Martens Heidi, Van Nuffelen Gwen, Dekens Tomas, Hernández-Díaz Huici Maria, Kairuz Hernández-Díaz Hector Arturo, De Letter Miet, De Bodt Marc
Antwerp University, Faculty of Medicine and Health Sciences, Universiteitsplein 1, B-2610 Wilrijk, Belgium.
Antwerp University, Faculty of Medicine and Health Sciences, Universiteitsplein 1, B-2610 Wilrijk, Belgium; Antwerp University Hospital, Rehabilitation Centre for Communication Disorders, Wilrijkstraat 10, B-2650 Edegem, Belgium; Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185, B-9000 Ghent, Belgium.
J Commun Disord. 2015 Nov-Dec;58:91-105. doi: 10.1016/j.jcomdis.2015.10.004. Epub 2015 Oct 14.
Most studies on treatment of prosody in individuals with dysarthria due to Parkinson's disease are based on intensive treatment of loudness. The present study investigates the effect of intensive treatment of speech rate and intonation on the intelligibility of individuals with dysarthria due to Parkinson's disease.
A one group pretest-posttest design was used to compare intelligibility, speech rate, and intonation before and after treatment. Participants included eleven Dutch-speaking individuals with predominantly moderate dysarthria due to Parkinson's disease, who received five one-hour treatment sessions per week during three weeks. Treatment focused on lowering speech rate and magnifying the phrase final intonation contrast between statements and questions. Intelligibility was perceptually assessed using a standardized sentence intelligibility test. Speech rate was automatically assessed during the sentence intelligibility test as well as during a passage reading task and a storytelling task. Intonation was perceptually assessed using a sentence reading task and a sentence repetition task, and also acoustically analyzed in terms of maximum fundamental frequency.
After treatment, there was a significant improvement of sentence intelligibility (effect size .83), a significant increase of pause frequency during the passage reading task, a significant improvement of correct listener identification of statements and questions, and a significant increase of the maximum fundamental frequency in the final syllable of questions during both intonation tasks.
The findings suggest that participants were more intelligible and more able to manipulate pause frequency and statement-question intonation after treatment. However, the relationship between the change in intelligibility on the one hand and the changes in speech rate and intonation on the other hand is not yet fully understood. Results are nuanced in the light of the operated research design.
The reader will be able to: (1) describe the effect of intensive speech rate and intonation treatment on intelligibility of speakers with dysarthria due to PD, (2) describe the effect of intensive speech rate treatment on rate manipulation by speakers with dysarthria due to PD, and (3) describe the effect of intensive intonation treatment on manipulation of the phrase final intonation contrast between statements and questions by speakers with dysarthria due to PD.
大多数关于帕金森病所致构音障碍患者韵律治疗的研究都基于响度强化治疗。本研究调查语速和语调强化治疗对帕金森病所致构音障碍患者可懂度的影响。
采用单组前测-后测设计，比较治疗前后的可懂度、语速和语调。参与者包括11名主要患有中度帕金森病所致构音障碍的荷兰语使用者，他们在三周内每周接受5次一小时的治疗课程。治疗重点是降低语速，并放大陈述句和疑问句之间的句末语调差异。使用标准化句子可懂度测试对可懂度进行感知评估。在句子可懂度测试以及段落阅读任务和故事讲述任务中自动评估语速。使用句子阅读任务和句子重复任务对语调进行感知评估，并根据最大基频进行声学分析。
治疗后，句子可懂度有显著提高（效应量为0.83），段落阅读任务中的停顿频率显著增加，听众对陈述句和疑问句的正确识别有显著改善，并且在两个语调任务中，疑问句最后一个音节的最大基频显著增加。
研究结果表明，参与者在治疗后更易被理解，并且更有能力控制停顿频率和陈述句-疑问句语调。然而，一方面可懂度的变化与另一方面语速和语调的变化之间的关系尚未完全明了。鉴于所采用的研究设计，结果存在细微差别。
读者将能够：（1）描述语速和语调强化治疗对帕金森病所致构音障碍患者可懂度的影响，（2）描述语速强化治疗对帕金森病所致构音障碍患者语速控制的影响，以及（3）描述语调强化治疗对帕金森病所致构音障碍患者陈述句和疑问句之间句末语调差异控制的影响。
