治疗前及对照组治疗后均显著升高(P<0.01),对照组仅FVC值较治疗前明显升高(P<0.05)。结论:综合呼吸训练可以改善脑卒中患者运动性构音障碍,改善言语与呼吸的协调性。
英文摘要:
  Objective: To discuss the effect of comprehensive respiratory training on motor dysarthria in stroke patients. Methods: All 58 stroke patients with motor dysarthria were randomly divided into test group (30 cases) and control group (28 cases). The control group received basic articulation training, and the test group received comprehensive respiratory training on this basis, including respiratory control training, lip contraction-abdominal breathing training and threshold training of inspiratory muscle. Both groups were trained for 6 weeks. Before and after training, the curative effects of the two groups were evaluated by Frenchay dysarthria assessment (FDA), Maximum Phonation Time (MPT), Maximum counting ability (MCA) and pulmonary function test. Results: After 6 weeks of training, the FDA scores (8 items) in the test group were significantly reduced (P<0.01) and the FDA scores (except for respiratory items) in the control group were also significantly declined (P<0.01) as compared with those before training; the FDA scores of breath, lip movement, soft palate movement, throat movement, tongue movement and speech in test group were significantly lower than those in the control group (P<0.01 or 0.05). After 6 weeks of training, the values of MPT and MCA in the two groups were significantly higher than those before training (P<0.01), and the values of MPT and MCA in the test group were significantly different from those in the control group (P<0.01). As compared with those before training and after traning in the control group, the values of FVC, PEF and MIP in the test group were significantly increased (P<0.01), and only the FVC value in the control group was significantly increased (P<0.05). Conclusion: Comprehensive respiratory training can improve motor dysarthria and the coordination of speech and respiration in stroke patients.
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