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

开发联合上腭提升和 CPAP 治疗中风腭咽功能障碍的新策略

• 批准号: 12671879
• 负责人: WADA Takeshi
• 金额: $ 1.98万
• 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: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671879/
• 关键词: stroke; speech appliance; dysarthria; velopharynx; levator veli palatini; rehabilitation; nasal air pressure; 運動療法; スピーチェイド; 音声言語

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 change d 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 GPAP 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来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．平滑的提腭大肌活动在PLP到位时往往趋于稳定，但其随言语产生次数的变化而变化。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。实验证明 CPAP 可以在 PLP 条件下激活上睑提肌活动。一些对诱导的 GPAP 表现出积极反应的患者被认为是家庭治疗 CPAP 并使用 PLP 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

Tachimura, T., Nohara, K, Fujita, Y, et al.: "Change in levator veli palatini muscle activity for patients with cleft palate in association with placement of a speech-aid prosthesis."Cleft Palate-Craniofatial Journal. 39(5). 503-508 (2002)

Tachimura, T.、Nohara, K、Fujita, Y 等人：“腭裂患者的提腭帆肌活动变化与言语辅助假体的放置相关。”Cleft Palate-Craniofatial Journal。

平田創一郎, 和田健, 舘村卓, 他: "関西方言話者におけるナゾメータ検査での日本語被験文と鼻咽腔閉鎖不全の評価"日本口蓋裂学会雑誌. 27・1. 14-23 (2002)

Soichiro Hirata、Ken Wada、Takashi Tatemura 等：“日语测试句子和关西方言使用者鼻咽功能不全的评估”日本裂腭协会杂志 27・1（2002 年）。

TACHIMURA, T., et al.: "Effect of placement of a speech appliance on levator veli palatini muscle activity during speech"Cleft Palate-Craniofacial Journal. 37・5. 478-482 (2000)

TACHIMURA, T., et al.：“言语器具的放置对言语过程中提肌腭肌活动的影响”Cleft Palate-Craniofacial Journal 37・5 (2000)。

舘村卓, 他: "水嚥下量と口蓋帆挙筋活動の関係-最大努力でのblowing時の筋活動を基準にして-"日本摂食嚥下リハビリテーション学会雑誌. 5・2. 19-25 (2001)

Taku Tatemura 等：“吞咽量与提腭肌活动的关系 - 基于最大努力吹气时的肌肉活动 -”日本饮食吞咽康复学会杂志 5・2（2001 年）。 ）

Nohara, K., Tachimura, T., Wada, T.: "Levator Muscle Fatigue during Blowing at Maximum Intensity in Normal Speakers-Difference from Speakers with Operated Cleft Palate with Velopharyngeal Incompetence."Jpn. J. Logoped. and Phoniatr. J.. 43. 302-307 (2002)

Nohara, K.、Tachimura, T.、Wada, T.：“正常说话者以最大强度吹气时提肌疲劳——与腭裂手术且腭咽功能不全的说话者的差异。”Jpn。