A Novel Protocol Designed to Treat Spastic Dysarthria Secondary to Traumatic Brain Injury: A Case Study

2021 ◽  
pp. 1-11
Author(s):  
Kristine Galek ◽  
Ed M. Bice ◽  
Katie Allen
Keyword(s):  
Motor Learning ◽  
Range Of Motion ◽  
Speech Intelligibility ◽  
Treatment Protocol ◽  
Exercise Science ◽  
Motor Speech ◽  
Motor Speech Disorder ◽  
The Central Nervous System ◽  
Vocal Quality ◽  
Activation Pathways

Introduction Spastic dysarthria is a motor speech disorder produced by bilateral damage to the activation pathways of the central nervous system. Its speech characteristics reflect the effects of hypertonicity and weakness of the bulbar musculature in a way that slows movement and reduces range of motion and force. Perceptually, speech has a high-pitched, strained, hypernasal vocal quality with decreased intelligibility. Purpose The purpose is to present a case illustration describing the use of a novel treatment protocol to improve speech intelligibility in the presence of spastic dysarthria. Method An underlying framework, including principles of exercise, neuroplasticity, and motor learning with adjunctive biofeedback, is described. The protocol consisted of four sessions per week for 4 weeks with daily homework. Results The participant exhibited improvements in intelligibility, patient satisfaction, lingual, and jaw range of motion, nasality, and tongue strength. Conclusion The use of a novel protocol using biofeedback and incorporating principles of exercise science, neuroplasticity, and motor learning for the treatment of spastic dysarthria demonstrated positive outcomes.

A Description of Phonetic, Acoustic, and Physiological Changes Associated With Improved Intelligibility in a Speaker With Spastic Dysarthria

2001 ◽  
Vol 10 (3) ◽  
pp. 274-290 ◽  
Author(s):  
Nelson Roy ◽  
Herbert A. Leeper ◽  
Michael Blomgren ◽  
Rosalea M. Cameron
Keyword(s):  
Recovery Period ◽  
Motor Speech ◽  
Perceptual Analysis ◽  
Motor Speech Disorder ◽  
Physiological Information ◽  
Close Relationship ◽  
Assessment Techniques ◽  
The Central Nervous System ◽  
Perceptual Assessment ◽  
Activation Pathways

Spastic dysarthria is a motor speech disorder produced by bilateral damage to the direct (pyramidal) and indirect (extrapyramidal) activation pathways of the central nervous system. This case report describes the recovery of an individual with severe spastic dysarthria and illustrates the close relationship between intelligibility measures and acoustic and physiological parameters. Detailed phonetic feature analyses combined with acoustic and physiological information helped to clarify (a) the loci of the intelligibility deficit, (b) the features of deviant speech whose improvement would lead to the greatest gains with treatment, and (c) the changes contributing to improvement in intelligibility observed over a 30-month treatment/recovery period. Though auditory-perceptual analysis remains the foundation of day-to-day dysarthria assessment, this case illustrates the potential for instrumental assessment to (a) supplement perceptual assessment techniques, (b) parse speech subsystem deficits, and (c) track the effects of interventions.

scholarly journals Assessment of Dysphonia in Children with Pompe Disease Using Auditory-Perceptual and Acoustic/Physiologic Methods

2021 ◽  
Vol 10 (16) ◽  
pp. 3617
Author(s):  
Kelly D. Crisp ◽  
Amy T. Neel ◽  
Sathya Amarasekara ◽  
Jill Marcus ◽  
Gretchen Nichting ◽  
...  
Keyword(s):  
Pompe Disease ◽  
Voice Quality ◽  
Motor Speech ◽  
Maximal Volume ◽  
Laryngeal Function ◽  
Vocal Function ◽  
Relative Contribution ◽  
Motor Speech Disorder ◽  
Speech Performance ◽  
Vocal Quality

Bulbar and respiratory weakness occur commonly in children with Pompe disease and frequently lead to dysarthria. However, changes in vocal quality associated with this motor speech disorder are poorly described. The goal of this study was to characterize the vocal function of children with Pompe disease using auditory-perceptual and physiologic/acoustic methods. High-quality voice recordings were collected from 21 children with Pompe disease. The Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale was used to assess voice quality and ratings were compared to physiologic/acoustic measurements collected during sustained phonation tasks, reading of a standard passage, and repetition of a short phrase at maximal volume. Based on ratings of grade, dysphonia was present in 90% of participants and was most commonly rated as mild or moderate in severity. Duration of sustained phonation tasks was reduced and shimmer was increased in comparison to published reference values for children without dysphonia. Specific measures of loudness were found to have statistically significant relationships with perceptual ratings of grade, breathiness, asthenia, and strain. Our data suggest that dysphonia is common in children with Pompe disease and primarily reflects impairments in respiratory and laryngeal function; however, the primary cause of dysphonia remains unclear. Future studies should seek to quantify the relative contribution of deficits in individual speech subsystems on voice quality and motor speech performance more broadly.

