Murdoch B E, Pitt G, Theodoros D G, Ward E C
Department of Speech Pathology & Audiology, University of Queensland, Brisbane, Australia.
Pediatr Rehabil. 1999 Jan-Mar;3(1):5-20. doi: 10.1080/136384999289630.
The efficacy of traditional and physiological biofeedback methods for modifying abnormal speech breathing patterns was investigated in a child with persistent dysarthria following severe traumatic brain injury (TBI). An A-B-A-B single-subject experimental research design was utilized to provide the subject with two exclusive periods of therapy for speech breathing, based on traditional therapy techniques and physiological biofeedback methods, respectively. Traditional therapy techniques included establishing optimal posture for speech breathing, explanation of the movement of the respiratory muscles, and a hierarchy of non-speech and speech tasks focusing on establishing an appropriate level of sub-glottal air pressure, and improving the subject's control of inhalation and exhalation. The biofeedback phase of therapy utilized variable inductance plethysmography (or Respitrace) to provide real-time, continuous visual biofeedback of ribcage circumference during breathing. As in traditional therapy, a hierarchy of non-speech and speech tasks were devised to improve the subject's control of his respiratory pattern. Throughout the project, the subject's respiratory support for speech was assessed both instrumentally and perceptually. Instrumental assessment included kinematic and spirometric measures, and perceptual assessment included the Frenchay Dysarthria Assessment, Assessment of Intelligibility of Dysarthric Speech, and analysis of a speech sample. The results of the study demonstrated that real-time continuous visual biofeedback techniques for modifying speech breathing patterns were not only effective, but superior to the traditional therapy techniques for modifying abnormal speech breathing patterns in a child with persistent dysarthria following severe TBI. These results show that physiological biofeedback techniques are potentially useful clinical tools for the remediation of speech breathing impairment in the paediatric dysarthric population.
研究了传统和生理生物反馈方法对一名重度创伤性脑损伤（TBI）后持续性构音障碍儿童异常言语呼吸模式的改善效果。采用A - B - A - B单受试者实验研究设计，分别基于传统治疗技术和生理生物反馈方法，为受试者提供两个独立的言语呼吸治疗阶段。传统治疗技术包括为言语呼吸建立最佳姿势、解释呼吸肌的运动，以及一系列非言语和言语任务，重点是建立适当的声门下气压水平，并改善受试者对吸气和呼气的控制。治疗的生物反馈阶段利用可变电感体积描记法（或呼吸追踪仪）在呼吸过程中提供胸廓周长的实时、连续视觉生物反馈。与传统治疗一样，设计了一系列非言语和言语任务，以改善受试者对其呼吸模式的控制。在整个项目中，通过仪器和感知评估对受试者的言语呼吸支持进行了评估。仪器评估包括运动学和肺活量测量，感知评估包括Frenchay构音障碍评估、构音障碍言语可懂度评估以及对言语样本的分析。研究结果表明，用于改善言语呼吸模式的实时连续视觉生物反馈技术不仅有效，而且在改善重度TBI后持续性构音障碍儿童的异常言语呼吸模式方面优于传统治疗技术。这些结果表明，生理生物反馈技术可能是修复小儿构音障碍人群言语呼吸障碍的有用临床工具。
