New strategy to treat velopharyngeal dysfunction for stroke with combination of a palatal lift and CPAP.

联合上腭提升和 CPAP 治疗中风腭咽功能障碍的新策略。

• 批准号: 10838019
• 负责人: TACHIMURA Takashi
• 金额: $ 1.92万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10838019/
• 关键词: stroke; speech appliance; dysarthria; velopharynx; levator veli palatini; rehabilitation; nasal air pressure; 脳卒中; スピーチエイド

The study was aimed to examine whether new strategy to improve velopharyngeal function for stroke patients by means of CPAP (Continues Positive Air Pressure) with support of a palatal lift prosthesis to decrease fatigability of the related muscles.The results obtained here as follows :1. Levator veli palatini muscle activity (% peak levator activity) was ranged in a bipolar manner ; For some speech sounds, the range was estimated to be closed to 100 % of the possible maximum activity level while for other sounds it was no or less.2. There was no tendency in the characteristics of bipolar manner across speech sounds. The aspect of bipolar manner was variable even for same speech sounds for each subject.3. The smoothed levator veli palatini muscle activity was tended to be stabilized with a PLP in place while it was variably changed in association with number of production of speech.4. The fatigability of the levator veli palatini muscle was identified to be decreased by placement of a PLP by mean of FFT analysis of MPF (Mean Power Frequency)5. Experimental CPAP was proved to activate levator muscle activity in the condition of a PLP.Some patient showing active response to induced CPAP was indicated to be candidate for home treatment of CPAP with a PLP in place.6. The response of home CPAP therapy was variable across candidates : Significant response was showed by subjects with young age and/or good management after onset of stroke.

本研究旨在探讨是否有新的策略可以通过CPAP（持续正气压）并辅以腭提升假体来降低相关肌肉的疲劳度，从而改善中风患者的腭咽功能。本文获得的结果如下： 1．提肌腭大肌活动（％峰值提肌活动）以双极方式排列；对于某些语音，该范围估计接近可能的最大活动水平的 100%，而对于其他声音，该范围则为零或更低。2．语音中双极方式的特征没有趋势。即使对于每个受试者相同的语音，双极性方式的方面也是可变的。3．平滑的提腭帆肌活动在PLP到位时趋于稳定，但随着言语产生的次数而变化。4．通过 MPF（平均功率频率）5 的 FFT 分析，发现放置 PLP 可降低提腭大肌的疲劳性。实验性CPAP被证明可以在PLP条件下激活上睑提肌活动。一些对诱导CPAP表现出积极反应的患者被认为是在家中使用PLP治疗CPAP的候选者。6．家庭 CPAP 治疗的反应因受试者而异：年龄较小和/或中风发作后管理良好的受试者表现出显着反应。

项目成果

HARA,H: "Effect of head position on levator veli palatini muscle activity in patients with borderline velopharyngeal competence/incompetence"J.Jpn.Cleft Palate Assoc.. 25. 233-238 (2000)

HARA,H：“头部位置对腭咽功能/功能不全患者的提腭肌活动的影响”J.Jpn.Cleft Palate Assoc.. 25. 233-238 (2000)

原久永 他: "頭位の変化が口蓋帆挙筋に与える影響-軽度鼻咽腔閉鎖不全症例について-"日本口蓋裂学会雑誌. 25・3. 233-238 (2000)

Hisanaga Hara 等：“头部位置变化对腭提肌的影响 - 轻度腭咽不全的病例 -”日本裂腭学会杂志 25・3（2000 年）。

舘村 卓: "境界線上の鼻咽腔閉鎖不全状態における内視鏡所見と nasalance score の乖離-Palatal Lift Prosthesis (パラタルリフト) 作成過程に伴う nasalance score の変化"音声言語医学. 40・2. 107-113 (1999)

Takashi Tatemura：“边缘腭咽不全的内窥镜检查结果和鼻音评分之间的差异 - 与腭提升假体的制作过程相关的鼻音评分的变化”言语语言医学 40・2。

TAKASHI TACHIMURA,et al.: "EPPECT OF PLACEMENT OF A SPEECH APPLIANCE ON LEVATOR VELI PALATINI MUSCLE ACTIVITY DURING BLOWING" THE CLEFT PALATE-CRANIOFACIAL JOURNAL. 36・2(in print). (1999)

TAKASHI TACHIMURA 等人：“吹气时言语器具在提肌上皮拉蒂尼肌肉活动的放置”《腭裂颅面杂志》36・2（印刷中）。

TACHIMURA,T.,: "Effect of placement of a speech appliance on levator veli palatini muscle activity during speech."Cleft Palate-Craniofacial Journal. 37. 478-482 (2000)

TACHIMURA,T.，：“言语器具的放置对言语过程中提肌帆腭肌活动的影响。”裂腭颅面杂志。