scholarly journals A Phonetic Level Analysis of Dysarthria in Kannada Language

2020 ◽  
Vol 9 (1) ◽  
pp. 1235-1241
Keyword(s):  
Speech Intelligibility ◽  
Vocal Tract ◽  
Normal Subjects ◽  
Speech Disorders ◽  
Human Beings ◽  
Formant Frequency ◽  
Motor Speech ◽  
Acoustic Characteristics ◽  
Motor Speech Disorder ◽  
Kannada Language

Dysarthria is a motor speech disorder and the most common neurodegenerative disease characterized by low volume in precise articulation, poor coordination of respiratory and phonatory subsystems, irregular pauses and so on. The challenging factor in improving the communication with dysarthria is speech intelligibility. The intelligilibility of speech can be determined by measuring the acoustic characteristics and phonetic structures of speech. In our analysis, we have concentrated on bisyllabic words in the Kannada language. The analysis is carried out with respect to basic acoustic parameters and spectrogram to extract fundamental frequency, formant frequency, jitter, shimmer, HNR and Standard Deviation using PRAAT tool. These results are helpful to identify and differentiate the complex natural frequency of the vocal tract functions with respect to normal subjects and dysarthria subjects. This study provides inputs to increase efficacy in the clinical assessments for monitoring and diagnosing the speech disorders for improving communication among human beings.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

10-Effects of non-invasive brain stimulation on motor speech disorder in Parkinson’s disease

2018 ◽  
Vol 129 (4) ◽  
pp. e9
Author(s):  
L. Brabenec ◽  
J. Mekyska ◽  
Z. Galáž ◽  
P. Klobušiakova ◽  
M. Koštálová ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Brain Stimulation ◽  
Speech Disorder ◽  
Motor Speech ◽  
Non Invasive ◽  
Motor Speech Disorder

scholarly journals Childhood Apraxia of Speech. Developmental Speech Patterns. A Wide Retrospective Study

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 54-68
Author(s):  
Elad Vashdi ◽  
◽  
Amit Avramov ◽  
Špela Falatov ◽  
Huang Yi-Chen ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Sound Production ◽  
Speech Disorder ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Entry Level ◽  
Motor Speech Disorder ◽  
Speech Patterns

Patterns of a phenomenon define the entity. If one understands the patterns of the maze, he can find his way there. Patterns of colors on a dress will hold its characters and soul. Understanding the expressive patterns of a developmental syndrome enables treating it with success. It is true for treating Childhood Apraxia of speech (CAS) as well. CAS as motor-speech disorder involves difficulties in sounds production for speech purposes. The difficulties can be demonstrated in patterns that would be specific to CAS. These patterns can distinguish one phenomenon from another. A retrospective research was conducted based on 277 entry level evaluations of children diagnosed with CAS or suspected of CAS who visited a private clinic between 2006 and 2013. The analysis included speech variables alongside background and environmental variables. This article is dealing with speech patterns of children with motor speech disorder. Among the patterns examined are vowels ladder, single syllable ladder, Blowing and SSP (single sound production), Oral motor and SSP, Consonant group ladder and Consonants Exploratory factor analysis. The findings demonstrated the relationship and order of vowels, consonants and single syllables among Hebrew speaking children diagnosed with motor speech disorder. The Consonants Exploratory factor analysis gave validity to the existence of unique consonant groups. Further discussion regarding every result and its implication is included. Understanding the unique patterns of consonants and vowels strength among children with CAS can help clinicians in the decision-making process and goals targeting.

scholarly journals Effect of Medicinal Cannabis Therapy (Mct) On Severity of Chronic Low Back Pain, Sciatica and Lumbar Range of Motion

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Chronic Low Back Pain ◽  
Sagittal Plane ◽  
Treatment Protocol ◽  
Adjunctive Treatment ◽  
Low Back ◽  
Patient Reported ◽  
Medicinal Cannabis

Background: Anecdotal evidence indicates the possible efficacy of cannabis use as an adjunctive treatment in chronic low back pain. The purpose of the current study was to assess the results of treatment of patients suffering from chronic low back pain by medicinal cannabis (MCT). Methods: A cohort of 46 patients was followed for a minimum of twelve months. They were evaluated at baseline prior to MCT, 3 months later when MCT was begun and up to 12 months of MCT by patient reported outcome questionnaire (SF-12), visual analogue scale (VAS) and the Brief Pain Inventory (BPI), back specific function was assessed using the Oswestry score, range of motion was measured using the Saunders digital inclinometer. Opiate use was assessed using pharmacy dispensation records at baseline and after 12 months of MCT. Inclusion criteria included: age over 25 years, sciatica with documented treatment for at least 12 months, evidence on CT or MRI scan of disc herniation or spinal stenosis, failure of at least two narcotic drugs, and consent to use medicinal cannabis. Exclusion criteria included evidence of bone cancer, evidence of diabetic neuropathy, and evidence of prior psychotic reactions. Treatment protocol: Cannabis usage was at a fixed dosage of 20 grams per month, dose increase was considered at least after 6 months of treatment. The cannabis was smoked at a recommended rate of 4 dosages per day. Results: After 12 months of MCT BPI VAS decreased from 8.4 ± 1.4 to 2.0 ± 2.0; SF12-PCS improved from 47 ± 14 to 55 ± 12; SF12-MCS improved from 44 ± 6 to 50 ± 10; and sagittal plane active range of motion improved from 34º ± 8º degrees to 48º ± 8º, In conclusion, short term usage of smoked medicinal cannabis appear to improve both physical and mental function while decreasing pain levels of chronic low back pain sufferers.

scholarly journals Embryonal rhabdomyosarcoma with distant spinal cord metastasis: case and MR-imaging

2020 ◽  
Vol 19 (4) ◽  
pp. 158-164
Author(s):  
N. A. Strumila ◽  
A. S. Krasnov ◽  
M. M. Andrianov ◽  
G. V. Teresсhenko
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Treatment Protocol ◽  
Soft Tissue Sarcomas ◽  
Distant Metastases ◽  
Good Prognosis ◽  
Embryonal Rhabdomyosarcoma ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Embryonal rhabdomyosarcoma (eRMS) is one of the most common soft tissue sarcomas in children, accounting for 4.5% of all childhood tumors. Half of the eRMS occuring in the head and neck are parameningeal. About 40% of patients with eRMS can develop distant metastases. In patients with intracranial tumors, metastatic spread can occur along the central nervous system (CNS) meninges. The literature describes only 4 clinical cases of eRMS with distant metastases in the spinal cord and along the meninges. Only in two out of these four cases, CSF cytology was positive (meaning that tumor cells were detected in cerebrospinal fluid). Magnetic resonance imaging (MRI) of the central nervous system with contrast enhancement can be used to detect distant metastases in the CNS and meninges. We present a clinical case of a 4-year old girl with parameningeal eRMS. MRI of the CNS performed as part of a diagnostic check-up revealed nodal metastatic foci along the meninges of the spinal cord. In accordance with the treatment protocol, the patient was diagnosed with stage 4 disease and received intensive polychemotherapy resulting in the disappearance of the nodal lesions in the spinal cord and a good prognosis. The parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

scholarly journals Estimation of Phoneme-Specific HMM Topologies for the Automatic Recognition of Dysarthric Speech

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Santiago-Omar Caballero-Morales
Keyword(s):  
Neurological Diseases ◽  
Gaussian Mixture ◽  
Motor Speech ◽  
Motor Speech Disorder ◽  
Acoustic Modelling ◽  
Speech Database ◽  
Recognition Systems ◽  
Dysarthric Speech ◽  
Different Levels

Dysarthria is a frequently occurring motor speech disorder which can be caused by neurological trauma, cerebral palsy, or degenerative neurological diseases. Because dysarthria affects phonation, articulation, and prosody, spoken communication of dysarthric speakers gets seriously restricted, affecting their quality of life and confidence. Assistive technology has led to the development of speech applications to improve the spoken communication of dysarthric speakers. In this field, this paper presents an approach to improve the accuracy of HMM-based speech recognition systems. Because phonatory dysfunction is a main characteristic of dysarthric speech, the phonemes of a dysarthric speaker are affected at different levels. Thus, the approach consists in finding the most suitable type of HMM topology (Bakis, Ergodic) for each phoneme in the speaker’s phonetic repertoire. The topology is further refined with a suitable number of states and Gaussian mixture components for acoustic modelling. This represents a difference when compared with studies where a single topology is assumed for all phonemes. Finding the suitable parameters (topology and mixtures components) is performed with a Genetic Algorithm (GA). Experiments with a well-known dysarthric speech database showed statistically significant improvements of the proposed approach when compared with the single topology approach, even for speakers with severe dysarthria.

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